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EHD LOG# <br /> G. MANDATORY CONTACTS <br /> San Joaquin County Environmental Health Linda Turkatte Time: Q Date: <br /> Department p San Joaquin Joaquin County Board of Supervisors- Michael Cockrell Time: LOX <br /> Date: <br /> Contact-Office of Emergency rvi <br /> Seces - <br /> H. HEALTH AND SAFETY CODE 25180.7 <br /> (b) Any designated government employee who obtains information in the course of his official duties <br /> revealing the illegal discharge or threatened illegal discharge of a hazardous waste within the <br /> geographical area of his jurisdiction and who knows that such discharge or threatened discharge is <br /> likely to cause substantial injury to the public health or safety must,within seventy-two hours, disclose <br /> such information to the local Board of Supervisors and to the local health officer. No disclosure if <br /> information is required under this subdivision when otherwise prohibited by law, or when law <br /> enforcement personnel have determined that such disclosure would adversely affect an ongoing <br /> criminal investigation, or when the information is already general public knowledge within the locality <br /> affected by the discharge or threatened discharge. <br /> (c) Any designated government employee who knowingly and intentionally fails to disclose information <br /> required to be disclosed under subdivision (b)shall, upon conviction, be punished by imprisonment in <br /> the county jail for not more than one year or by imprisonment in state prison for not more than three <br /> years. The court may also impose upon the person a fine of not less than five thousand dollars <br /> ( 500 0)or more t an twen y-five thousand dollars($25,000). The fe ony conviction for 6iolation of this -- — - <br /> section shall require forfeiture of government employment within thirty days of conviction. <br /> I. SIGNATURE DISCLOSURE <br /> I make this report on behalf of all designated employees of the County of San Joaquin, and <br /> San Joaquin County Environmental Health Department <br /> (Agency Name) , �g,, <br /> Signature: S� " -Wa( 1 <br /> Printed Name: !�_ 0.k\(1(&) Z CK <br /> Title: .2RD S\QJ & 4'Z_Vlu"4 anV4lon-'d \AQ(1ky) S�eC', cnQ4Sa <br /> Date: Time: _Lv. Lk <br /> cc: DTSC Site Code: <br /> CVRWQC13 <br /> Vi -'i!o,_ 0/Vn0 3106 `S (au���''lIL A''"`e,' -rC✓� Con MFR Yes No <br /> CA opp7 of Fi 51n W id l r(-� , A Lomcllr Referred: <br /> t.DF-W- " r /resno,(A <br /> k0a, Ku�j-0 t nc sof y r cet :ut C. <br /> ovvyc [6 ox ;0553, � , tl,ngs, A/) T <br /> tdwr W sem-4a 5 f-G""O /10 U. 5(V' <br /> Revised 11103114 A-Wl'. /a.m ,je .�-D(�S Page 2 of 2 NOTIFICATION OF HAZ WASTE DISCHARGE <br /> C100 �PO.UI 1 �. (p'J,sht,CA <br />