Laserfiche WebLink
4�ENU� <br /> H,TOC���N <br /> 2cl9t�B- 'DO <br /> �� �� �� � � � � � �� � � � �� � � � � �� � � ' � �� � � �� �� ���� �� �� ���� �� � <br /> -- - -- --- -- -- - <br /> - --- ' - --- -- - - - - -- - ' - - - - - - - - -- - - - - - - ----- - -- ---- ---- ----- -- - - <br /> _�E�TRIC�ED �ATERZERMITPermit# � ��-O�-39O4�7� <br /> County HQ District# : F <br /> °~ <br /> V & V FORMS Expiration Date: 12/3 2 <br /> � O BOX 2244 Effective Date I/�� /��/ <br /> , / <br /> ODI , CA 95241- <br /> -z0SE VIRAMOHTES Home : (209)367-5571 <br /> S28 MAPLE ST Shop: (209)941-5434 <br /> --ODI ` CA 95240- Fax.. <br /> Mobile: (209)482-6806 <br /> ft.�ermittee Typo Permit Type Possession NO! Method of Submission <br /> ____----------- ____________ ______________ <br /> '-nrivate App [X] Seasonal [X] Poss & Use [X] Phone [X] Fax [ ] <br /> � A Cert [ ] Job [ ] Poss Only [ ] Box [X] Modem [ ] <br /> �~g PCO [ ] In Person [X] <br /> Non-Ag [ ] NOZ required 24 hours prior to application <br /> =����=�=�====����==�===�===�== <br /> 4"umb Pesticide Pest(s) Form' Method(s) Applicator(s) <br /> ----- --------------- ------------ -------- ---------------- -------------- - <br /> 051. SEVIN SEVIN LARVAE Liquid Ground PCO Grower <br /> ~=360 CHLOROPICRIN #EMATODE Fumigant Ground PCO Grower <br /> 3141 GUTHZON MITES Liquid Ground PCO Grower <br /> `950 METHYL BROMIDE SOIL/STORED Fumigant Qround PCO Grower <br /> '801 2, 4-D AMINE WEEDS Liquid Ground PCO Grower <br /> ~Z6Ol1 PARAQUAT WEEDS Liquid Ground PCO �rovie r <br /> _16891 SUPRACIDE LARVAE Liquid Ground PCO Grower <br /> 3571 NEMACUR NEMATODE Fumigant Fumigate PCO Grower <br /> � <br /> *_on-Ag Use: <br /> Conditions � PQW <br /> ------- --- --- -- ------------ - ----- ----- ------------- - --------------- ----------- <br /> ------- --------------------------------------- ------ --- -- --- -- ---------------- <br /> °� understand that this permit does not relieve me from Iiability for any damage, <br /> to persons or property caused by ti-le use of these pesticides . I waive any <br /> Iaim of liability for damages aQainst the County Department of Agriculture <br /> �.ased on the issuance of this permit ' Z further understand that this permit <br /> may be revoked when pesticides are used in conflict with the manufacturer' s <br /> - abeling or in violation of applicable laws , rogulations and specific <br /> ~�onditions 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 /> `:�qunty Department of Agriculture of all areas treated or to be treated, storage <br /> aoiIities for pesticides or emptied containers and equipment used or to be used <br /> *�ln the treatment . [Form PR-ENF-12S (Rev . 07/92) Pesticide Enforcement Branch) <br /> ermit Applicant : Sign : 4. <br /> /2 <br /> Title " Date : <br /> Issuing Office Date : <br /> �� <br />