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SU0006895 SSCRPT
Environmental Health - Public
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SU0006895 SSCRPT
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Entry Properties
Last modified
5/7/2020 11:32:46 AM
Creation date
9/9/2019 9:00:45 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
FileName_PostFix
SSCRPT
RECORD_ID
SU0006895
PE
2622
FACILITY_NAME
PA-0700554
STREET_NUMBER
15792
Direction
N
STREET_NAME
RAY
STREET_TYPE
RD
City
LODI
APN
02514034
ENTERED_DATE
12/20/2007 12:00:00 AM
SITE_LOCATION
15792 N RAY RD
RECEIVED_DATE
12/18/2007 12:00:00 AM
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\R\RAY\15792\PA-0700554\SU0006895\SSC RPT.PDF
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EHD - Public
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SAN JOAQUIN COUNTY <br /> 1868 E. HAZELTON AVENUE <br /> STOCKTON, CA 95205- <br /> E-mail' Web:www.co.sar,•jc aquin.ea.uslagcoinm <br /> Office: (209)468.3300 Fax: (709)468.3330 Reoorder(1vOI'e): (209)468.3300 <br /> RESTRICTED MATERIALS PERMIT <br /> L1ND, DAVE :Permit Number: 39-47-3944298 <br /> C owtty District#: G <br /> 4258 W SARGENT RD - <br /> LODI, CA 95242- Expiration Date: December 31, 2007 <br /> Effective Date: -lay 13, 2005 <br /> DAVE LIND Home Phone. (209) 334-1814 <br /> 3434 W SARGENT RD Shop Phone: <br /> LODI, CA 95242- Mobile Phone: ( ) <br /> Fax <br /> Pemvttee Type: Private Applicator N01 Method of Submission: <br /> Permit `Type: Seasonal Phone: X Fax: X Box: <br /> Possession: Possession & Use In Person: X Modem: 'Web: Y <br /> NOI required 24 hours prior to application. <br /> Conditions: A,P <br /> Ole end of pest for <br /> code descnphons <br /> I understand that this permit does not relieve me from liability for any damages to any pawns or property caused <br /> by the use of these pecradea I waive any claims of liability for damages against the County Department of <br /> Agriculture based on the issuance of this perrut I further understand that this permit may be revoked when <br /> pesticides are used ire conflict with the manufacturer's labeling or in violation of applicable laws,regulations and <br /> specific conditions of this permit. I authorize inspection at all rew;nable tunes and whenever an emergency exists <br /> by the Department of Pesticide Regulation or the County Department of Agriculture of all areas treated cr to be <br /> treated,atorage facilities for pesticides or emptied containers and equipment used nr to be used in the treatment.. <br /> [Fcrrn PR-ENF-125 (Rev. 07192)Pesticide Enforcement Branch <br /> nett ----_._ <br /> Pen3ut .Applicant: Si'.-� _ - g _ -----�__ <br /> ease Prinit--- -- <br /> Title: Issue Date: <br /> ease Pent, � <br /> _ r � ,lJr� <br /> Issuing Officer: -are( }"�G( ` E t/' ,�xx /`t�'f Issue Date: -- <br />
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