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SAN JOAQUIN COUN-I r <br /> zoo �f <br /> 1868 E. HAZELTON A WUE <br /> STOCKTON, CA 95205- <br /> E-mail: Web:www.co.s®•joagda ca.us/agcornra <br /> Office: (209)4683300 Fax: (209)168.3330 Recorder(NOPs): (209)4683300 <br /> RESTRICTED MATERIALS PERWr <br /> Permit Number: 39-04-3903187 <br /> GREEN FARNM <br /> County District#: C <br /> 30324 E LONE TREE RD <br /> OAKDALE. CA 95361- Expiration Date: December 31, 2004 <br /> Effective Date: 1940— <br /> RICIz GREE-N Horne Phone: (209)848-0401 <br /> 30324 E LONE TREE RD Shop Phone: (209) 847-1238 <br /> OAKDALE, CA 95361- Mobile Phone: (209)985-3930 <br /> Fax <br /> Penn ittee Type: Private Applicator NOI Method of Submission <br /> Permit Type: Seasonal Phone: X Fax. X Box: X <br /> Possession: Possession&Use In Person: X Modern: Web: X <br /> NOI required 24 hours prior to application. <br /> Conditions: AP,QXr-'E See end of permit for <br /> code descriptions. <br /> I understand that this permit does not relieve tie from liability for any damages to any persons or propetty caused <br /> by the use of these pesticides. I waive any clairnns of liability for damages against the CountyDepartment of <br /> Agicultin•e based on the issuance of this permit. I further understand that this permit may be revoked when <br /> pesticides are used in conflict with the nvanufacturer s labeling or in violation of applicable laws,regulations and <br /> specific conditions of this permit, I authorize inspertion at all reasonable times and whenever at etnergency exists <br /> by the Departruent of Pesticide Regulation or the County Department of Agriculture of all areas treated or to be <br /> treated,storage facilities for pesticides or•emptied containers and equipment used or to be used in the treatment. <br /> (Frnrn PR-EN77-125 (Rev. 07192)Pesticide Enforcement Branch] <br /> P?ttlut aLnniic�+.st: ';�,. hce �c� Car�.e Siate��/�� ✓ , _ <br /> Please print) 0 <br /> Tide: �d a 1­1�11-r el ^c. 4, o Issue Date: <br /> ,,!l (Please Pi <br /> — Issuing Officer- C/ � ' --� Issue Date: - <br /> 7� N � <br />