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SU0009141 SSCRPT
Environmental Health - Public
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SU0009141 SSCRPT
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Last modified
5/7/2020 11:33:52 AM
Creation date
9/9/2019 10:56:20 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
FileName_PostFix
SSCRPT
RECORD_ID
SU0009141
PE
2622
FACILITY_NAME
PA-1200049
STREET_NUMBER
5772
Direction
S
STREET_NAME
VAN ALLEN
STREET_TYPE
RD
City
STOCKTON
APN
18335011 12
ENTERED_DATE
4/6/2012 12:00:00 AM
SITE_LOCATION
5772 S VAN ALLEN RD
RECEIVED_DATE
4/6/2012 12:00:00 AM
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\V\VAN ALLEN\5772\PA-1200049\SU0009141\SSCR RPT.PDF
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EHD - Public
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E-mail: <br />Office: (209)468.3300 <br />MATERIALS PERMTI <br />MURPHY RANCH <br />17350 FRONT STREET <br />LINDEN, CA 95236 <br />TIM SUNBURY <br />PO BOX 15 <br />FARMINGTON, CA 95230 <br />Permittee Type: Private Applicator <br />Pennit Type: Seasonal <br />Possession Possession c& Use <br />Conditions: A. P, Q, X, W <br />See and of penmt for <br />code descriptions. <br />SAN JOAQUIN COUNTY <br />1868 E. HAZELTON AVENUE <br />STOCKTON, CA 95205- 0 <br />Web:www. co. san•ioaqum. ca.uslagcarmn <br />Fax: (709)468.3330 Recorder (NOI's): (209)468.3300 <br />Permit Number: <br />County District #: <br />Expitation Date: <br />Effective Date: <br />39-08-3903311 <br />C. <br />December 12000 8 <br />January +7t9" - <br />Rome Phone: (209)887-1150 <br />Shop Phone: (209)886-5493 <br />Mobile Phone: (209)969-9889 <br />Fax (209)886-5494 <br />NO! Method of Submission: <br />Phone: X Fax: X Box. X <br />In Person: X Modem: Web: X <br />NOI required 24 hours prior to application. <br />------------------------- <br />I understand that this permit does not relieve me from liability for any damages to any persons or property caused <br />by the use of these pesticides. I waive any claims of liability for damages against the County Department of <br />Agriculture based on the issuance of this permit I further understand that this permit maybe revoked when <br />pesticides are used in conflict with the manufacturer's labeling or in violation of applicable laws, regulations and <br />specific conditions of this permit I authorize inspection at all reasonable times and whenever an emergency exists <br />by the Department of Pesticide Regulation or the County Department of Agriculture of all areas treated or to be <br />treated, storage facilities for pesticides or ernptied containers and equipment used or to be used in the treatment <br />[Form PR-ENF-125 (Rev. 07192) Pesticide Enforcement Branch ] <br />Signed: hn <br />Issue Date: 01 – I I – 06 <br />Issue Date: I — 7-6 ty <br />-111ri <br />6 B u g-( <br />Permit Applicant <br />U 0i <br />(Please Pant <br />Title: <br />t 4r--� <br />M rA C1- <br />(P ease <br />.� Issuing Officer. <br />Signed: hn <br />Issue Date: 01 – I I – 06 <br />Issue Date: I — 7-6 ty <br />
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