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A G. MANDATORY CONTACTS Public Health Services ) of San Joaquin County Environmental Health Division: f7J ) I 1 San Joaquin County (Contact Name) Board of Supervisors:Ic I (Contact Name) / 1 L HEALTH AND SAFETY CODE S 2518 • LD (Time) (Date) (Time)"' (D (b) 0.7. Any designated government employee who obtains information in the course of his duties revealing the illegal discharge or threatened illegal discharge of a hazardous wast within the geographical area of his jurisdiction and who knows that such discharge or t official threatened discharge is likely to e within seven y cause substantial injury the ty two hours, disclose such information to heolocal Board of Supervisors and to the local health officer. No disclosure of information is requiredunder this hsubdor safety must, otherwise prohibited by law, or when law enforcement personnel have determined that such disclosure would adversely affect an on g vision when ahead oin criminal investigation, or when the information is y general public knowledge within the locality affected by the discharge or threatened discharge. (c) Any designated government employee who knowingly and intentionally fails to disclose to the information required disclosed under subdivision b s by imprisonment in the county jail for not more than one year or by imprisonment in state () hall, upon conviction, be punished prison for not more than three years. The court may also impose upon the person a fine of not less than five thousand dollars ($5,000) or more than twenty-five thousand person ($25,000). The felony conviction for violation of this section shall require forfeiture of government employment within thirty days of conviction. 1. SIGNATURE DISCLOSURE I make this report on behalf of all the designated employees of the County of San Joaquin, and ,' r (Agency Name) Signature: r1, 1 f,{ Typed Name: Title: _ P r--« Date: 2j0=s ,4n Time: ')-n cc: U H S EI -1 22 03 (Rev. 7/89)