Laserfiche WebLink
Y.: SANtiJ®AU <br />QI Restricted Materials Permit—Supplement Application <br />COU N TY Notes: Permit#: 3904457 ver <br />Grcorncss groi:s. izcrc.Operator: Round Valley Ranches <br />n�*e. �l19/SCI?T <br />SITE ID <br />LOCATION <br />'RVN <br />RNG <br />SEC <br />DIRECTIVE <br />{Checkeox) <br />COMMODITY <br />UNITSS/ <br />PESTICIDES <br />4 <br />o <br />K <br />5 <br />0 <br />z <br />7 <br />= <br />v <br />PESTS <br />PCB/ <br />Grower <br />Applied? <br />Ann <br />awcG! <br />REMCVf <br />2- VRGH[v123 <br />NT FNERI2MIFPAVS <br />04N <br />06E <br />33 <br />O <br />0 <br />Soil T-AMF- 1 PWLIW I <br />&1) <br />1,3-D <br />F <br />Se IPis <br />PCB <br />2 WDBAY15 <br />04N <br />06E <br />34 <br />0 <br />0 <br />S01LFUMP-f RREPLAi T <br />15 <br />1,3-D <br />I, <br />SOIL t�3GS <br />PCS, <br />3. <br />O <br />4- <br />S- <br />O <br />6.0 <br />0i�Irow <br />IgLL P,-A,UUT <br />co <br />)i30A/S_ <br />7. <br />a. <br />9' <br />01010 <br />10. <br />,0100 <br />11. <br />12 <br />23. <br />1 <br />0010 <br />14. <br />1s. <br />L=liquid B=6cit <br />D=Du t F=Fumigant <br />G-Granutc <br />WP=WettCT&ft Powder <br />c=Other <br />"'Method: A=Air <br />F=Fum:gctfon <br />Applicant <br />Name Signature <br />Issued By: ` 0(L V 6 f%/ <br />Name rU� Signature <br />. xar.z:nma <br />3.%712-1 <br />Date <br />Date <br />Pagctl � of <br />