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*%P/ SAN JOAQUIN COUNTY � <br /> 1868 E . HAZELTON AVENUE <br /> ' STOCKTON. CA - 95205 <br /> Web uRL`.www. co . san-joaquin . ca . us/agcomm <br /> h' E-Mail : <br /> Office : ( 209 ) 468-3300 Recorder (NOI ) : ( 209 ) 468-3300 FAX: (209 ) 466-3330 <br /> 'RESTRICTED MATERIALS PERMIT PERMIT # 39-02-3902114 <br /> County HO District # : J <br /> � THOMING-WILLIAMS Expiration Date : 12/31/2002 <br /> 33600 KOSTER RD Effective Date : �- <br /> TRACY, CA 95376- /� <br /> ROBERT WILLIAMS Home : (209 ) 835-2792 <br /> L33600 KOSTER RD Shop : ( 209 ) 835-2792 <br /> TRACY, CA 95376- Fax: <br /> Mobile (BOB) 601-3909 <br /> L - <br /> Permittes Type Permit Type Possession NOI Method of Submission <br /> -------------- ------------ -------------- -------------------------- <br /> LPrivate App IXISeasonal IXI Poss & Use IXi Phone IXI Fax IXI <br /> `.Q A cert { { Job { { Poss Only j { Box { i Modem I I <br /> Ag PCO- I I In Person IXI Web I I <br /> Non-Ag I { NOI required 24 hours prior to application <br /> - ----------- ------------ - ------------------------------------------------ <br /> Non-Ag Use : None <br /> LConditiors: PQZ <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 /> 6.facilities for pesticides or emptied containers and equipment used or to be used <br /> in the treatment . [Form PR-ENF-125 (Rev. 07/92 ) Pesticide En oreeme, neh7 <br /> h.Permit Applicant : R0V"A �1�`�{'44,`-'� Sign : <br /> Title : Puf, xTY' Issue Date: a1 <br /> —r <br /> 6. Issuing Officer : Issue Date : © �� <br /> Page 1 <br /> v <br /> bw <br /> r <br />