Laserfiche WebLink
SAN JOAQUIN COUNTY p DP <br /> z L.. JIRONMENTAL HEALTH DEPART .,ENT <br /> N. { <br /> 600 E.Main Street, Stockton,CA 95202-3029 <br /> Telephone:(209)468-3420 Fax:(209)468-3433 Web:www.sjgov.org/ehd <br /> o ' \ <br /> NOTIFICATION OF HAZARDOUS WASTE DISCHARGE <br /> California Health & Safety Code, Section 25180.7 <br /> EHD LOG#: <br /> A. EMERGENCY LEVELkI II III <br /> (Circle One) <br /> B. SOURCE OF INFORMATION <br /> Name: R 16� 60GS C+�- Phone: (714 .5!°1 -!U <br /> 23 <br /> Company: 19 P <br /> Address: P. O. qD>c (o O 3 9 City: 4 r Zip Code: CIO- <br /> 707-Designated Employee Name: q M 7Nh Uvp\j F(LA_� <br /> Reporting Agency Name: S x G E <br /> Address: _�" Lc. MA I Tj ?+ City: Zip Code: �rS'ZOz <br /> C. LOCATION AND DATE OF DISCHARGE I <br /> Location: I &j)�A �/--. �T'6G zk-\ / Ci r Count <br /> (Best Physical Description) ircle One) <br /> Date of Discharge: 2 ( Z Date Notified: 2 11-7 ( 2— Time: 7 V Ly� A.M. e.M. <br /> D. RESPONSIBLE PERSON/BUSINESS <br /> Name of Business: U 0 lL�c3wi. <br /> Contact Person: Phone: ( ) <br /> Physical Address: City: Zip Code: <br /> Mailing Address: City: Zip Code: <br /> E. DESCRIPTION rr <br /> Type of Discharge: O V I'f It l �-VM �O PPS r� rr�' OIX �AA k_ <br /> Volume: I <br /> Chemicals: V C f <br /> Circumstances: D I S� <br /> F. ACTION TAKEN: 4t.-6&A_ SA <br /> eA 6/' 4 n r- 4 k N, <br /> SITE DISPOSITION: 1J\ f z4r v <br /> EHD 22-03 Notification of Haz Discharge <br /> 11/26/2007 <br />