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SU0003975 SSCRPT
Environmental Health - Public
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SU0003975 SSCRPT
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Entry Properties
Last modified
5/7/2020 11:30:27 AM
Creation date
9/9/2019 10:40:32 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
FileName_PostFix
SSCRPT
RECORD_ID
SU0003975
PE
2622
FACILITY_NAME
PA-0200194
STREET_NUMBER
11665
Direction
E
STREET_NAME
TOKAY COLONY
STREET_TYPE
RD
City
LODI
ENTERED_DATE
5/11/2004 12:00:00 AM
SITE_LOCATION
11665 E TOKAY COLONY RD
RECEIVED_DATE
5/16/2002 12:00:00 AM
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\T\TOKAY COLONY\11665\PA-0200194\SU0003975\SSC RPT.PDF
Tags
EHD - Public
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-RESTRIC-ED MATERIALS PERMIT continued . . . . . Page# : 5 <br /> CORRAD I , MICHAEL Permit#: .=9-00-7900067 <br /> WORKERS SAFETY SERIES ATTACHED <br /> ------------------------------------------------------------------------------- <br /> i XI A-1 through �-T General info. C_] B-j Cholinesterase Testing <br /> PERMIT CONDITIONS ATTACHED <br /> ---------------•----------------------------------------------------------------- <br /> [X] P - General <br /> [X] Q - Dicamba & Phenoxy Herbicides - Central Valley/Hazardous Area <br /> C_] R - Dicamba & Pheno ys - Special Hazardous Area <br /> S - Metam Sodium (Vapa m) <br /> C_] T A1dicarb ( Te,m.1.k ) <br /> C_1 U - Endosul fan (Thiodan ) <br /> ] V - Rice Pesticides Program <br /> E-1 Molinate (Ordram) Worker Safety <br /> _ [_] Attachments 1-4: Molinate ( 1 ,6) thiobencarb (2,6,7) , carbofuran <br /> (j.6) , :methylparathion (4,?) and malathion (voluntary: 5,B) <br /> CXI W - Methyl Bromide <br /> C_1 Soil within greenhouses <br /> E-1 Commodity <br /> C 1 Soil injection <br /> C ] Tarped potting soil <br /> Single 'tree site <br /> C X - Furadan chemigation of grapes <br /> C 7 Z - other <br /> PESTICIDE SALES: GROUNDWATER PROTECTION <br /> -------------------------------------------------------------------------------- <br /> The material I am purchasing will not be used in a Pesticide Management <br /> Zone (as described in Section 6602, Title =, California rode of Reg- <br /> ulations) for agricultural , outdoor institutional or outdoor industrial <br /> US& . <br /> The material I am purchasing will be used in a Pesticide Management cone <br /> (as described in Section 6802, Title ?, California Code of Regulations ) <br /> tLr-r--i-1 q ot-utdoor- rnst-i- utiorra-1--or -ou-tdooriiid�t=tr-ice1 Wiese--and a- -- <br /> copy of my restricted materials permit is attached . <br /> Material purchased : [_] Atrazine [_] Simazine C_] Bromacil <br /> [_] Diuron C_] Prometon C_] Bentazor <br /> _ 1 Certify under penalty of perjury that the foregoing statement is true , <br /> and that I will not _apply any material listed in Section 6900(s) in any <br /> Pesticide Management Zone for agriculture, outdoor institutional or <br /> outdoor industrial uses except in accordance with a permit issued by the <br /> county agricultural commissioner or the director in a county in which <br /> there is no commissioner. <br /> Purchaser Date <br />
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