Laserfiche WebLink
SAN JUAQUIN CUUN l`Y <br /> i NOTIFIC1N OF I-IA'LARDOUS WASTE ,TARGE <br /> �- <br /> 1-WALTI-I & SAFETY CODE 2S18u / <br /> 1 <br /> ' A. , EMERGENCY LEVEL: IICo-D) -EH LOG # <br /> (Circle One)B. } SOURCE OF INFORMATIO UUU <br /> Original Source: Telephone: /S 72-.44 �f <br /> Reporting Agency Name: <br /> Agency Contact: Telephone: c( a 9)Y(o,P—L�/��a O <br /> 1= <br /> Address: P• 0. 9'er,-' a o n 9 , S�`o�� �� �� 9s eQ n / <br /> C. LOCATION AND DATE OF DISCHARGE <br /> i n C l�`{79nJ <br /> F Location: n JV. <br /> (Best Physical Description) (City or County) <br /> Date of Discharge: <br /> Date Notified: Time: <br /> D. RESPONSIBLE PE SO4/BUSINESS <br /> r " Name of Business <br /> Contact Person: Telephone: (,/S <br /> Physical Address 1 �1J GCJ; //B u) a SS Rc/. �u f foo , G°eviCd�c� <br /> E. " DESCRII'TION <br /> 9�sao <br /> Type Release: <br /> I <br /> Volume: <br /> Chemicals: <br /> N m <br /> F. ACTION TAKEN <br /> r <br /> ssP - o <br /> J <br /> EH 013 (Rev. 02/90) <br />