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SAN JOAQUIN COUNTY AGRICULTURAL COMMISSIONERS OFFICE <br />2101 E EARHART AVE, SUITE 100 <br />STOCKTON, CA 95206 <br />Office: (209) 953-6000 <br />Email: stocktonag2@sjgov.org <br />RESTRICTED MATERIALS PERMIT: 39-17-3900095 <br />Operator:RECLAMATION DISTRICT #2119 <br />12500 E FAIRCHILD RD <br />STOCKTON, CA 95215 <br />Agent:MUZIO,EUGENE <br />Certified Applicator: MUZIO, EUGENE <br />12500 E. FAIRCHILD <br />STOCKTON, CA 95215 <br />Type of Use:Agricultural Use <br />Pesticide Possession: Possession and Use <br />Permit Duration: Seasonal <br />Employees Handle Pesticides <br />Permit Conditions:A, GWP -ROW IC, R Q, 0, B <br />Regulatory Notes: <br />Fax: (209) 953-6022 <br />Web: mAv.co.san-Ioaquin.ca.us/agcomm <br /># 3900095 -2017 -Version: 1 <br />County District #:H <br />Issued on: <br />Valid as of: I' <br />Expires on: 12/31 /2017 <br />Primary Phone: <br />Alternate Phone: <br />Mobile Phone: <br />Fax: <br />Phone: <br />License 4:104086 <br />Expiration: 12/31/2017 <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 />I 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. I 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. I 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, I have adopted those that are feasible and would substantially lessen any significant adverse <br />impact on the environment. <br />[Form PR -ENI' -125 (Rev 11/06) Pesticide Enforcement Brand)) <br />Applicant: �, zJ C'L1LC <br />(N' ma R rillu) <br />Applicant Signature: fc,� ..> ,_. �e..L: <br />c�i <br />Issuing Officer: <br />Page 1 <br />Date: <br />Date: <br />