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• SALE! JOAOULN COUNTY <br /> NOTIFICATION OF HAZARDOUS WAS D(SC.-TARGE FILE COPY <br /> HEALTH & SAFETY CODE 25180.7 <br /> A. EMERGENCY LFfEL.CIL III <br /> PHS-EH LOG # �9 - 12 a <br /> (Circle One) <br /> B. SOURCE OF (NFOR.ti1ATI NPhone: 'D r 00 <br /> Name: a C) b K <br /> Company n � <br /> Address: Phone: (2L0*19-3VI-2.Y <br /> Designated Employee Name: t t li ' <br /> Reporting Agency Name: <br /> Address: <br /> C. LOCATION AND DAA OF DISCHARGE �_ <br /> Location: o Couon: �� L� ''t <br /> (Best Physical Descripnon) <br /> (/ nty Circle One <br /> Date of Discharge: <br /> Date Notified: �y Time: <br /> p. RESPONSIBLE PE.-',SON/BUSLNiESS <br /> EA <br /> Name of Business: 1CL,13� Te 33 3 1r In CJ <br /> Contact Pe-rson: c> ephone: c <br /> Physical Address: Lf. <br /> ylailing Address: 1'r U <br /> E DESCRIPTION <br /> Type of Discharger <br /> Volume: 11 r2 <br /> Chemicals: Q <br /> Circimstances: �_ <br /> Q � <br /> ACTION TAKENEET <br /> G <br /> o - <br /> SiTE_STATUS <br /> r <br /> EH 22 013 (1,7,ev.4/91) <br />