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SAW JOAQUIN COUNTY <br /> 1868 E. HAZELTON AVENUE <br /> STOCKTON, CA 9 205 <br /> - Office: (209)468-3300 Recorder (NO! ) : (209)465-3300 FAX : ( 209` <br /> RESTRICTED MATERIALS PERMIT PERMIT/OPERATOR I . D. # : 39-99-3904623 <br /> - County HQ District # : E <br /> SCHALLBERGER, JOHN Expiration Date: 999 <br /> 10799 N ALPINE RD Issue Date: 7yc� '� <br /> _ STOCKTON, CA 95212 ' <br /> MARIE SCHALLBERGER Home: ( )369-2546 <br /> 10799 N ALPINE RD Shop: ( )369-2546 <br /> ~^ STOCKTON, CA 95212 Mobile : <br /> =============================================================================== <br /> FOR RESTRICTED MATERIALS PERMIT USE ONLY <br /> - Permit Type: Poss. Only [ ] Seasonal [X] Poss. & Use [X] Job [ ] <br /> Permittee Type: Q.A. Cert [ ] Ag . PCO [ ] Private App [X] Non-Ag [ ] <br /> NO! required 24 hours prior to application . <br /> _ Method : Phone [X] Box [ ] Person [X] Modem [ ] Fax [X] <br /> =============================================================================== <br /> Numb Pesticide Pest(s) Form. Method (s) Applicator (s) <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 2,00 AMINE Weeds Liquid Air Ground PCO Grower <br /> 16011 PARAQUAT Weeds Liquid Air Ground PCO Grower <br /> _ <br /> .......... . ------ <br /> Non-Ag <br /> _�Non-Ag Use: <br /> � Conditions: PQ <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 <br /> used in the treatment. [Form 33-125/v3. 53 (Rev. 02/16/90) Pesticide Enforcement <br /> Branch] <br /> _ <br /> Permit Applicant: ign : <br /> - Title: Date: <br /> Issuing Officer: Date: x <br />