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f M <br /> L SAN JOAQUIN COUNTY <br /> 1868 E. HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> LWeb URL :www. co . san-joaquin . ca . us/agcomm <br /> E-Mail : <br /> L --Office- : ( 209 ) 468-3300-- -- --Recorder-(NOI )-( 209 ) 468-33300-FAX: (209) 468-3336 <br /> RESTRICTED MATERIALS PERMIT PERMIT # : 39-02-3902116 <br /> County HQ District # : J <br /> r <br /> THOMSEN FARMS - Expiration Date : 1.2/31/20 <br /> L 2365 w DURHAM FERRY RD Effective Date : 01/16/20 <br /> TRACY, CA 95376- <br /> KENNETH THOMSEN Home : ( 209) 835-3136 <br /> 2365 w DURHAM FERRY RD Shop: ( 209 )835-5442 <br /> TRACY, CA 95376- Fax: ( 209 )835-5488 <br /> Mobile : ( 209 )918-0651 <br /> Permittee Type Type Permit Type Possession NOI Method of Submission , <br /> Private App IXI Seasonal IX1 Poss & Use IXI Phone IXI Fax IX( <br /> Q A Cert 1 1 Job 1 1 Poss Only 1 1 Box 1 1 Modem I ( <br /> Ag PCO I I In Person IXI web IX) <br /> LNon-Ag --- I - I --- -------------------NOI-required-24-hours-prior-to-applicati- <br /> Non-Ag Use : None <br /> ` Conditions : PQz ------------ <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 /> L may.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 <br /> rr(Rev. 07/92 ) Pesticide Enforcement Branch] <br /> LPermit Applicant : Sign : <br /> LTitle : / ✓ �f Issue Date : 1 Z <br /> Issuing Officer : Issue Date : <br /> Page l <br /> 6 <br /> L <br /> L <br />