Laserfiche WebLink
f ' <br /> SAN JOAQUIN COUNTY <br /> NOTIFICATION OF HAZARDOUS WASTE DISCHARGE <br /> HEALTH SAFETY CODE 25180.7 CIO <br /> Ae EMERGENCY LEVEL: II III HEALTH DISTRICT LOG #It <br /> (Circle One­f <br /> "­ .C) --ym,3 <br /> B. SOURCE OF INFORMATION <br /> Original Source: 1 <br /> � lug f� Telephone: ' (&L) <br /> Reporting Agency Name: <br /> Agency Contact: - Telephone: (207 ) U-3Ys6 <br /> Address: <br /> C. LOCATION AND DATE OF DISCHARGE <br /> Location: " -~ <br /> (Best Physical Description) / (Ci t' or ount <br /> I Y) <br /> Date of Discharge: f <br /> Date Notified: -,Z -_ � Time: � <br /> D. RESPONSIBLE PERSON/BUSINESS <br /> Name of Business �� qC. ,B_ ,`11Aa L <br /> Contact Person: /ukelf �4ig , ) Telephone: (.fit ) 900 2 4/ <br /> Physical Address: <br /> L. UL•'SCR I PT,ION <br /> Type Release: I-0 _ <br /> Volume: ,n <br /> 1'. <br /> ACTION TAKEN � <br /> _ <br />