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SAN JOAQUIN COUNTY _ �,f <br /> Z z L /IRONMENTAL HEALTH DEPAR'_ ENT l <br /> 600 E.Main Street, Stockton, CA 95202-30292 5 <br /> P Telephone:(209)468-3420 Fax:(209)468-3433 Web:www.sjgov.org/e <br /> 4�IFORa <br /> NOTIFICATION OF HAZARDOUS WASTE DISCHF' `: r <br /> California Health & Safety Code,Section 25180.7 cs <br /> EHD LOG#: 150 <br /> A. EMERGENCY LEVEL II III <br /> (Circle One) <br /> B. SOURCE OF INFORMATION <br /> Name: Co �3eS�--� Phone: � `�6�- D33c( <br /> Company: re-p 914 1!^[ <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: n er` I�-b, Cit o Count <br /> (Best Physical Description) (Circ <br /> Date of Discharge: U M VAD" Date Notified: Time: 3' A.M. P 1 <br /> D. RESPONSIBLE PERSON/BUSINESS <br /> Name of Business: y 1!5 1 � en co'L F At P� <br /> Contact Person: Rill U1 S I PJ1z&\R, Phone: QOT C*9 — 66 I <br /> Physical Address: _791'I S" AY)Cri5&PL__City: SVZLIG{&-\ Zip Code: CiS_2l <br /> Mailing Address: K k City: K Zip Code: l` <br /> E. DESCRIPTION <br /> Type of Discharge: T g4gLU of`i S pp���i.-, 4D Sol L <br /> Volume: U 1 j Know: <br /> Chemicals: 2 � <br /> Circumstances: in i t- d <br /> A 6cr2, Dov NcZ � M �4 R iL i C D e V_L <br /> F. ACTION TAKEN: y-as <br /> SITE DISPOSITION: p AA L/0 O U l� <br /> EHD 22-03 Notification of Haz Discharge <br /> 11/26/2007 <br />