Laserfiche WebLink
SAN JOAQUIN COUNTY <br /> NOTIFICATION OF HAZARDOUS WASTE DISCHARGE <br /> HEALTH & SAFETY CODE 25180 . 7 <br /> A. EMERGENCY LEVEL: (DI II III HEALTH DISTRICT LOG # <br /> (Circle One) <br /> B. SOURCE OF INFORMATION <br /> Original Source: Kati rwa. Telephone: (Za9 )RS2 -3260 <br /> Reporting Agency Name: <br /> Agency Contact: Dav'� Cams Telephone: (2oq ) 41eg-3yyo <br /> Address: lbo I <br /> r R �s roi <br /> C. LOCATION AND DATE OF DISCHARGE <br /> Location: 6 (0 )J . <br /> i <br /> ('Best Physical Description) (City or County) <br /> Date of Discharge: <br /> lk Date Notified:` � Timer �w��• <br /> D. RESPONSIBLE PERSON/BUSINESS <br /> Name of Business <br /> v _ <br /> Contact Person: RAy rw a Telephone: (eo4 ) gs,i - 3z�o <br /> Physical Address : G � N . }ev SF, S4ac��o r-A SSzol <br /> E. DESCRIPTION <br /> Type Release: ll,,•de�yro.. <br /> Volume: <br /> Chemicals : _ P2'{vo(6�w �1l dve c.e.r�eow <br /> F. ACTION TAKEN y d ` - 1 <br /> S; � aS5 GSSw¢.n 1 w:\\ 6j .:� 'l" <br /> •tle_ <br /> ffQv�c�a.y Gcs,,.cy <br /> V <br /> sowces ov, ,-o <br />