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� C . <br /> — SAN JOAQUIN COUNTY <br /> NOTIFICATION OF HAZARDOUS WASTE DISCHARGE <br /> HEALTH & SAFETY CODE 25180.7 <br /> A. EMERGENCY LEVELO II III PHS-EH LOG # 9S <br /> (Circle One) <br /> B. SOURCE OF INFORMATION <br /> Original Source: r'1 irk5 1'fUN't Telephone: <br /> Reporting Agency Name: 5=1JOEI� f'^ A,4 <br /> Agency Contact: n '(445 r.w I Telephone: tory -344U <br /> Address: :E (D 5c-A- OCK2 S oc14-w-4 CA- - <br /> C. LOCATION AND DATE OF DISCHARGE <br /> Location: 2No.z � s�- C-4 <br /> (Best Physical Description) (City or County) <br /> Date of Discharge: <br /> Date Notified: s/31�71 Time: 9: so a,+ <br /> D. RESPONSIBLE PERSONBUSINESS <br /> Name of Business Z, r, li;,�r <br /> y Contact Person: 6!---- t S'e<kkr Telephone: o- <br /> Physical Address: - <br /> E. DESCRIPTION <br /> Type Release: UAA? <br /> Volume: G7 k o <br /> Chemicals: <br /> F. ACTION TAKEN <br /> C��..,� o/� C7�f TAe SO'� /✓/l. S'-krI'�YZ /.vim//OC/�/� f/`u/ /� _ <br /> 7 <br /> Gveulel 62 pors,66, c0414" rl cP r. f Skd 1,el,r d1t p <br /> ==I- .. '- <br /> �-I J <br /> Gvoulc� ac f fe ro 9/Tnr car q °:�• <br /> 3H 22 013(Rev. 02/90) <br />