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SAN JOAQUIN COUNTY <br /> NOTIFICATION OF HAZARDOUS WASTE DISCHARGE <br /> HEALTH & SAFETY CODE 25180.7 <br /> A. EMERGENCY LEVEL:01 II III PHS-EH LOG # COPY <br /> (Circle One) <br /> B. SOURCE OF INFORMATION <br /> Original Source: Telephone: ( a rt ) ,1(o(0 -20-42 <br /> Reporting Agency Name: Six )02:�0('n C,n,)nl-4 p!)bhC" (4 o/ Ak Srnrtlr 17 <br /> Agency Contact: _N,-nn(�- 14PALVI- Telephone: (20q) clog 3cL37 <br /> Address: 1(001 E. N Air r a J A"Ue • . &(--fj .Gor �G?S;3,O <br /> C. LOCATION AND DATE OF DISCHARGE <br /> Location: 51-77- 1A1. rJ r <br /> (Best Physical Description) (City or County) <br /> Date of Discharge: ULk-r1C AJ0 <br /> Date Notified: ���3IN Time: 110000 M <br /> D. RESPONSIBLE PERSONBUSINESS <br /> Name of Business ctup}RS--)IOn- GeRu1FbP-D <br /> Contact Person: b(-W,i� TLPPF nj )n Telephone: <br /> Physical Address: SIS 1/.). r2em6-Y)T <br /> E. DESCRIPTION <br /> Type Release: rP enc a uce7j J'isff)oe rr) Aor" p n"Prnc)Ja f <br /> Volume: l'n�nrn,J <br /> Chemicals: Crn-�-nllnv <br /> F. ACTION TAKEN <br /> FL( rrlq c r 5 i�r& C A �Pryl- uji I IYX rpQ U i red to r9 -term r na <br /> �� tlr]-ttA"rP Ca�r\�� Px1z?rtifi �l �nr�tt)rvlrrY.Yf'ICN) Y'Pnr� rlx1 �o r <br /> J <br /> EH 22 03 (Rev. 7/89) <br />