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SAN JOAQUIN COUNTY -- <br /> NOTIFICATION OP HAZARDOUS WASTE DISCHARGE <br /> HEALTH & SAFETY CODE 25180.7 <br /> /I <br /> A. EMERGENCY LEVEL:� II III PHS-EH LOG # I <br /> (Circle One) <br /> B. SOURCE OF INFORMATION <br /> Original Source: 161S T - Telephone: O L'7;-0 7 <br /> Reporting Agency Name: .5-4111 % i.✓ Co I �61/i1- <br /> Agency Contact: VD Of �j✓'Gsa� Telephone: <br /> Address: o . ge,C ,2o a q S7o�c7v�, Gf9- �/Sj�o <br /> C. LOCATION AND DATE OF DISCHARGE <br /> Location: ;3�0 QST 5-le, <br /> (Best Physical Description) (City ounty) <br /> Date of Discharge: VAIL"W^' <br /> Date Notified: /—//-9/ Time: 'ell <br /> D. RESPONSIBLE PERSON/BUSINESS <br /> Name of Business N,c.K� FX?<o rl <br /> Contact Person: V-ttAAl2b i 2E\1 5 Telephone: <br /> Physical Address: 0 qlw S?' 7jddj4 <br /> E. DESCRIPTION <br /> Type Release:'' <br /> Volume: V ��� Gv "j <br /> Chcmical� oyo �P,uvv� � .�� olv oc �z leo oJS <br /> F. ACTION TAKEN <br /> ,F,K , Uri bu-4 .c( ct50L/\e , -T" Y-k w ft 5 Pln wi a7cc( ens. p� y b Y 0441, <br /> � P- Si e �S5e55 �t^ -� r., , 1 Ye�wirLP� <br /> &4"kti i V�P <br /> Le4 t i x e4 pug/ <br /> EH 22 03 (Rev. 7/89) <br />