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SAN JOAQUIN COMM <br /> NOT* <br /> OT ATION OF 1-IAGARDOUS WA.,_L DISCHARGE <br /> I-IEALTl-I & SAFE'T'Y COIL 25180.7 <br /> COPY <br /> A. EMERGENCY LEVEL:CI 11 III PHS-EH LOG # _gyp-.-2 7 <br /> (Circle One) <br /> B. SOURCE OF INFORMATION <br /> Original Source: Telephone: 4/( 6 ) 3 6 G-/70 <br /> Reporting Agency Name: S=1,1 (x.R W. , LCLO4(r P��Lf;c <br /> Agency Contact: �/eu /o/ Telephone: zo <br /> Address <br /> C. LOCATION AND DATE OF DISCILARGE <br /> Location: <br /> (Best Physical Description) (City or County) <br /> Date of Discharge: err �ria�o <br /> t*' Date Notified: -___:5- Z y_9v Time: <br /> D. RESPONSIBLE PERSON/BUSINESS <br /> Name of Businesso� <br /> Contact Person: �r���'.i /'Iclvti Telephone: d7 71``15"- CG S / <br /> Physical Address: '. 0• ox <br /> E. DESCRIPTION <br /> Type Release: <br /> Volume: <br /> Chemicals: <br /> F. ACTION TAKEN <br /> s 'orv�ii�s a C�� t✓trt' /nS/f����G� � ��� /�G�/r� �1�� � <br /> / <br /> ��4�" �T ) / /j J� �'� I /✓l //G <br /> JI1<�o'7C 9 r i'Nf. Y7' ` - LY^✓.F <br /> nuc i ir�1r.->�s <br /> r iro i i <br /> m r'©�77'i2Ji'rt D// <br /> r Jr� � aioroor/a 71r <br /> ETI 22 013 (Rev. 02/90) <br />