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SAN TOAQUIN COUNTV <br /> 'y <br /> 1868 E, HAZELTON AVENUE <br /> STOCKTON, CA 95205- <br /> E-mail: Web:www.co.san-ioaquin.causla¢comm <br /> Office: (209)168.3300 Fax:(209)468.3330 Recorder(NOI's):(209)468.3300 <br /> RESTRICTED MATERIALS PERMIT <br /> MIZUNO FARMS Permit Number: 39-05-3902124 <br /> 29050 AHERN RD County District#: J <br /> TRACY, CA 95304- Expiration Date: December 31, 2095 <br /> Effective Date: <br /> '771'4' 71-712-"_�_ <br /> CLARK MIZUNO Home Phone, OFF 835-5154 <br /> 29050 AHERN RD Shop Phone: (209) 835-5154 <br /> TRACY, CA 95304- Mobile Phone: (209)483-2500 <br /> Fax: <br /> Permittee Type: Private Applicator NOI Method of Submission: <br /> Permit Type: Seasonal Phone: X Fax: X Box: <br /> Possession: Possession &Use In Person: X Modem: Web: X <br /> NOI required 24 hours prior to application. <br /> Conditions: AAQ See end o£permit for <br /> code deectiptione: <br /> —————————————————————————————————————————————— <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 claims of liability for damages against the County Department of <br /> Agriculture 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 manufacturer's 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 ernergency exists <br /> by the Department of Pesticide Regulation or the County Department of Agriculture of all areas treated or to be <br /> treated,stooge facilities for pesticides or emptied ecotainers and equipment used or to be used in the treatment <br /> [Form PR-ENF-125 (Rev.07/92)Pesticide Enforcement Branch] <br /> Permit Applicant Signed <br /> (Please Print <br /> 'IStle: Issue Date: <br /> pease Print <br /> Issuing Officer. t Issue Date: <br /> G' <br />