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SAN JOAQUIN COUNTY � �G <br /> J P ;7 <br /> 1868 K BAZELTON AVENUE <br /> STOC.'KTON, CA 95205- ` .. <br /> E-ttiai1: <br /> Web:www.co.san-joagii-ca udageormn <br /> Office: (209)468.3300 Fax: (209)468.3330 Recorder(NOPs):(209)468-3300 <br /> RESTRICTED MATERLALLS PERMIT <br /> NILSSON FARMS INC; Permit Number: 39-04-3901267 <br /> 12550 S JACK TONE RD County District#: B <br /> MANTECA, CA 95336- Expiration Date: December 31, 200.4 <br /> Effective Date: February;2004 <br /> JAMES NU SSON Home Phone: {209)463-7003 <br /> 9970 S JACK T C)1VE RD Shop Phone: (209'463-7003 <br /> STOC.,'KTON, CA 95212- Mobfle Phone: (209)609-0075 <br /> Fax <br /> Permittee Type: Private Applicator NOI Method of Submission: <br /> Permit Type: Seasonal Phone: X. Fax X Box X <br /> Possession Possession&Use In Person: X Modem Web: X <br /> NOI required 24 hours prior to application. <br /> PCA.Jesse Sandavol 209-988-8149 <br /> Conditions: AP,Q,S,U See end of permit for <br /> code descriptloriv, <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 clairns of liability for damages against the County Department of <br /> Agricultix-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 manufacturers 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 e)dsts <br /> by the Department of Pesticide Regulation or the County Department of Agriculture of all areas treated or to be <br /> treated,stc-n-age facilities for pesticides or emptied containers and equipment used or to be used in the treatment. <br /> [Form PR-ENF-125 (Rev. 07/92)Pesticide Enforcement Branch <br /> Perrot Apppcant EA N 6-G— Signed-- <br /> (Please <br /> igned:(Please MAY <br /> Title: /t2yy 1 S e y Issue Date: O 09 — <br /> _T <br /> Issuing g Om Issue Date: Com' 0 <br />