Laserfiche WebLink
_, ".` ,�: %7 <br />SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />�> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br />` (209) 468-3420 - Fax: (209) 464-3433 - Web: www.sogov.org/ehd <br />NOTIFICATION OF HAZARDOUS WASTE DISCHARGE <br />A. EMERGENCY LEVEL III E H D LOG# <br />R- SOIJRCF OF INFORMATION <br />NAME: <br />Q a4MK Lp, <br />PHONE: <br />I Zeq- I• 5,S <br />COMPANY: <br />C6 N a— <br />CITY: <br />PHYSICAL ADDRESS: <br />ADDRESS: <br />"j o, <br />DESIGNATED EMPLOYEE NAME: <br />PHONE: <br />REPORTING AGENCY NAME: <br />San Joaquin County Environmental Health Department <br />ADDRESS: <br />1868 E. Hazelton Ave., Stockton, CA 95205-6232 <br />LOCATION AND DATE OF DISCHARGE <br />LOCATION: �� Cijj1 L (4'(/l��1, I Incor orated <br />Best Physical CITY '^'( <br />Description ❑ Unincorporated <br />DATE OF DISCHARGE: v w V1 1450s <br />DATE NOTIFIED: 3 TIME: Z3o <br />n RFRPONRIRI F PFRRON/RIISINFSS <br />NAME OF BUSINESS: <br />v <br />CONTACT PERSON:PHONE: <br />L'tw fid'" <br />CHEMICALS: <br />(�{ <br />PHYSICAL ADDRESS: <br />4� <br />MAILING ADDRESS: <br />TYPE OF DISCHARGE: <br />(_OrI VdA <br />VOLUME: <br />L'tw fid'" <br />CHEMICALS: <br />(�{ <br />CIRCUMSTANCES: <br />tdTA, S lS � CL( (u�PiV Q LS 0� TA�-X-F- JC T)n <br />I C/V I V Y' V I `'v'�I lb VL bU Y t vlkN I r 16 v w t t1V V M,k k4L& i-3 - w <br />ACTION TAKEN <br />+w o 1(D00�( & 6a, SDD �dl si�1�� V 4021 �adk; NItDVe4 DPA <br />LD -► + l3 • 5 vos fqw a ds Aa c) -M . <br />SITE DISPOSITION <br />Revised 08/02!12 ��� t C 7U"Air 1 CV <br />_ W NOTIFICATION OF HAZ WASTE DISCHA GE <br />