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SAN JOAQUIN COUNTY <br /> NOT_. __DATION OF HAZARDOUS WASTE L.SCHARGE <br /> HEALTH & SAFETY CODE 25180.7 <br /> (COF)Y <br /> A. EMERGENCY LEVEL: I�j I III PHS-EH LOG # '75-16-3 <br /> 6-3 <br /> (Circle One) <br /> B. SOURCE OF INFORMATION <br /> Name: 3z-Z_ 2ZOPhone: 2ZG7o- 5�c <br /> Company:_ ecovU�S Co�•�A y <br /> Address: 70z-60 S F- <br /> Designated Employee Name: Phone: �) <br /> Reporting Age Name: <br /> Address: _ - o; Avg,C. LOCATION AND DAT OF DISCHAR E <br /> Location: 3Z�Z- DaG/� /� / S <br /> (Best Physical :es i riptign) r County) Circle One <br /> Date of Discharge: vow l <br /> Date Notified: 30 Time: �: ��g••t <br /> D. RESPONSIBLE PERSON/BUSINESS <br /> Name of Business: vG: <br /> Contact Person: r314-1— Telephone: c4 70 <br /> Physical Address: <br /> Mailing Address: 10o. 3a o X27 s c 90 7oZ - 60-S ' <br /> E. DESCRIPTION <br /> Type of Discharge: s � � <br /> Volume: , j. G- <br /> Chemicals: 6s <br /> Circumstances:�,,2. 7�M - 0��4 soiG �o ;�-� 7Z, - ,O <br /> F. ACTION TAKEN <br /> SITE DISPOSITI N <br /> EH 22 013 (Rev.4/91) <br />