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SAN JOAQUIN COUNTY " <br /> NOTIFICATION OF HAZARDOUS WASTE DISCHARGE <br /> HEALTH & SAFETY CODE 2.7 <br /> A. EMERGENCY LEVEL: II III PHS-EH LOG # <br /> (Circle One) <br /> B. SOURCE OF INFORMATION <br /> Original Source: & O.� Telephone: 4( /i)" a9�"54 <br /> Reporting AgenName: - Pub )�.�/LUZCPiT �G/t✓- <br /> Agency Contact: Telephone: <br /> Address: 44 9 !� <br /> C. LOCATION AND DATE OF ISCHARGE <br /> Location: /05Ds <br /> (Best Physical Description) l <br /> (City or County) <br /> Date of Discharge: <br /> Date Notified: Time: <br /> D. RESPONSIBLE PE SONBUSINESS n. <br /> Name of Business da Ad Ai I G amu= <br /> Contact Person: cPt_ / Telephone: Lzt — <br /> Physical Address <br /> E. DESCRIPTION <br /> Type Release: G u a� C2�ia U,a�r�oti&u� d LL <br /> Volume: <br /> Chemicals: � � � <br /> F. ACTION TAKEN <br /> J,al{l90OVu (A eL4�AAVfit�4 <br /> Act <br /> L71 4k Akio <br /> EH 22 013(Rev. 02/90) O Fly <br /> �Iv <br />