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SAN JOAQUIN COUNTY <br /> 1868 E. HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Office: (209)468-3300 Recorder (NOI) : (209)468-3300 FAX: (209)468-33; <br /> ------------------------------------------------------------------------------ <br /> RESTRICTED MATERIALS PERMIT Permit#: 39-01-39021. <br /> County HQ District#: J <br /> THOMSEN FARMS Expiration Date: 12/31/2001 <br /> 2365 W DURHAM FERRY RD Effective Date : 01/07/2001 <br /> TRACY, CA 95376- <br /> KENNETH THOMSEN Home: (209)835-31. <br /> 2365 W DURHAM FERRY RD Shop: (209)835-544 <br /> 'TRACY, CA 95376- Fax: (209)835-54E <br /> Mobile: (209)918-06! <br /> ------------------------------------------------------------------------------ <br /> Permittee Type Permit Type Possession NOI Method of Submission <br /> L -------------- ------------ -------------- -----e---------=--Fax--------- <br /> Private App [X] Seasonal [X] Poss & Use CX] Phone [X] [X] <br /> Q A Cert C ] Job [ ] Poss Only C ] Box CX] Modem C ] <br /> LAg PCO C ] In Person CX] <br /> Non-Ag [ ] NOI required 24 hours prior to applicatic <br /> ------------------------------------------------------------------------------ <br /> ------------------------------------------------------------------------------ <br /> LNumb Pesticide Pest(s) Form. Method(s) Applicator(s) <br /> ----- --------------- ------------ -------- --- ------ ----------------- <br /> 1051 SEVIN LARVAE Liquid Air Ground PCO Grower <br /> 1061 FURADAN NEMATODE Liquid Air Ground PCO Grower <br /> L1360 CHLOROPICRIN NEMATODE Fumigant Ground PCO Grower <br /> 2000 DICAMBA WEEDS Liquid Air Ground PCO Grower <br /> 2301 DI-SYSTON APHID Liquid Air Ground PCO Grower <br /> 3141 GUTHION MITES Liquid Air Ground PCO Grower <br /> 3824 METASYSTOX-R APHID Liquid Air Ground PCO Grower <br /> 3830 METHOMYL LARVAE Liquid Air Ground PCO Grower <br /> L3850 METHYL BROMIDE SOIL/STORED Fumigant Ground PCO Grower <br /> 3940 METHYL PARATHIO LARVAE Liquid Air Ground PCO Grower <br /> ****** PESTICIDES CONTINUED ON NEXT PAGE ****** <br /> Non-Ag Use: <br /> Conditions: PQZ <br /> I understand that this permit does not relieve me from liability for any damag( <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 /> Lmay be revoked when pesticides are used in conflict with the manufacturer-s <br /> labeling or in violation of applicable laws, regulations and specific <br /> conditions of this permit. I authorize inspection at all reasonable times and <br /> Lwhenever 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 use <br /> in the treatment. [Form PR-ENF-125 r(Rev. 07/92) Pesticide Enforcement Branch] <br /> �tx <br /> L Permit Applicant: �/fp�"► r.Grq rito_ <br /> f OC Sign• 4-0� -7A,� <br /> 4 Title: Ilef 5 - Date. _1 - 7 W <br /> L <br /> Issuing Officer: Date: - r7 - O t <br /> L <br /> L <br />