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r'ubllc Health Services <br /> of San Joaquin County f ' <br /> Environmental Health Division: <br /> (Contact Name) (Time) (Date) <br /> San Joaquin County . <br /> Board of Supervisors: �rr ��Ln �/ �: �,� /::7""� ? '—�'� �/ <br /> (Contact Name) (Time) (Date) <br /> . I-iLALTH AND SA. TY CODE S 25180.7. <br /> (b) Any designated gove-=.=ent employee who obtains information in the course of his ofricial <br /> dunes revealing the illegal discharge or threatened M--ga �~l di. arge of a hazardous waste within <br /> thegeographical area or his jurisdiction and who knows that such discharge or threatened <br /> discharge is likely to cause substantial injury to the public health or safety must, within seventy- <br /> two hours, disclose such infoination to the local Board of Supervisors and to the local health <br /> officer. No disclosure of information is required under this subdivision when otherwise prohibited <br /> by law, or when law enforcement personnel have determined that such disclosure would adverse- <br /> affect <br /> affect an ongoing crm�n mvesdoanon, or when the information 1s already general public <br /> knowledge within the locality affected by the discharge or threatened discharge. <br /> (c) Any designated gove-=ent ern:_ loyee who knowingly and intentionally fails to disclose <br /> information required to the disclosed under subdivision Ca) shaL, u:on conviction, be punisher- <br /> by <br /> unishedby itnprison_ment in the county jail for not more than one year or by unprisonment in state prison <br /> for not more than three years. i he court may also impose upon the persona fine of not less than <br /> Eve thousand dollars (S5,000) or more than twenty-five thousand dollars ($25,000). The felony <br /> conviction for violation of this section shall require forfeiture of gave_Tnment employment within <br /> :hirry days (30) of convicrion. <br /> I. SIGNATURE DISCLOSUP! <br /> I make Lhs report on behaL of all the designated employee of the County of San Jeaouir, and <br /> (Agency Name) <br /> Signature: <br /> Typed/Printed Name: Mery �1S �"w <br /> Title: <br /> Date:- Time: 3=5 <br /> cc: <br /> sWr-- ..pS-/S.�'E' CODES: <br /> C, rt)04) CONMI-R Y / <br /> ' REFEREED TO: <br /> EH 22 013 (Rev-4/9a) <br />