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t <br /> ff SAN! JOAQUZN COUNTY iiGG <br /> NOTIFICATION OF HAZARDOUS: WASTE DISCHARGE., <br /> HEALTH & SAFETY CODE 25190.7 E <br /> i <br /> A. EMERGENCY LEVEL: I. I ITI HEALTH DISTRICT Lt3G I <br /> {Ciarcle One). , <br /> F3. SOURCE OF <br /> Tt+TFQRtA'II.t}.t�i.. <br /> I ter:i inial source <br /> Telephc►ne. { r <br /> ReP 5 A� nc.. ortib e : Name• <br /> Y <br /> xw - : Telephone; f <br /> Agency Contact. <br /> `1 <br /> C. LOCATION ;AND .DATE OF DISCHARGE <br /> Locations W* q1 <br /> (Best :Ph s1cal Description)` r {:Gxty or County) <br /> Date of Discharge: j <br /> if <br /> Date Tot].f ed: l l ` ! Timms c es JE. L <br /> D++ RESPONSIBLE PERSON/BUSINESS. <br /> f <br /> Name of Business <br /> 1 , <br /> Contact Person: Telephone: C � no <br /> Physical Address: 7 <br /> i E. DESCRIPTION <br /> Type Release: lzg4� It <br /> L <br />' Volume: <br /> Chemicals <br /> F, AST 'ON TAK <br /> , ,. <br /> ,, ;; . <br />