Laserfiche WebLink
• SAN JOAQUIN COUNTY 0 <br /> &00 F• ENVIRONMENTAL HEALTH DEPARTMENT <br /> �A ffi"� '` rd r,Stockton,CA 95202-2708 d D <br /> (209)468-3420•Far:(209)464-0138•Web:www.co.san joaquia.ca.us/ O <br /> a <br /> NOTIFICATION OF HAZARDOUS WASTE DISCHARGE <br /> California Health & Safety Code,Section 25180.7 <br /> EHD LOG#: 67-1Z-_1- <br /> A. EMERGENCY LEVEL II III COPY(Circle One) <br /> B. SOURCE OF INFORMATION <br /> Name: R 4m Vl9N PI LA' Phone: i2Oq) 469'994PQ <br /> Company. S91,%4- RT a perk'°-'wo 'Otoyc'e-- <br /> Address: u City: Zip Code: <br /> Designated Employee Name: <br /> Reporting Agency Name: <br /> Address: City: Zip Code: <br /> C. LOCATION AND DATE OF DISCHARGE y„� J <br /> Location: t 1 W e s f- LN' 1 S dc� �l / ( Ci r Countv <br /> (Best Physical Description) ' cle One) <br /> Date of Discharge: U NK"10w rJ Date Notified: Time: A.M. PM <br /> D. RESPONSIBLE PERSONBUSINESS <br /> Name of Business: Pert )S Cpn sS r-u&{ tort <br /> Contact Person: Mel1IV D,h &reW EM Phone: (7o) 7qS O.T•80 <br /> Physical Address: f3S'3 L f N Go I N YVAY Z,=city: 4u b u/`►J Zip Code: <br /> Mailing Address: k ` City: Zip Code: " <br /> E. DESCRIPTION <br /> Type of Discharge: <br /> Volume: APEX. `3�s L(oV,^e5ce4 17�$ <br /> Chemicals: M ('Cut4 <br /> Circumstances: CoN f1A-r' on oior1L1'As avIn 2.`! ^ally- �jc�lhJ� in <br /> S611h 011191 ds�t�sfcti {tic�eah O� t^ZG iU���� �Q�1 <br /> F. ACTION TAKEN: Recce N+mzPi)c-n 41,k4, - &019 1 G19/�e Q Ylg2gCpUU� <br /> SITE DISPOSITION: bur^ p S EA f CI-1 0 OA Y_i�2 <br /> EHD 22.02-003 Notification of Haz Discharge <br /> 10/2/2003 <br />