Laserfiche WebLink
C <br /> SAN JOAQUIN COUNTY <br /> NOTIFICATION OF HAZARDOUS WASTE DISCHARGE <br /> HEALTH & SAFETY CODE 25180.7 <br /> A. EMERGENCY LEVE I II III PHS-EH LOG # <br /> (Circle One) <br /> B. SOURCE OF INFORMATION <br /> Original Source: Qv-jrrpe Telephone: (:202_) <br /> Reporting Agency Name: `x ,1-�rtur <br /> Agency Contact: Telephone: <br /> Address: ?/2, -2Aj n4 <br /> C. LOCATION AND DATE OF DISCHARGE <br /> Location: 2c2y 4' Clnar4t� (Ala / 74nrk4o" <br /> (Best Physical Description) (City r County) <br /> Date of Discharge: �^" 'JOLA� <br /> DD M <br /> Date Notified: ` r�2�9I Time: <br /> D. RESPONSIBLE PERSONBUSINESS <br /> Name of Business <br /> C! "V F <br /> , <br /> Contact Person: /7/a,-k Telephone: (Z22_) <br /> Physical Address: <br /> E. DESCRIPTION <br /> Type Release: U�� <br /> Volume: <br /> Chemicals: <br /> F. ACTION TAKEN <br /> qAArr <br /> EH 22 013(Rev. 02/90) <br />