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14W 1.,/ <br /> SAN JOAQUIN COUNTY <br /> NOTIFICATION OF HAZARDOUS WASTE DISC <br /> HEALTH & SAFETY CODE 25180.7 COPY <br /> A. EMERGENCY LEVEL: 1 II III PHS-EH LOG # 9 - ,)-S 3 <br /> (Circle One) <br /> B. SOURCE OF INFORMATION <br /> Original Source: y i �i`�t_ �f ,C C1, Telephone: of C'1 )4_Cn_cA — 3 q,3 <br /> Reporting Agency Name: S!' 1,- et C, <br /> Agency Contact: l 'int c ti/ ' l ti� Telephone: (d L) <br /> Address: P O , 4?--C'rX 00 '? , ('•�/C , C,,,,+ i o / <br /> C. LOCATION AND DATE OF DISCHARGE <br /> Location: ]/o , ���ti �� BLe F l —�Cvc Z A cz c c- c <br /> (Best Physical Description) (City or County) <br /> Date of Discharge: <br /> Date Notified: Time: <br /> D. RESPONSIBLE PERSON/BUSINESS <br /> 15L <br /> Name of Business 614e-L <br /> Contact Person: LC. Telephone: <br /> Physical Address, <br /> E. DESCRIPTION <br /> Type Release: <br /> Volume: a-)1�.i� <br /> Chemicals: amu' n di& 4 ) <br /> F. ACTION TAKEN <br /> ltt.�-th c[�B-�c - 1 ('� s / a � h.0 , tet, - • Q "� ,el <br /> P *9 b-CZE 5-cr)n ' Lj - <br /> YI-i,t9� <br /> AV <br /> EH 22 037'' <br />