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SAN JOAQUIN COUNTY <br /> NOTIFICATION OF HAZARDOUS WASTE DISCHARGE <br /> HEALTH & SAFETY CODE 25180 .7 <br /> Co <br /> A. EMERGENCY LEVEL:, II III HEALTH DISTRICT LOG ,/3 <br /> (Circle One) v <br /> B. SOURCE OF INFORMATION <br /> Original Source: Telephone-Q) <br /> Reporting Agency Name: e 5-ox/ <br /> Agency Contact: ,�7,g1MC–_ Telephone: (20 <br /> Address: /60/ <br /> C. LOCATION AND -DATE OF DISCHARGE <br /> Location: <br /> (Best Physical Description) (Cit or ounty ) <br /> � r <br /> r <br /> Date of Discharge: <br /> Date Notified: ZZ-- �� Time: -'yT/d, � - <br /> D. RESPONSIBLE PERSON/BUSINESS <br /> Name of Business ,n <br /> Contact Person: f2C HA2 ?) Telephone: (- 2 Vvl�� <br /> Physical Address: t17VCc/ " <br /> i <br /> L. DESCRIPTION <br /> Type Release: <br /> Volume : <br /> Chc_mic:als : /F3r�� C c.�. LTlo.iC��iC�C' _ 1-3 75r�l— Lwi <br /> F. ACTION 'T11KLtJ (�p7LZ�/lG�GCI.6� / <br /> O <br /> i <br /> M <br /> '-.-.+„-...., :.:-:.•v .�-T-e—^..n+-ha:-.,�--�. ^. .�Y-•'.Y-'- ^^^+r.--.-tea. .... .---�-"�—��- �.a...�Wa._..-r' <br />