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SAN JOAQUIN COUNTY <br /> 1868 E. HAZELTON AVENUE <br /> STOCK'TON, CA 952205 <br /> Office: (209 )468-:17�i0 Recorder (NO I ) ( 2209) 468-73.00 FAX : ( (.)9)468 =:�c i <br /> 'ESTRICTED MATERIALS PERMIT PERMIT/OPERATOR I .D. #: 79-96-3904187 <br /> County HO District #: E <br /> GOEHRING FARMS Expiration Date: 12/-' /96 <br /> LODI , CA 95�4C>- <br /> OD 1 N CURRY RD Issue Date : <br /> ELWARD GOEHRING Home: ( 209)-68-461." <br /> 1:721 N CURRY RD Shop: ( ) - <br /> LODI , CA 95240- Mobile: ( ) - <br /> ------------------------------------ <br /> FOR RESTRICTED MATERIALS PERMIT USE ONLY <br /> =rmit Type: Foss. Only ; ; Seasonal ; X ; Poss . & Use ; X ; Job <br /> =rmittee Type: C .A. Cert ; ; Ag . PCO ; ; Private App ; X ; Non-Ag ; <br /> NOI required 24 hours prior to application . <br /> �'--thod : phone ; X ; box ; X ; person ; X ; modem <br /> fax <br /> .dumb Pesticide Pest (s) Form. Method (s) Applicator(s) <br /> --- <br /> -------- ---------------- ----------------- <br /> .)51 SEVIN Larvae Liquid Ground PCO Grower <br /> )61 FURADAN Nematode Dust Ground PCO Grower <br /> 1-60 CHLOROPICRIN Nematode Fumigant Ground PCO Grower <br /> '591 THIODAN Larvae Liquid Ground PCO Grower <br /> -)91 MANED DUST Fungi Granules Ail- Ground PCO Grower <br /> :850 METHYL BROMIDE Soil/Stored Fumigant Ground PCO Grower <br /> 5540 STRYCHNINE Gophers Bait Ground PCO Grower <br /> )011 PARAQUAT Weeds Liquid Ground FCO Grower <br /> 3571• NEMACUR Nematode Fumigant Ground PCO Grower <br /> .•.)n-Ag Use: <br /> :onditions: PUw.1 <br /> understand that this permit does not relieve me from liability for any damage <br /> to persons or property caused by the use of these pesticides. I waive any <br /> aim of liability for damages against the County Department of Agriculture <br /> Lsed on the issuance of this permit . I further understand that this permit <br /> may be revoked when pesticides are used in conflict with the manufacturer' s <br /> labeling or in violation of applicable laws, regulations and specific <br /> )nditions of this permit . I authorize inspection at all reasonable times and <br /> . Aenever an emergency exists, by the Department of Pesticide Regulation or the <br /> :ounty Department of Agriculture of all areas treated or to be treated , storage <br /> cilities for pesticides or emptied containers and equipment used or to be <br /> ;ed in the treatment . CForm 37-12-5/v3. 53 (Rev . 02/16/90) sticid E forcemen <br /> Branch] <br /> -rmit Applicant : [�- Sign . <br /> Title: Date: } - <br /> sluing Officer- : Date: <br /> I �lG <br />