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0 <br />C. <br />Ie <br />0 SAN JOAQUIN COUNOY <br />NOTIFICATION OF HAZARDOUS WASTE DISCHARGE <br />HEALTH & SAFETY CODE 25180.7 <br />COPY <br />EMERGENCY LEVE40-1 II III PHS -EH LOG # X10 - c2 S t-1 <br />(Circle One) <br />SOURCE OF INFORMATION <br />Original Source: Nw-'l< >an,� Telephone: (Le�.) ZIK%! 1412,10 <br />Reporting Agency Name: ;Sn^2 1.1.1zil"N Irnux?l. Puf 6c YouN, - <br />Agency Contact: 4�,�) ,.,fi <br />Address: <br />LOCATION AND DATE OF DISCHARGE <br />Telephone: (2, 9 1162 —34V I <br />Location: JqW At, ,, r,, 0 CA - <br />(Best Physical Description) (City or County) <br />Date of Discharge: 044, -amu <br />Date Notified: I )-/0.3LO Time: S , SZ EM <br />RESPONSIBLE PERSONBUSINESS <br />Name of Business e -(C E2270,12 <br />Contact Person: /''1d4e Foc.,�Ire-^ Telephone: L4-) <br />) <br />Physical Address: l �{9`/ MGr' i.L cti i �—� i cr k;oi ('A <br />E. DESCRIPTION <br />Type Release: (�1A <br />Volume: U4 NiS w n) <br />Chemicals: Sgt ro Inyam four ,—c,4L.Ns <br />F. ACTION TAKEN <br />EH 22 03 (Rev. 7/89) <br />