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I ) )-i) <br />�� J✓' SAN JOAQUIN COUNTY <br />NOTIFICATIAOF HAZARDOUS WASTE DISJ�RGE <br />HEALTH & SAFETY CODE 25180.7 <br />A. EMERGENCY LEVEL:Pircle <br />II III PHS -EH LOG # <br />One) <br />B. SOURCE OF INFORMATION 3q 6 Z <br />Original Source: TfiG[ 1 Telephone: 01-7 l-L,�- 351 <br />3 oi�GoRE 2 a J1U /zhrrc,41 coPWOVI c c75 <br />Reporting Agency Name: <br />Agency Contact: �� Z - !226 f� Telephone: <br />Address: 4W 5 c% Ate aiJ our [J sT Smc ro[� c� 4 Z <br />C. LOCATION AND DATE OF DISCHARGE GGFi��F�I,T'S <br />Location: Znq 1-3; <br />e #{ ly l <br />(Best Physical Description) (City or County) <br />fo <br />E. <br />F <br />Date of Discharge: <br />Date Notified:,//�f �l / <br />Time: <br />RESPONSIBLE PERSON/BUSINESS <br />Name of Business �z [ E/�T <br />Contact Person: �/1 <br />i l 04-P 13F_Q Telephone: (�) '�'� `f <br />Physical Address: �4no ' AOAT4444 RrvM <br />DESCRIPTION <br />Type Release: nlAvrtf04fL <br />Volume: t'*4 lG dwLl <br />Chemicals: _ S 4- [ a� <br />ACTION TAKEN <br />e- <br />UST <br />o�J'�n�Nec�( lJ�/�Nc� UST (�e.rvvl` <br />�v�L rte( S///Y�Qo �lr�ic�T <br />/nIA'Tlot/ w �L L /3E /)UGiJi <br />a,j TE! v�A2 2E�o�TI��r/� r¢aJiJ TD ccxCTiJ�t/N�4T� s�TE <br />n.An-�4- BASE &i.eTNE�2 znr vE5'r/�/'-Troy/ �o /PFiYEDZ+�-T/O/J <br />EH 22 013 (Rev. 02/90) <br />