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SU0005837 SSCRPT
Environmental Health - Public
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SU0005837 SSCRPT
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Last modified
5/7/2020 11:31:48 AM
Creation date
9/9/2019 10:59:16 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
FileName_PostFix
SSCRPT
RECORD_ID
SU0005837
PE
2622
FACILITY_NAME
PA-0500829
STREET_NUMBER
16411
Direction
S
STREET_NAME
VICTORY
STREET_TYPE
RD
City
OAKDALE
APN
22922030
ENTERED_DATE
12/21/2005 12:00:00 AM
SITE_LOCATION
16411 S VICTORY RD
RECEIVED_DATE
12/20/2005 12:00:00 AM
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\V\VICTORY\16411\PA-0500829\SU0005837\SSC RPT.PDF
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EHD - Public
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6. SAN JOAQUIN COUNTY <br /> 1868 E. HAZELTON AVENUE <br /> ,. STOCKTON, CA 95205- <br /> E-mail: Web:www.co.sm-joaquimmusfagcom <br /> ` Office: (209)4683300 Fax: (209)468.3330 Recorder(NOI's): (209)468.3300 <br /> RESTRICTED MATERL41S PERMIT <br /> Permit Number: 39-05-3903187 <br /> GREEN FARMS , <br /> ` 30324E LONE TREE RD County District# C <br /> OAKDALE, CA 95361- Expiration Date: December 31, 2005 <br /> bw Effective Date: <br /> . gas <br /> RICK GTMEN Home Phone: (209)848-0401 <br /> 30324 ELONE TREE RD Shop Phone: (209) 847-1238 <br /> OAKDALE, CA 95361- Mobile Phone: (209)985-3930 <br /> ►- Fax= <br /> Permittee Type: Private Applicator NOI Method of Submission: <br /> 6- Permit Type: Seasonal Phone: X Fax: X Box X <br /> Possession: Possession&Use In Person: X Modem: Web: X <br /> NUI required 24 hours prior to application. <br /> ` Conditions: A,P,Q <br /> See end ofpeam For <br /> code descriptions. <br /> n.. _ — — — — — — — — — — — — — — — — — — — — — — — — — — — — <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 darnages against the County Department of <br /> Agriculture 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 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 /> L 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 emptied containers and equipment used or to be used in the treatment- <br /> [Form <br /> reatment[Form PR-E.NF-125 (Rev. 07/92)Pesticide Enforcement Branch j <br /> L <br /> Permit Applicant h (7 t Sifpe <br /> L (Please Print) <br /> Tide: Issue Date: —Jf— O S <br /> ?ease Pont` <br /> L nn <br /> Issuing 011icer , Issue Date: p( — I1G— <br /> L <br /> L <br />
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