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J I <br /> G M„1NU 10f?y CUNIAC I; <br /> Joaquin County (� <br /> Local Health District: <br /> Contact_N a—m— <br /> ame Timc Date <br /> San Joaquin County n <br /> Board of Supervisors: <br /> Contact Name Time Oate <br /> li. HEALTH AND SAFETY CODE 4 25180.7. <br /> (b) Any designated government employee who obtains information in the <br /> co -se of his official duties revealing the illegal discharge or <br /> threatened illegal discharge or threatened illegal discharge of a <br /> hazardous waste within the geographical area of his Jurisdiction and who <br /> knows that such discharge or threatened discharge is likely to cause <br /> substantial injury to the public health or safety must. within <br /> seventy-two hours. disclose such information to the local Board of <br /> Supervisors and to the local health officer. No disclpsure of <br /> info,"ution is required under this subdivision when otherwise prohibited <br /> by law. or when law enforcement personnel have determined that such <br /> disclosure would adversely affect an ongoing criminal investigation. or <br /> when the information is already general public knowledge within the <br /> locality affected by the discharge or threatened discharge. <br /> (c) Any designated government employee who knowingly and intentionally <br /> fails to disclose information required to be disclosed under subdivision <br /> (b) shall . upon conviction. be punished by imprisonment in the county <br /> jail for not more than one year or by imprisonment in state prison for <br /> not more than three years. The court may also impose upon the person a <br /> fine of not less than five thousand dollars ($5.000) or more than <br /> twenty-five thousand dollars ($25.000). The felony conviction for <br /> violation of this section shall require forfeiture of government <br /> employment within thirty days of conviction. <br /> [ . SIGNATURE OISCLOSURL <br /> I make this report on behalf of all the designated employees of the <br /> County of San Joaquin . and the San Joaquin County Local Health District. <br /> aril <br /> ---Agency Name <br /> Signature: <br /> CQRwQc 3 — --- <br /> (( Typed Name: <br /> Title: <br /> Date: <br /> Revised 11-87 <br />