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• SAN JOAQUIN COUNTY 0 <br /> NOTIFICATION OF HAZARDOUS WASTE DISCHARGE <br /> HEALTH & SAFETY CODE 25180.7 <br /> A. EMERGENCY LEVEL:011I III PHS-EH LOG # <br /> (Circle One) <br /> B. SOURCE OF INFORMATION <br /> Original Source: .5oW sago%s Telephone: <br /> Reporting Agency Name: i o¢r-u-� Ou 6/Ic /mea/fes Sri✓ccs <br /> Agency Contact: a/ oe-- Telephone: ,2� YJ- - 3 y <br /> Address: Av, D�- <br /> C. LOCATION AND DATE OF DISCHARGE <br /> Location: C 6 <br /> (Best Physical Description) (City or County) <br /> Date of Discharge: <br /> Date Notified: Els/moi Time: <br /> D. RESPONSIBLE PERSONBUSINESS <br /> Name of Business — --Z1 <br /> Contact Person: 6, e-, . Telephone: jam! <br /> Physical Address: Z Ste. 2-,w� ,, (7q <br /> E. DESCRIPTION <br /> Type Release: <br /> Volume: <br /> Chemicals: <br /> F. ACTION TAKEN <br /> EH 22 013(Rev. 02/90) <br />