Laserfiche WebLink
SAN JOAQUIN COUNTY. <br /> HARD LE COP y <br /> NOTIFICATION AYCWASTE ISC <br /> HTH&SFETE <br /> 25180.7 <br /> PHS-EH LOG# Off, ' 4� <br /> A. EMERGENCY LEVE I11 1 <br /> irc e one <br /> B. SOURCE OF INFORMATION <br /> Name: <br /> CIA(-'l 11141 UL Phone:��� �03 <br /> O � ?tJN�1 <br /> Company: ARLo pb <br /> Address: nrnkPlnoltilZ �f1VV Qk�MQ Phone ov �c7 —J 33S <br /> Designated Employee Name: <br /> Reporting Agency Name: N KA <br /> Address: <br /> C. LOCATION AND DATE OF DISCHARGE 4 <br /> y%55 s 4v--1 <br /> Location: (City or oun Circle one <br /> (Best Ph - alescnption) L( fM <br /> Date of Discharge: l 2 3 0l q ' <br /> Time: •371 4 M <br /> Date Notified: 12 4 0 Z <br /> i <br /> D RESPONSIBLE PERSONIBUSINESS <br /> P�+�l eu� <br /> •� Name of Business: r r4�R bo Phone: To 3. <br /> Contact Person: <br /> Physical Address: CID <br /> lo <br /> Mailing Address: ` u Lv PDI^ L D,4 LA- f M <br /> E. DESCRIPTION p neU' <br /> Type of Discharge: Z t A 6t I <br /> Volume: 1 • 1) ��� <br /> Chemicals: YAR per. <br /> Circumstances: <br /> -�1�a �e�j��al s91�-S Malar �� � Za CAL' FaS� <br /> F. ACTION TAKEN N e �.M' ,3 �'a"h <br /> of rel rt 1 iv C lt9A {.. s M +^ <br /> n T t <br /> raf� JA 1-v e D <br /> SITE DISPOSITION <br /> -up Gori e�6:14� V�wn gprfvd <br /> v4 vv v Pv" 4 N a0 <br /> r v N i <br /> EH 22 013 (Rev.08/20/98) <br />