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SAN JOAQUIN COUNTY Q� <br /> NOTIFICATION OF HAZARDOUS WASTE DISCHARGE <br /> HEALTH & SAFETY CODE 25180.7 ^ <br /> \�J <br /> A. EMERGENCY LEVELO II III PHS-EH LOG # `2- <br /> (Circle One) <br /> B. SOURCE OF INFORMATION <br /> Original Source: //] ✓, 9YR Telephone: <br /> Reporting Agency Name: Ru b //" , 14Gr,-4 Srjw1 PS' OF _�+11y <br /> Agency Contact: I ONNA" �F62AN Telephone: (ZeZ3 W62 Sia <br /> Address: 2, 1) , '60Y 200q , S70c 611'1, " 9S7-0/ <br /> C. LOCATION AND DATE OF DISCHARGE <br /> Location: 265710 <br /> (Best Physical Description) (City or (founty) <br /> Date of Discharge: UNK4Aownl <br /> Date Notified: F9-18-02 Time: <br /> D. RESPONSIBLE PERSONBUSINESS <br /> Name of Business <br /> Contact Person: _fj1/6S 141ye,Q/S Telephone: (� <br /> Physical Address: v�-.S624 C/6iC;Szff 229, 11:2<37� <br /> E. DESCRIPTION <br /> Type Release: UnlAIARIDE-IZed <br /> Volume: M d I _ / <br /> Chemicalc (i' C <br /> F. ACTION TAKEN <br /> ii/tt/�f2'G//'' LC/���ti /v �h9' ,S�✓a-�'� �i�S �E�dQ�a n/ /� /�— ��i <br /> C��� Nh��,�vri�,H��rq r,� �7,ft>✓� /��v�r7!/-�( v n/ /,Z. �—r�� <br /> ��� � ✓/��l �SG,.o�s /�iA4� ���E,� S//� GCSeSS�cG,.•1�1,,' ,� <br /> GlefP/zzWir7e, 72ie /-2f7fl-e, <br /> �� C�JN�/iM inJH?7/1i✓ /� <br /> EH 22 03 (Rev. 7/89) <br />