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0 .Uurly c SAN JOAQUIN COUNTY AGRICULTURAL COMMISSIONERS OFFICE <br />2101 E EARHART AVE, SUITE 100 <br />STOCKTON, CA 95206 <br />Office: (209) 953-6000 Fax: (209) 953-6022 <br />Email: stocktonag2@sjgov.org Web: wvvi.co.san-loaquin.ca.uslagcomm <br />RESTRICTED MATERIALS PERMIT: 39-20-3905501 <br />Operator:BLAGG FAMILY FARMS <br />12630 ATKINSON RD. <br />Lodi, CA 95240 <br />Agent:TYLER BLAGG <br />Certified Applicator: BLAGG, TYLER S <br />12630 ATKINSON RD <br />LODI, CA 95240 <br />Type of Use:Agricultural Use <br />Pesticide Possession: possession and Use <br />Permit Duration: Seasonal <br />Permit Conditions:Appendix C, Appendix H, QL, P <br />Regulatory Notes: <br /># 3905501 -2020 -Version: 1 <br />County District #:E <br />Issued on:2/3/2020 <br />Valid as of:2/3/2020 <br />Expires on: 12/31/2020 <br />Primary Phone: <br />Alternate Phone: <br />Mobile Phone: <br />Fax: <br />Phoneâ–  <br />License #:3911146 <br />Expiration: 12/31 /2021 <br />Notices Of Intent required 24 hours prior <br />to application of pesticide containing <br />restricted materials <br />See condition detail for <br />code descriptions. <br />understand that this permit does not relieve me from liability for any damages to any persons or property caused by the <br />use of these pesticides. I waive any claims of liability for damages against the County Department of Agriculture based on <br />the issuance of this permit. I further understand that this permit may be revoked when pesticides are used in conflict with <br />the manufacturer's labeling or in violation of applicable laws, regulations, and specific conditions of this permit. 1 authorize <br />inspection at all reasonable times and 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 facilities for pesticides or emptied <br />containers and equipment used or to be used in the treatment. l have considered alternative and mitigation measures <br />pursuant to Title 3, California Code of Regulations, section 6426. Taking into account economic, environmental, social, <br />and technological factors, 1 have adopted those that are feasible and would substantially lessen any significant adverse <br />impact on the environment. <br />[Form PR-ENF-125 (Rev 11/06) Pesticide Enforcement Branch] <br />Applicant: L r-12. S ,(f 1 A(,L UL -j1 -,/&'Y2- <br />( ame & Title) <br />Applicant Signature Date: <br />Issuing Officer: _ ~ Date: 17-0 Z.b <br />Page 1 <br />