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q I e o <br /> G NLSNDATORY CONTA( <br /> Public Health Services lor4 �^ <br /> of San Joaquin County ki `o����� i 0 . G] vlJ <br /> Environmental Health Division: <br /> (Contact Name) (Time) (Date) <br /> 1 San Joaquin County1,�� <br /> Board of Supervisors : <br /> �7 , 2CGC <br /> (Contact Name) (Time) (Date) <br /> H HEALTH AND SAFETY CODE S 25180. 7. <br /> (b) Any designated government employee who obtains information in the course of his official <br /> duties revealing the illegal discharge or, threatened illegal discharge of a hazardous waste within <br /> the geographical area of his jurisdiction and who knows that such discharge or threatened <br /> injury to the public health or safety must, within seventy- <br /> discharge is likely to cause substantial <br /> two hours, disclose such information to the local Board of Supervisors and to the local health <br /> officer. No disclosure of information is required under this subdivision when otherwise prohibited <br /> by law, or when law enforcement personnel have determined that such disclosure would <br /> alversely <br /> public <br /> affect an ongoing criminal investigation, or when the information is already , P <br /> knowledge within the locality affected by the discharge or threatened discharge. <br /> (c) Any designated government employee who knowingly and intentionally fails to disclose <br /> information required to the disclosed under subdivision (b) shall, upon conviction, be punished <br /> by imprisonment in the county jail for not more than one year or by imprisonment in state prison <br /> for not more than three years. The court may also impose upon the person a fine of not less than <br /> five thousand dollars 05 , 000) or more than twenty-five thousand dollars 025,000) . The felony <br /> conviction for violation of this section shall require forfeiture of government employment within <br /> thirty days (30 ) of conviction. <br /> Is SIGNATURE DISCLOSURE <br /> I make this report on behalf of all the designated employees of the County of San Joaquin, and <br /> (Agency Name) <br /> Signature: <br /> Typed/Printed <br /> Title : S <br /> Date : 10 S — j Time' <br /> cc: � X J SWEEPS#/SITE CODE# : <br /> t14L <br /> �� i�f?1 ) CONMFR`� N <br /> / REFERREDTO : <br /> EH 22 013 (Rev. 4/91 ) <br />