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L `O `/ SAN JOAQUIN COUNT`/ `I G7_� <br /> 1868 E. HAZELTON AVENUE <br /> STOCKTO <br /> Recorder (NOI ) : ( 95205=====__________________________ <br /> Office : (209 )468-3300 Recorder (NOI ) : ( 209 )468-3300 FAX: ( 209 )468-333C <br /> RESTRICTED MATERIALS PERMIT Permit# : 39-00-3903133 <br /> County HQ District# : C <br /> EXPORT IMPORT ASSOC INC Expiration Date: 12/31/2000 <br /> 17495 S SEIDNER Effective Date I ' l— ?-000 <br /> pL ESCALON, CA 95320- <br /> JIM BRUGHELLI Home : (209 )838-7049 <br /> 17,695 S SEIDNER Shop: ( 209 )838-7049 <br /> ESCALON, CA 95320- Fax: <br /> Mobile : ( )541-6897 <br /> �. Permittee Type Permit Type Possession NOI Method of Submission <br /> --------------- ------------ -------------- -------------------------- <br /> LPrivate App [ ] Seasonal [X] Poss & Use [X] Phone [X] Fa:, (X] <br /> Q A Cert ( ] Job [ ] Poss Only [ ] Boz: (X] Modem ( ] <br /> Ag PCO ( ] In Person [X] <br /> Non-Ag [X] NOI required 24 hours prior to application <br /> Numb Pesticide Pest( s ) Form, Method(s) Applicator( s ) <br /> ----- ------- ------- ------------ -------- ----------- ----- ---------------- <br /> y 4840 ALUMI*IUM PHOSPH RODENTS Fumigant Fumigate PCO Grower <br /> Non-Ag Use : COMMODITY FUMIGATION <br /> Conditions : P QAL#QL34429 <br /> ------------ <br /> ` I understand that this permit does not relieve me from liability for any damage <br /> to persons or property caused by the use of these pesticides . I waive any <br /> claim of liability for damages against the County Department of Agriculture <br /> based on the issuance of this permit . I further understand that this permit <br /> may be revoked when pesticides are used in conflict, with the manufacturer ' s <br /> Llabeling or in violation of applicable laws, regulations and specific <br /> conditions of this permit . I authorize inspection at all reasonable times and <br /> whenever an emergency exists , by the Department of Pesticide Regulation or the <br /> County Department of Agriculture of all areas treated or to be treated, storage <br /> Lfacilities for pesticides or emptied containers and equipment used or to be use <br /> in the treatment , [Form PR-ENF-125 (Rev, 07/92 ) Pesticide Enforcemen nch] <br /> LPermit Applicant : 'TkA j)V"r-)4-\CL.( I S-g <br /> Title : Oe r% )A \AC2EEte D ate .7 jc�---FLO � <br /> LIssuing Officer : Date : <br /> L <br />