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r ( I'„1NDAILRY CONIACIS <br /> San Joaquin County <br /> Local Health District: k6 a � <br /> V � <br /> Contact Name Time Date <br /> San Joaquin County <br /> Doard of Supervisors: �01Q EALOCJ'/� <br /> Contact Name <br /> Time Date <br /> H. HEALTH AND SAFETY CODE 4 25180.7. <br /> (b) Any designated government employee who obtains inforuation to the <br /> Co -se of his official duties revealing the illegal discharge or <br /> threatened illegal discharge or threatened illegal discharge of a <br /> hazardous waste within the geographical area of his Jurisdiction and who <br /> knows that such discharge or threatened discharge is likely to cause <br /> substantial Injury to the public health or safety must, within <br /> seventy-two hours, disclose such information to the local Board of <br /> Supervisors and to the local health officer. No discipsure of <br /> information is required under this subdivision when oth'"se prohibited <br /> by law. or when law enforcement personnel have determined that such <br /> disclosure would adversely affect an ongoing criminal investigation, or <br /> when the information is already general public knowledge within the <br /> locality affected by the discharge or threatened discharge. <br /> (c) Any designated government employee who knowingly and Intentionally <br /> fails to disclose information required to be disclosed under subdivision <br /> (b) shall , upon conviction, be punished by imprisonment in the county <br /> jail for not more than one year or by imprisonment in state prison for <br /> not more than three years. The court may also impose upon the person a <br /> fine of not less than five thousand dollars ($5,000) or more than <br /> twenty-five thousand dollars ($25,000). The felony conviction for <br /> violation of this section shall require forfeiture of government <br /> employment within thirty days of conviction. <br /> 1 . SIf,NATURC DISCLOSURE <br /> I make this report on behalf of all the designated employees of the <br /> County of San Joaquin, and the San Joaquin County Local Health District, <br /> and <br /> Agency Name <br /> S I g n a t u r e: Z�'�/G�i_.. / <br /> Typed Name: _ U <br /> l� lZf/S. 7s�d <br /> Date: 12 <br /> Time; <br /> Revised 11-87 <br />