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PUBLIC HEALTH SERVICES <br /> SAN JOAQUIN COUNTY <br /> JOGI KHANNA M.D.,M.P.H. 4 <br /> Health Officer <br /> P.O. Box 2009 . (1601 East Hazelton Avenue) Stockton,California 95201 <br /> 9CiFoati. <br /> (209) 468-3400 <br /> PERSONAL TOXIC SUBSTANCE EXPOSURE RECORD <br /> * Substances not considered to be a cancer risk at this time may <br /> be defined as a carcinogen in the future. Cancer and cancer- <br /> related diseases may take 5-30 years to develop in humans. <br /> * Individuals who are exposed (suspected or confirmed) at an <br /> emergency response incident should document the specifics <br /> of the exposure within 24 hours and mail or phone in this <br /> information to the Environmental Health Division at the <br /> letterhead address above. <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> EH 22 020 5/90 <br /> A Division of San Joaquin County Health Care Services <br />