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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 304 East Weber Avenue, 3`d Floor, Stockton, CA 95202-2708 <br /> . P (209)468-3420•Fax: (209)464-0138 • We6: www.co.san-joaquin.ca.us/ehd �� <br /> k <br /> NOTIFICATION OF HAZARDOUS WASTE DISCHARGE # <br /> California Health & Safety Code, Section 25180.7 <br /> EHD LOG#: 0(o _D 7-0 <br /> A. EMERGENCY LEVEL 11 III <br /> (Circle One) <br /> B. SOURCE OF INFORMATION <br /> Name: BDb Ne w AAA nl Phone: (Za-7) 2 2 N I <br /> Company: S-�DvwG f Fi a2.F be �- <br /> Address: City: Zip Code: <br /> Designated Employee Name: <br /> Reporting Agency Name: <br /> Address: City: Zip Code: <br /> C. LOCATION AND DATE OF DISCHARGE <br /> Location: f I N A U �r, S- OG �'O+.I / (Cit r Count <br /> (Best Physical Description} ircle One) <br /> Date of Discharge: 10 B ] Date Notified: 16 8 6 C Time: (o - r A.M. P.M. <br /> D. RESPONSIBLE PERSON/BUSINESS <br /> Name of Business: Z A G 14 y FA 2M S L Ci <br /> Contact Person: ,Q p ti A&6 LAM M. P ra.e, � Phone: (2dq) Y9 -D12-17 <br /> Physical Address: fill N 4VV 0/-, City: S- 'OG kP of Zip Code: .AZO <br /> Mailing Address: L,� City: Zip Code: at <br /> E. DESCRIPTION <br /> Type of Discharge: L A <br /> Volume: VN k N 0 w <br /> Chemicals: A&�0"; 4 <br /> Circumstances: A i (e b VA l V e. C A t'S'e b <br /> F. ACTION TAKEN: S ,P, 0 M 4_f) E T1,C6 CC <br /> Dn S i beb v A cum <br /> SITE DISPOSITION: We 4 A - V-4 t e.:y <br /> Po v� rr� fv L r u <br /> EHD 22-02-003 Notification of Haz Discharge <br /> 10/2/2003 <br />