Laserfiche WebLink
� • �� _ dye <br /> 0 '.Lv\DATO PLY C0NtTA io <br /> Fub[ic ;frith S -vices or San Joaquin County <br /> caviroameaml Health Divisiaa: l7enn c` �/e�c 1 - <br /> (Conmcc Name) Time) (Dart) <br /> San Joaquin Counr; <br /> Board of SucermorS: /Tic —GL7 <br /> (Coerac Name) (Time) (Date) <br /> [4:E>L.TH A&ND S.ktc[Y CODE Zj[30.7 <br /> b) Aay designated government amoiovee%%:ho obeias information in tie caurse or his otaesl dudes <br /> reveling the illegal discharge or t uvo- - d illeal discharge of a ba=rdnus w—e wtain tie <br /> geog -phiei[ arc of his jurisdiction and .who lciows ±-C such z scharge or dzrcuead discim-M-2 <br /> is tile_-,y ro ^usa mostandz[ injury to to public health or s¢tcv must wirhia smeary wo hours. <br /> disc!cse sura iaiormarion co -tie lccl Board of Super Tsars and to tie loci Health Ota . No <br /> disc!osum of jr ormaaoa is wird ander :his subdivision when odiernise orobibicd by lav; or <br /> when txw o-*rc=cat prs <br /> eoanei have dt•-^Bind :hat sura disc;osure would adversely an= <br /> ongoing crmiml invesapaoa. or wEea die mforraaaairc <br /> oa is dy general oubiic caowidge <br /> within the !oclity aa'ea-ea by tie disci:z�e or trea=d dischm?e. <br /> c) env desiS=md govemmeat amolav= who :crowinev and inteadaaafly ails to disclose <br /> infera=oa _uirai :c tie disc!osd unce.-subdivisioa tb)shall. upoa coavidon. 'Ce vuaisaed by <br /> imoriso=t=r a tie ccunr,. ;ail :or roc -era ma one ;z=r or by iamrisoamear in i...T orison or <br /> not ,,more an zr a vers. i ne cur=v also Lraucscucoa:he person a ane of acc[ess dz;m Eve <br /> aousand iciLzs M.000) or more tvens;r ave thousand dolls (S'�.000). :tie feionv <br /> croavicam :or 'rioianan of chis setion i:._t »'Uir_ rcrmZ alrC or 3ovm=cnt em[ovmeat within <br /> airty days (:0)of coavidoa. <br /> L Sift Ai�R D[SCLOSLRE <br /> [ .:.alce Bis _-pert on oe^ if of ail die des; td ^ptoyrs of to Couary of San foaquixz ad <br /> (_mac_•Name) <br /> Signaai+e: <br /> Tvved/Printed NameO <br /> Title: rt'�FiS <br /> Dare: /i /f -lam iUc. OL y0 <br /> 0-os- s,=- SI:STCODE.-. 73aD - <br /> /ew-Q r.a 4Ta nE) CONLV it R(V N <br /> Ars C_ x—C--—r—Lqm To: <br /> [)I- (Rev. 03/30/93) <br />