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�. www <br /> w '. U <br /> i s G-:�- --,\"L-k'�BATORY COiNT[ C i <br /> I <br /> ?ubdc Healyd Se:rices of Saa Ioaquin Ccuaty� <br /> C-"vlranrnenrai ,`with Division: <br /> �, r,Ca:I[ c. Marne) M-,n e) (Dace) \ <br /> I San Joaquin Counrr � • <br /> Board or Sunerrisars: <br /> ( ,it <br /> ! A ... /ISO e T -/—Q- 2 5 7� <br /> (Contac:Name) (T--ne) <br /> H• HE-A-LTrI:av73 SAF-r-7 CODE?j 130.7 <br /> b) Any designced zove:umeac e:nalove-e w,O obmins illmm=cjon m the ctiursc ofhis otucial dunes <br /> L-eveadag the ilIezmi disc=, rp or We=. --ed iile E Qis a of z as rdaus ud he <br /> ;eogtzniucal area or his jurisdiction and �vhOmeows ud= szzx:t dischar?e or <br /> - dI'CIIe.Ze;I dISC..=2_ <br /> i Is Uk-eiv m caus8 glf7Sj=;:j injury :o BIZ oui3dc i1eaith or m:ery This'. %xid�in sevencv-vo hours. <br /> disc'.ose such mrarizadaa co dIe locsE 3aalYi of SutXm-nsors and m die !ori Feaith E}tF.cer. �o <br /> I <br /> disclosure of idbrmanon is tuired'IL'Ce;17lS subdivis:an wCiC:I aCfiC:tcTs� ?IolStOile� �v { <br /> aw. cr <br /> when !aw enrorcemment personne# have ae-.er^Iine~ :.flat ,-Ucs disclosure wculd adve:seiv zd= :n <br /> ongoing c aminal vesti orL or shea to in orz>atioa is zrerdv zeaera! ?ublic `(nowiedzt- <br /> within rhe !oc::ficv arc ed by die disc.-ge or dere-mend disc!:ar <br /> C) v desi ;ToverBIneal _alalo� wf10 Qa-,Vmziy and intencica lly 3iis �o disc!ose <br /> iarorrmrion wired to :he disc:osed ^der;sodivision (b) sada ccn-rlction_ bz aurzisae:l byilnnrisnameat a dxe couar. ail or 30c .tore dada one s-eczr or by =risoar.Ieac :a ��e JtLSon cr <br /> aac sore Baa +zap. i ae ccurc:I; :isa inzpesa uooa�e fie.-sod ; ~:nc ar aoc :mss � Ove <br /> tousrnd dors lla1,5.).000) or more � Rv=v-dve 3oud dollars (T .000). -Lae 5eionv <br /> canvic:ioa -or,tofaaon ar dlis sermon snail =.uire immix m or zove:-.. nemc --mido-qm �vi�fiiu • <br /> tirry days (20)of czavi�on. ear- <br /> I. KGVr1 T L-E DISCLQSUM <br /> I ~Iake tiseaorr o �ehaif of ail dza desi` ed�atofomf s of #ce Ccunry of San :oacuin. =d r <br /> I <br /> (mac:-Name) <br /> w ` <br /> Typed/Printed-farce: <br /> Ide: <br /> D=e: <br /> r � <br /> CONNWR Y .1,N <br /> .e T 0: <br /> i <br /> I " <br /> L <br />