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SAN JOAQUIN COUNTY <br /> NOTIF.' 'CION OF 1-IAZARDOUS WAST 1ISCI-IARGE <br /> `'HEALTI-T & SAFETY CODE 251` .7 <br /> A. EMERGENCY LEVEL I /II III PHS-EH LOG # <br /> (Circle One) - <br /> B. SOURCE OF INFORMATIO/N'' ) _ <br /> Original Source: A90q L) Telephone: (209) V66 -916y0 <br /> Reporting Agency Name: <br /> Agency Contact: Pa/1Ly/6 /Q Telephone: (f-�n V�-V' 3 V&q <br /> Address: 7YS N° - 5A17 7&W qF- n 5Act --7Len <br /> C. LOCATION AND DATE OF DISCI-IARGE <br /> Location: //�/ /) .5-11eet / 77�bG/�46-A <br /> (Best Physical Description) (City or County) <br /> Date of Dischargepr,ev o U/9K/%owen <br /> Date Notified: /U-2q-,/o y q/ Time: N` <br /> D. RESPONSIBLE PERSPN/BUSINESS <br /> Name of Business N14610 /%Dabs , Zit/c. <br /> Contact Person: Q hKn 2 5 tae Telephone: (L9) el(0lO - '?58 0 <br /> Physical Address: PJGY 92p0 S74aCi(- d-M OA `1SZ & <br /> E. DESCRIPTION _ <br /> Type Release: U K � <br /> Volume: n <br /> Chemicals: <br /> F. ACTION TAKEN <br /> Zabara S01V 5a <br /> 10(7%- d res 35d a-P 1,015k, �i' �a c <br /> /b1 S/9C� fr�rrZ�r�i, 5;� �s5-e ssme� Gyri// !2e re�c� 7`z� <br /> ` W- I? d&IX- " -tet 44d 07/' 61i 74Or G S <br /> YP�-rtivc-e 0 E�ri �t.t' oi_I6-a22c ani /�Q tic.Da �,-� C,��� eN <br /> EH 22 013 (Rev. 02/90) <br />