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FILE COPY <br /> SAN JOAQL N COUNTY <br /> vOTIFICaTLON OF H.�ZARDOUS W-kS DLSCH3�GE <br /> Q9A gE�I T3 & SAr=i. CODE ''-::130.7 <br /> A. Eti[ERCc`fCY L�/EL:� S III PFS-EH LCG = Cl c) • 0 cJ <br /> k4'4`, r`t (C rciz one) <br /> B. SOURCE OF aNFOR A-170N <br /> vamz: Phone: (aolfl 57°1- 0900 <br /> C,)Mo=v: <br /> adarss: <br /> Desi areaamicve- `=c. f ✓ ' 4 Q S ?hcne: oZ <br /> Rzporvn sency Mame: <br /> -kdaz=: <br /> C. LOC.aTiONt /AND DATH CF D(SC ARG° <br /> LJcaacn: 16 `fS (_ a Mrd1—� ��n C�1E 7 o�N <br /> (Bess Ph%-sici Descroacn) (City o auaiv C:rc:e ane <br /> Dare of Discs rte: <br /> Date vca ed: / ;:me: ODo m <br /> D. R-SPONJIBLt ? SON BGJu cSS <br /> Name of Bus'mess: <br /> CJnmc- ?9rsca: J~icuc: D 7 <br /> .+ares: _ o•7 <br /> MaiEn �caress: G <br /> L. <br /> DES CR&T!ON nn n <br /> Vci rne: <br /> Y <br /> Cie^ucis: 1s. <br /> A=ON <br /> 5T'= D(SPO=ON <br /> . '_: 0 L3 (R-'`. <br />