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mac . <br /> SAN JOAQUIN COUNTY NOTIFICATION OF HAZARDOUS WASTE DISCHARGE <br /> HEALTH & SAFETY CODE 25180 . 7 Cal <br /> A. EMERGENCY LEVEL: II III HEALTH DISTRICT LOG # <br /> (Circle One ) , ) <br /> B. SOURCE OF INFORMATION 0 <br /> Original Source: 1MAl t �� �GtJ <br /> CL Telephone: <br /> Reporting Agency//Name: 5 .1 L . A, 6. <br /> Agency Contact: Telephone: ( 269) 4/6(Y-3V-20 <br /> Address: Z001 , <br /> C. LOCATION AND DATE OF DISCHARGE <br /> Location: I�730 LdWPIy&Cht✓�wi» o / LOL7 <br /> (Best Physical Description) (City or County) <br /> Date of Discharge: 112 <br /> Date Notified: 3 /6 88 Time: <br /> D. RESPONSIBLE PERSON/BUSINESS <br /> Name of Business LleuTq B <br /> Contact Person: Telephone: ( Z,01�) <br /> Physical Address : OSS <br /> E. DESCRIPTION <br /> Type Release: LQ „r ��.�•f. T. <br /> Volume: L <br /> Chemicals : ZtrLN wlx.. <br /> V <br /> F. ACTION TAKEN <br /> OA( t�t Q tlu <br />