Laserfiche WebLink
SAN JOAOUIN COUNTY <br /> NOTIFICATION OF HAZARDOUS WASTE DISCHARGE <br /> HEALTH & SAFETY CODE 25180.7 G <br /> A. EMERGENCY LEVEL: <br /> (Circle One) I III PHS-EH LOG # <br /> B. SOURCE OF INFORMATION <br /> Original Source: <br /> ,phone: <br /> Tutt. <br /> Reporting Agency Name: /a,nv��/ 1, �, etc lh <br /> Agency Contact: �,m o ��;r�o Telephone: ,do `//n 7 —� <br /> Address: /C/sv r )� „ <br /> ,4 9 ,�pi <br /> C. LOCATION AND DATE OF DISCHARGE <br /> Location: /oso <br /> (Best Physical Description) (City or County) <br /> Date of Discharge: //.- <br /> Date Notified: _ /, „z/s2_ Time: <br /> D. RESPONSIBLE PERSON/BUSINESS <br /> Name of Business z�no�� <br /> Contact Person: C� Telephone: <br /> Physical Address: �c,�,,/ <br /> E. DESCRIPTION <br /> Z�r <br /> Type Release: Z}le x e <br /> Volume: <br /> Chemicals: <br /> F. ACTION TAKEN <br /> l�Ali <br /> EH 22 03 (Rev. 7/89) <br />