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END LOG# -� <br /> G. MANDATORY CONTACTS <br /> San Joaquin County Environmental Health <br /> Department Donna Heran Time: Ll,lj' Date: I0-Z7rj <br /> San Joaquin County Board of Supervisors— r <br /> Contact—Office of Eme en Services Michael Cockrell Time: LI ,�jI Date: <br /> H. HEALTH AND SAFETY CODE 25180.7 <br /> (b) Any designated government employee who obtains information in the course of his official duties <br /> revealing the illegal discharge or threatened illegal discharge of a hazardous waste within the <br /> geographical area of his jurisdiction and who knows that such discharge or threatened discharge is <br /> likely to cause substantial injury to the public health or safety must,within seventy-two hours, disclose <br /> such information to the local Board of Supervisors and to the local health officer. No disclosure if <br /> information is required under this subdivision when otherwise prohibited by law, or when law <br /> enforcement personnel have determined that such disclosure would adversely affect an ongoing <br /> criminal investigation, or when the information is already general public knowledge within the locality <br /> affected by the discharge or threatened discharge. <br /> (c) Any designated government employee who knowingly and intentionally fails to disclose information <br /> required to be disclosed under subdivision (b) shall, upon conviction, be punished by imprisonment in <br /> the county jail for not more than one year or by imprisonment in state prison for not more than three <br /> years. The court may also impose upon the person a fine of not less than five thousand dollars <br /> ($5000) or more than twenty-five thousand dollars($25,000). The felony conviction for violation of this <br /> section shall require forfeiture of government employment within thirty days of conviction. <br /> I. SIGNATURE DISCLOSURE <br /> I make this report on behalf of all designated employees of the County of San Joaquin, and <br /> San Joaquin County Environmental Health Department <br /> (Agw.y Name) <br /> Signature: 64//,9 <br /> Printed Name: Garrettckus <br /> Title: Senior Registered Environmental Health Specialist <br /> Date: I d--2 3 /3 Time: C}.30 j .__ <br /> cc: DTSC Site Code: <br /> CVRWQC13 <br /> �� r7f �� Con MFR Yes No <br /> fuGj{10e- 1500d MQ,✓f/ Referred: <br /> A�t� �sM�ihalof n/I�+aye,- <br /> it(0 e 44 4 , (JI-hroP, e'19 <br /> past- (A� Cwky?Le �GLL , <br /> (AIrn1 Lu 4tbr,(- 6,11, Hedd,," 1A <br /> Revised 08/02/12 Page 2 of 2 NOTIFICATION OF HAZ WASTE DISCHARGE <br />