Laserfiche WebLink
`-� SAN JOAOUIN COUNTY— <br /> NOTIFICATION OF HAZARDOUS WASTE DISCHARGE <br /> HEALTH & SAFETY CODE 25180.7 <br /> LL <br /> A. EMERGENCY LEVEL III III PHS-EH LOG # 20 <br /> (Circle One) �� <br /> B. SOURCE OF INFORMATION <br /> � <br /> Original Source: _� 1/y0 <br /> g �1Q(�/.S Un, Telephone: (�) W-3 <br /> Reporting Agency Name: /WAAi Qu Na h{011X� 5�fV109s EtirirVI'MOI&I AW04 LM10" <br /> Agency Contact: �aQl'(/5 IA Telephone: <br /> Address: Lo. Sny ..2n0-'1 sfil-k:�2N CA 9g,-,?o/ <br /> C. LOCATION AND DATE OF DISC14ARGE <br /> Location: T61 ()j r l(y PP Sd- / S:JP1C i'n-1 rA <br /> (Best Physical Description) (City or County) <br /> Date of Discharge: fAtik"ex&N <br /> Date Notified: ( joe'j '0 Time: - 10'0S R.M. <br /> D. RESPONSIBLE PERSON/BUSINESS <br /> Name of Business �tifn F-e, KG7��ror[r� <br /> Contact Person: �laoe Clark Telephone: Vj/ ) 7 SySy <br /> Physical Address: 'EM Dlawar-y SclnPkfoN C'¢ <br /> E. DESCRIPTION <br /> Type Release: Lt Ale- <br /> Volume: <br /> 2Volume: UNnrnw. s <br /> Chemicals: n I N �roertr6on�� <br /> F. ACTION TAKEN <br /> Tick '76{00r) q dl PSc{ *4 1412/20 0-24 /s-mavd r f ,d 9 <br /> .WFO Ai/ fci L //�'7P1� r���raPc� Sai/ �rco%r sv i 6s/k E ti kt <br /> Oil' * riiaa' '(tierivclir r!i a Jnr/ rn itsni✓// c v �Dr{re�W," 'w <br /> �� �6wrarb <br /> aNc! �ti� n/' �a�,fmniNnfio�✓� os n�ruir� ,dr. f��n; rra��rlla� <br /> EH 22 03 (Rev. 7/89) <br />