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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 )468-3330 <br /> ---------------------------------- -- <br /> RESTRICTED MATERIALS PERMIT Permit# : 39-02-3904623 <br /> County HQ District# : E <br /> SCHALLBERGER, JOHN Expiration Date: 12/31/2P02 <br /> 10799 N ALPINE RD Effective Date 916, <br /> -STOCKTON , CA 95212 <br /> HARIE SCHALLBERGER Home : ( )369-2546 <br /> .10799 N ALPINE RD Shop : ( )369-2546 <br /> STOCKTON, CA 95212 Fax : <br /> Mobile : <br /> Permittee Type Permit Type Possession NOI Method of Submission <br /> -------------- ------------ -------------- -------------------------- <br /> Private App [X] Seasonal [X] Poss & Use [X] Phone [X] Fax [X] <br /> -Q A Cert [ ] Job [ ] Poss Only [ ] Box [ ] Modem [ ] <br /> Ag PCO [ ] In Person [X] <br /> 'Von-Ag [ ] NOI required 24 hours prior to application <br /> -------------------------------------------------- <br /> Numb 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 /> 7861 RHOMENE WEEDS Liquid Air Ground PCO Grower <br /> 9801 2 ,4-D AMINE WEEDS Liquid Air Ground PCO Grower <br /> -16011 PARAQUAT WEEDS Liquid Air Ground PCO Grower <br /> Non-Ag Use: <br /> Conditions: PQ <br /> ------------------------------------------------------------------------------- <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 /> 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 /> 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 used <br /> in the treatment. [For PR-ENF-125 (Rev .` 07/92 ) Pesticid Enforc ment Branch] <br /> Permit Applicant: ^� � JG ` Y� Sign : <br /> Title : <br /> �� � Date : /7, £i 60 <br /> Issuing Officer: Date: 112-8 06 <br />