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SAN JOAQUIN COUNTY <br /> 1868 E. HAZELTON AVENUL'"W <br /> STOCK:TON, CA 95205 <br /> Office: (209)468-3300 ----Recorder (NOI ) : (209)468-3. 0 (209)468-3330 <br /> RESTRICTED MATERIALS PERMIT Permit#: 39-00-3903187 <br /> County HO District#: C <br /> GREEN FARMS Expiration Date: 12/3112000 <br /> 30324 E LONE TREE RD Effective Date : (,�D <br /> OAK.:DALE, CA 95361- <br /> RICK GREEN Home: (209)848-0401 <br /> 30324 E LONE TREE RD Shop: (209)848-0401 <br /> _ OAK:DALE, CA 95361- Fax : <br /> Mobile: (209)985-3930 <br /> Permittee Type Permit Type Possession NOI Method of Submission <br /> -------------- ------------ -------------- ------------------------- <br /> Private App [X] Seasonal [X] Pass & Use [X] Phone [X] Fax [X] <br /> O A Cert [ ] Job [ ] Pass Only [ ] Box [X] Modem [ <br /> Ag PCO [ ] In Person [X] <br /> Non-Ag [ ] NOI required 24 hours prior to application <br /> --------------- ------------- _ ____ <br /> Numb Pesticide ------Pests)------Form.--==Method(s)--------Applicators)---=_ <br /> — ----- --------------- ------------ -------- ---------------- ----------------- <br /> 1051 SEVIN LARVAE Liquid Air Ground FCO Grower <br /> 1061 FURADAN NEMATODE Granules Air Ground PCO Grower <br /> ` 3590 LINDANE LARVAE Liquid Ground PCO Grower <br /> 3940 METHYL PARATHIO LARVAE Liquid Air Ground PCO Grower <br /> 4491 ORDRAM WEEDS Granules Air Ground PCO Grower <br /> 4840 ALUMINUM PHOSPH RODENTS Fumigant Fumigate PCO Grower <br /> ` 5030 PROPANIL WEEDS Liquid Air Ground PCO Grower <br /> 7860 MCPA, DIMETHYLA WEEDS Liquid Air Ground PCO Grower <br /> 9801 2,4-D AMINE WEEDS Liquid Ground PCO Grower <br /> 16011 PARAQUAT WEEDS Liquid Air Ground PCO Grower <br /> ****** PESTICIDES CONTINUED ON NEXT PAGE ****** <br /> Non-Ag Use: <br /> Conditions: PC-.IV <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 emptx containers and equipment used or to be user <br /> in the treatment. a m FR-E AF- f/(Rev. 07/92) Pesticide Enforcement Branch] <br /> Perm-it App!'icant. fLCr Sign: <br /> Title: Date: <br /> Issuing Officer: --- eG✓ Date: -� ���� <br />