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SAN JOAOUTN COUNTY `-d <br />NOTIFICATION �)F HA7A7')OUS WASTE DISCI-IARGI? O� <br />HEALTH & SAFETY CODE 75180.7 <br />A- EMERGENCY LEVEL: (I J II III PHS -EH LOC # <br />(Circle On `/ <br />B• SOURCE OF INFORMATION <br />Original SourcF: <br />,; y Reporting Agency Name::---jy� DQ.4 <br />Agency r'-ntact: �(i� (SPjY9 <br />Address: <br />Telephone: 0-6ji <br />Telephone: <br />C• LOCATION AND DATE OF DISCHARGE <br />Location: fz- <br />(Best PhysicalDescLr�ip/tion)p (City or county) <br />Discharge: 1/ ! ! R <br />Date Notified: �3 <br />D. IZr-SPONSIBLE PE SON/BUSINESS}. <br />Name of,Business_L H>9 Lk V{ <br />Contact Person: Q�-r}t �.1 y� Telephone ,.o �'' 3 —a 7 S O <br />Physical Address.�91 %— S'p�� <br />E. DESCRIPTION f % <br />Type Release: <br />Volume:. Q <br />Chemicals: <br />U <br />r• <br />ACTION TAKEN— <br />%�/h-�?�-C�.ol <br />oi- <br />..-H 22 03 (Rev. 7/gg) <br />