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EHD LOG# <br /> G. MANDATORY CONTACTS <br /> San Joaquin County Environmental Health �/ T <br /> Department Donna Heran Time: 7� Date <br /> San Joaquin Joaquin County Board of Supervisors- Michael Cockrell Time: Date: <br /> Contact-Office of Emergency Services <br /> H. HEALTH AND SAFETY CODE 25180.7 <br /> N Any designated government employee who obtains information in the course of his official duties <br /> revealing the illegal discharge or threatened illegal discharge of a hazardous waste within the <br /> geographical area of his jurisdiction and who knows that such discharge or threatened discharge is <br /> likely to cause substantial injury to the public health or safety must, within seventy-two hours, disclose <br /> such information to the local Board of Supervisors and to the local health officer. No disclosure if <br /> information is required under this subdivision when otherwise prohibited by law, or when law <br /> enforcement personnel have determined that such disclosure would adversely affect an ongoing <br /> criminal investigation, or when the information is already general public knowledge within the locality <br /> affected by the discharge or threatened discharge. <br /> (c) Any designated government employee who knowingly and intentionally fails to disclose information <br /> required to be disclosed under subdivision (b) shall, upon conviction, be punished by imprisonment in <br /> the county jail for not more than one year or by imprisonment in state prison for not more than three <br /> years. The court may also impose upon the person a fine of not less than five thousand dollars <br /> ($5000) or more than twenty-five thousand dollars ($25,00(}). The felony conviction for violation of this <br /> section shall require forfeiture of government employment within thirty days of conviction. <br /> I. SIGNATURE DISCLOSURE <br /> I make this report on behalf of all designated employees of the County of San Joaquin, and <br /> San Joaquin County Environmental Health Department <br /> (Agency Name) <br /> Signature: <br /> Printed Name: <br /> Title: tnn <br /> Date: Time: -A4 <br /> cc: DTSC Site Code: <br /> CVRWQCB <br /> �I+Ll Oil ;>< 4aian t+"�: �C > ,dye f ia�or� Con MFR Yes No <br /> Referred: <br /> RC-,-bf- At,-r,> L_ay rte_ Pacheccs <br /> 2%S A 3� 4✓e Ck-kct� 4534o 1 <br /> ow/sex- Art+nur 6 t" rl1 DQ}req a-7,5-17 & Wv-d5 Rrf CscaJO4 qS.azo <br /> Revised 08/02112 Page 2 of 2 NOTIFICATION OF HAZ WASTE!DISCHARGE <br />