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SAN JOAQUIN COUNTY <br /> NOTIFICATION OF HAZARDOUS WASTE DISCHARGE <br /> HEALTH & SAFETY CODE 25180.7 <br /> A. EMERGENCY LEVEL: II III PHS-EH LOG # -- <br /> (Circle One) <br /> B. SOURCE OF INFORMATION q <br /> Original Source: 1S — 7 Telephone: ( ) 1L k--?S--o 7 <br /> Reporting Agency Name: Eld o i,✓ 6 . /G(`/�1- h�67W <br /> Agency Contact: Aug Telephone: CEfj <br /> Address: P o • Ba,"� Lo og S'To�k7 gS1�9 <br /> C. LOCATION AND DATE OF DISCHARGE D/Gl-s <br /> Location: ;?30/0 Eksr ST, <br /> (Best Physical Description) (City ounty) <br /> Date of Discharge: C1A1A'nVw^,1 <br /> Date Notified: /—//—V Time- "71 !3d� <br /> D. RESPONSIBLE PERSON/BUSINESS <br /> Name of Business 0i�K/5 FX�o uJ <br /> Contact Person: F.tuAAll-D �22\M 5 Telephone: ( !2fj LL 32-0 G <br /> Physical Address: 2 (00 JEW 59' -zj— , C 9 S�376 <br /> E. DESCRIPTION <br /> Type Release: 28' V-- <br /> Volume: <br /> ZVolume: W "I <br /> ChVA � .`i olv ocs�2�o 0.15 <br /> F. ACTION TAKEN L <br /> —r J I L cl �✓�i 51 w� � 0 0 O J T a4 dJ SSI O l' <br /> X • Vr VCP(A" �Gt5o (lyAQ , --F ,v V- w A 5 PA M P" 0 �7Q� <br /> P— Cke7 <br /> C.s-..�a��... �-t.r�^ 'ree, w 1 J2. e-c( i, ,, -+-t..e. c�✓'o�o%rx.le ct�eu,�j <br /> EH 22 03 (Rev. 7/89) <br /> 0 <br /> i <br />