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=*1 <br />A. <br />10 <br />C. <br />0 <br />E. <br />F. <br />SAN JOAQUIN COUNTO) <br />NOTIFICATION OF HAZARDOUS WASTE DISCHARGE Y' <br />HEALTH & SAFETY CODE 25180.7 <br />EMERGENCY LEVEL: 6) II III PHS -EH LOG # - _T/ -//6o <br />(Circle One) <br />SOURCE OF INFORMATION <br />Agency Contact: <br />Address: <br />,Jet,P Telephone: y7Z06 <br />/Voi t/�1rud/5��, L(l.S ,9S6Y/ <br />ame: <br />Telephone: ( <br />LOCATION AND DATE OF DISCHARGE - / <br />Location: 3 z& Wa&x— ,YX- / 5VecIt- 2�7f <br />(Best Physical Description) rty r County) <br />Date of Discharge: <br />Date Notified: _ <br />RESPONSIBLE <br />Name of Business 6&67z!�Q lga-4 <br />Contact Person: Telephone: (209) 23-2 Z <br />Physical Address: �� s tU.µo( o eci ��► 93a3 0 <br />DESCRIPTION'K <br />Type Release: �-ea <br />Volume: <br />EH 22 013 (Rev. 02/90) <br />