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�/ SAN JOAQUIN COUNTY <br /> 1868 E . HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> 6, Web URL :www. co . san-josquin. ca .us/agcomm <br /> E-mail : <br /> office : (209)468-3300 Recorder (NOI ) : (209)468-3300 FAX: ( 209) 468-3330 <br /> ------------------------------------------------------------------------------- <br /> ------------------------------------------- <br /> -------------- <br /> ------- PERMIT # 39-03-3902114 <br /> RESTRICTED MATERIALS PERMIT County HQ District # : J <br /> THOMING-WILLIAMS Expiration Date : 12/311200: <br /> 33600 KOSTER RD Effective Date la 1144f` <br /> TRACY. CA 95376- o/�O/�']m-D? <br /> V <br /> RICHARD HOVE Home : ( 209 )835-2792 <br /> 33600 KOSTER RD shop: ( 209) 835-2792 <br /> TRACY. CA 95376- Fax: 2098364609 <br /> Mobile : 2096785841 <br /> Permittee Type Permit Type Possession NOI Method of Submission <br /> ------------ -------------- ----------------- <br /> ` Private App IXI Seasonal IXI Poss 6 Use IXI Phone IXI Fax I-I <br /> Job I I Poss Only I I Box_ 1 1 Modem 1 1 <br /> Q A Cert I I In Person IXI Web I I <br /> Ag PCO I I <br /> Non-Ag I I NOI required 24 hours prior to applicatior <br /> r <br /> Non-Ag Use: None <br /> Conditions : PQ, PA-5001201 , expires 12-31-2003 <br /> r <br /> I understand that this permit does not relieve me from liability for any damage <br /> '00to 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 /> �w labeling 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 /> facilities for pesticides or emptied containers and equipment used or to be usec <br /> in the treatment . [Form PR-ENF-125 (Rev. 07/92 ) Pesticide Enforcement Branch] <br /> Permit Applicant : � YY?_ OUB — Sign : � �� <br /> Title : _ W`�--� � -- Issue Date : <br /> Issuing Officer : —_ Issue Date : <br /> r <br /> V <br />