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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 HEALTH DISTRICT LOG #_ —QQ Q <br /> (Circle One) <br /> B. SOURCE OF INFORMATION <br /> '/ <br /> Original Source: �as TS;Crrg ._. Telephone: ( LJy ) �ih^d 3fg, <br /> Reporting Agency Name: Sn }.aa., a (-CCnL F-ii-r,, ,,, V),s-r® rr <br /> Agency Contact: knsry Telephone: (.2orl ) ymg-343,) <br /> Address: 110n1 F. H�7k -,-, W <br /> i <br /> C. LOCATION AND DATE OF DISCHARGE <br /> Location: <br /> I (Best Physical 'Description) (City 6r County) <br /> Date of Discharge: 1 /20 12 <br /> —r <br /> Date Notified: _ III /--�Q1 Time: <br /> D. RESPONSIBLE PERSON/BUSINESS <br /> Name of Business Th ,. -Wr)VN7P-q C'NFVPnt ! <br /> Contact Person: JnNN 7ht/ Telephone: <br /> Physical Address: i333(o E , Nwv RR <br /> E. DESCRIPTION <br /> Type Release: _ Q(Yrsum Ta<,r �n ,l;.� �/vriy�L� rZ ��.fa✓gyp r /�rT <br /> Volume: r,�rtl ruk <br /> Chemicals: ' iquLla✓ 4- 11 r ,Lr( ori l YInlirg <br /> F. ACTION TAKEN <br /> C <br />