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SAN JOAQM COUNTY <br /> OFFICE OF EMERGENCY SERVICES r , <br /> VIOLATION REFERRAL SHEET AUS 3 0 <br /> ENVIRONMEN - <br /> his form is to be used to document details of noted violations and to track A5w&61�*y <br /> ppropriate agency and the District Attorney's Office. Write clearly or type and keep a copy with tht <br /> appropriate business tile. The Hazardous Material Specialist Supervisor responsible for referrals <br /> hould be verbally briefed as soon as practical after noting the violation(s) and should be given this <br /> heet for review and proper referral. <br /> SECTION L <br /> BACKGROU2ID IN FORS IATION, <br /> Location of Noted Violations:. <br /> Name of Business or Responsible Party, if known: Ne 1 fit. ' `L�)Cr <br /> Date/Time that violadon(s) were noted: �S/2 3�q <br /> Name of Specialist making this report:. - I �C l' '� 'C' <br /> SECTION 2 <br /> DESCRIPTION OF SITUATION <br /> Describe in detail what you saw, heard, or smelled and the circumstances that put you in the area of <br /> (possible violation(s). List applicable section(s) of Fode(s) if known. Attach additional sheets if nec- <br /> essary. Cx vc�.�.cett�c�� �" s�ret�o„ cL� ewe `vCvci - <br /> �tVo 55 c.0. QYA C3+' <<vnS ctaiS�.6E. 4r C1 0.^( Il�T <br /> LKlwa, '• t �(�on I� IcSC � �nS�eGftc�1 <br /> t Cl`C, I..JGrC, lr\l.\Y1\C1`O CIS t.Vll(�'�l <br /> a tV"} ehefcv-I0r C42 41-te burldist <br /> SECTION 3 <br /> REFERRAL INFORMATION <br /> Name of Supervisor and Time received Referral: <br /> Name of Aeencies sent a copy and date: <br /> �', � �isr��cy/�T7D��v6� ��i✓irrE /�.U7liLi��/ <br />