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SAN JOAQUIN COUNTY <br />NOTIF&TION OP HAZARDOUS WASADISCI-fARGE <br />HEALTH & SAFETY CODE 25180.7 <br />"a -S, <br />EH 22 03 (Rev. 7/89) <br />A. <br />EMERGENCY LEVEL: II III <br />"IPHS-EH LOG # <br />(Circle One) <br />B. <br />SOURCE OF INFORMATION <br />Original Source: QOM M /1_ RA Ll � N 0 <br />Telephone. <br />Reporting Agency Name:An/ <br />o <br />Agency Contact: 1 ti , LS6t. <br />Telephone• ���=3�i 2-vo <br />Address: 0, 66 <br />C. <br />LOCATION AND DATE OF DISCHARGE /Y/ ,- 41 Di7,! f N G <br />Location: rl%Syu, �eGoNc� s� <br />/ S?o6() %5m G <br />(Best Physical Description) <br />(City or County) <br />Date of Discharge: <br />Date Notified: - /(�—�— p <br />Time: 06 kl,,� <br />D. <br />RESPONSIBLE PERSON/BUSINESS <br />Name of Business (VI -, ILl <br />o N� c7p2 <br />Contact Person: �_NI AR- GLI'ANO <br />Telephone: <br />Physical Address: r17 W .� �{ <br />,(T ����-yon✓, G %SSD 6 <br />E. <br />DESCRIPTION <br />Type Release: <br />Volume: _ V-AIKh.o„ir <br />Chemicals: ae:Y'o L a lA w L � o/r o cAR� o ^ls <br />F. <br />ACTION TAKEN <br />ro <br />"a -S, <br />EH 22 03 (Rev. 7/89) <br />