Laserfiche WebLink
0 SAN JOAQUIN COUNTY 6 <br /> NOTIFICATION OF HAZARDOUS WASTE DISCHARGE <br /> HEALTH & SAFETY CODE 25180.7 0 n <br /> A. EMERGENCY LEVEL: I II III PHS-EH LOG <br /> (Circle One) <br /> B. SOURCE OF INFORMATION <br /> Name: a7u Phone: / f-;2 6'16y <br /> Company: f <br /> Address: SDS/ 5 6 <br /> Designated Employee Name: Phone: <br /> Reporting Agency Name: <br /> Address: <br /> C. LOCATION AND DATE OF DISCHARGE <br /> Location: /5615 �5- 5Et16W7# Z7- / P <br /> (Best Physical Description) City or County) Circle One <br /> Date of Discharge: &114 niQu Al' — <br /> Date Notified: 5•2Y 93 Time: �a +. <br /> D. RESPONSIBLE PERSON/BUSINESS �7 � /lfi9�KET <br /> Name of Business: ��ii/657UnS/ /7,.// ",, <br /> Contact Person: . /f1.2. SES �.�it/6 �/ Telephone: <br /> Physical Address: /S6/S s �SEdEn/rti s7� LfQDP C'�1 <br /> Mailing Address: P0. 4t 9S33b <br /> r <br /> E. DESCRIPTION <br /> Type of Discharge: <br /> Volume: u��vouOnl — <br /> Chemicals: E T c <br /> Circumstances: <br /> F. ACTION TAKEN:GJ '.5 <br /> �t-�srysF {�,e �J G Ts u� �rtdc�u.Ez7� Gws�dh�7eiv <br /> rF �C'UQt6syTt< i9Cnvr� i iNrCEsriFA�in/G <br /> �c�,u7- c �v�-�r�,�6 0� cd�✓v�x��/�rr�u �Ndc� <br /> GcX'ia-L <n�,aLcrn�;���< ops/ter. <br /> SITE DISPOSITION. r � <br /> v <br /> EH 22 013 (Rev.4/91) �-� o� UGTs• <br /> GG� CDGµ� '�OOOi—Z'L3 93 . <br />