Laserfiche WebLink
SAN JOAQUIN COUNTY <br /> NOTIFICATION OF HAZARDOUS WASTE DISCHARGE <br /> HEALTH & SAFETY CODE 25180.7 <br /> A. EMERGENCY LEVEL: I it III <br /> PHS-EH LOG <br /> ( ircle One) <br /> B. SOURCE OF INFORMATION <br /> _ Phone: a x/62 - /o q�l <br /> Name: <br /> Company: cc/c?c�/ <br /> Address: Phone: <br /> Designated Employee Name: <br /> Reporting Agency Name: SPS Zo I <br /> Address: <br /> C. LOCATION AND DATE OF DISCHARGE STocJGToi�f <br /> Location: (fir County) Circle One <br /> (Best Physical D scl. don) <br /> Date of Discharge 9ZI/ g 7,- <br /> Date Notified: q/�z/�YZ <br /> Time: <br /> D. RESPONS[BLE PERSON/BUSINESS ��i�� CocLEG c <br /> Name of Business: Sin/ `S Telephone. �) eJ2 50 3� <br /> Contact Person: o 2v <br /> Physical Address: <br /> Mailing Address: <br /> E. DESCRIPTION <br /> Type of Discharge: <br /> volume: G w <br /> Chemicals 6141 <br /> Circumstances: SEvE�7L �Fo/�GE EzPE ���� RSP <br /> lr� aQ a� %� Gv�NSn1CL/1�8i") lug/nl& 0 — <br /> i s ljEEnl EvAcv�>E/J vi`l`r� Z, <br /> F. ACTION TAKEN <br /> -Sc, A:cE OA <br /> SITE DISPOSIT:LO <br /> cv Y Zn/ BLESS of (�6RFoiA�ri/U� X612 <br /> - / 5ou PGE <br /> EH 22 013 (Rev.4/91) <br />