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�O n�� <br /> G. MANDATORY CONTACTS <br /> San Joaquin County Environmental Health Donna Heran —ILA <br /> -� ! <br /> rtment Time: 2 Date: )7'I <br /> San Joaquin County Board of Supervisors— Michael Cockrell / <br /> Contact—Office of Eme en Services Time: (,j; 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 /> f. 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 /> (Ap Nene) <br /> Signature: " CA:: <br /> %� <br /> Printed Name: Arts Cacapit <br /> Title: Senior Registered Environmental Health Specialist <br /> Date: Thursday, December 13,2012 Time: 3:45PM <br /> CO.' DTSC Site Code: <br /> CVRWQCB <br /> a 1�fl <br /> W l` TRA K U/te e <br /> I A./rly /' � ' v.��' Con MFR Yes No <br /> 14-7-7 1 II ie, 140Wi Sr Si C LA Referred: <br /> P,p l y i (aut <br /> III s��hA2 U&MY u-C C IV4 <br /> ou�rer< u I hL7 G tfe tll�lsbff.��cR <br /> Revised 08/02/12 Page 2 of 2 NOTIFICATION OF HAZ WASTE DISCHARGE <br />