Laserfiche WebLink
- <br /> 1 Y <br /> SAN JOAQUIN COUNTSOW <br /> NOTIFICATION OF HAZARDOUS WASTE DISCHARGE <br /> HEALTI-I & SAFETY QPDE.25180.7 <br /> A. EMERGENCY LEVE I II III PHS-EH LOG # 9 <br /> (Circle One) <br /> B. SOURCE OF INFORMATION <br /> Original Source: �106,4• &'f" _ Telephone: <br /> Reporting Agency Name: &Ilc Ps ti 414 - <br /> Agency Contact: P641 Telephone: (,26,?a ' <br /> Address: 137)v- .2ncri C4 915�0 <br /> C. LOCATION AND DATE/OF DISCI-TARGE <br /> Location: - X S�- -� <br /> (Best Physical Description) (City or County) <br /> Date of Discharge: <br /> Date Notified: ,4406,(qp Time: - 10/05 A.M. <br /> D. RESPONSIBLE PERSON/BUSINESS <br /> Name of Business w cxr� <br /> Contact Person: �lve_ [',�,-� _ Telephone: <br /> Physical Address: w� +? 0 e v <br /> E. DESCRIPTION <br /> Type Release: f . <br /> Volume: :,A +W^s <br /> Chemicals: �Arboas <br /> F. ACTION TAKEN <br /> r •��. d �a s Zb �Od c c�i Pse/l fad z p •, �JOvct 4 Odv <br /> c9i uN D- O u/Pr�l Sd-' �s /sv /-� 6e�ti •..,� ti�lK <br /> CJ c+� �tiS N / /✓[7T/G'/V C /dJ�l!/Yrf C!%/' art/ . <br /> 01Vd t- LILA�;/ /dam 5 <br /> Er I 22 03 (Rev. 7/$9) <br />