Laserfiche WebLink
SAN JOA UIN COUNTY <br /> NOTIFICATION OF HAZARDOUS WASTE DISCHARG00P <br /> HEALTH 6 SAFETY CODE 25180 .7 � <br /> A <br /> A. EMERGENCY LEVEL: I II III HEALTH DISTRICT LOG N � <br /> (Circle One) <br /> B. SOURCE OF INFORMATION // <br /> Original Source: 31LL 7iV11V <br /> SCY Telephone: (2,9? ) ��g -Z, Y�ry <br /> —T r <br /> Reporting Agency Name: L) <br /> //���/� <br /> Agency Contact: _8/LL 7 ntzE:L`- releplione: <br /> Address: (6DI re, tt)j,xGrj �7T/C/lr <br /> C. LOCATION AND DATEOF DISCHARGE <br /> /} <br /> Location: _ 7 y K/i f—'rZq,+G",( / lrraCIG70� <br /> (Best Physical Description) (City or County) <br /> Date of Discharge: .. .T/Ite"0u)&( <br /> Date Notified: 3//Q�$R- Time: <br /> D. RESPONSIBLE PERSON/BUSINESS <br /> Name of Business y4arzY 7NoG1704,12 JE <br /> Contact Person: �j�p26gr �,,.�t� Telephone: (2(9.9) 4(46—S71i <br /> Physical Address: �r <br /> E` <br /> E. DESCRIPTION <br /> Type Release: U <br /> Volume: .1 <br /> 1A <br /> ukfl[/.w <br /> Chemicals : L/:ifL4rfb+l�yF�7] <br /> p. ACTION TAKEN <br /> 1t(i7N�(r �iITFr_l4�rS�7SN•t k!T(.>rLL �R ���itu(��L_T'c2�Elirc�� r ;� <br /> 7urthtd.l � i Y7�ti�l'G?FCb��r�sr�;v�T�av A ., <'►: (.a�1R.I�l� f`. - � � <br /> ►�Ni'TtDi1�c,�i�/� i:sb�ira��t�`( Ab�rl �Y -- <br /> I' <br />