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d l <br /> 1 !73 <br /> SAN JOAQUIN COUNTY Q <br /> NOT OF HAZARDOUS WASTE DISCHARGE <br /> HEALTH & SAFETY CODE 25180.7 <br /> A. EMERGENCY LEVEL: (P II III HEALTH DISTRICT LOG # �'-CJOQ3 <br /> (Circle One) <br /> ## f <br /> B. SOURCE OF INFORMATION <br /> Original . Source: A ppRi&� e o s s+4L -- Telephone: i W1s ) CoS`1 lgora <br /> Reporting Agency Name: Lp�...l Nem llr�. D+s�vc� <br /> � F <br /> Agency Contact: �a��d Go,r1s Telephone: (204 ) 4(pk- 3gll <br /> Address: {(Qv i r-- . o� z SA-A-A-- c A e Szo-1 - <br /> C.1 LOCATION ANDil`DATE OF DISCHARGE <br /> ! TolI�/owd <br /> Location: �3q s �. 9— cA / �o ��•,.d <br /> r ¢ (Best P sisal Description) (City or County) <br /> j <br /> Date of Discharge: <br /> Al <br /> Date Notified: &s Time: <br /> D.k RESPONSIBLE PERSON/BUSINESS <br /> Name of Business <br /> Contact Person: Q�¢�} �,,��� 5 r Telephone: <br /> Physical Address: 139�j E a� �& L° cto••� c-A <br /> E.r DESCRIPTION <br /> j <br /> Type Releasez <br /> Volume: <br /> 4 Chemicals: <br /> F.z ACTION TAKEN i <br /> } T... 5A Ll,ICA .'llO0 4LVI 1e C..`iw..T W o1 ASSGSSwQ,� rt +V� T� Ct1RwQ�g <br /> 4,,,�..iG�„ [\t\� 15 W�C...N�.N O.�PMWM�6.iJGKM.�..w '1•rS� Hr1Qa 11.. ✓'M. � O� wCSCYrS4nCy� .. <br /> €,�Ao cll' <br /> i 1 <br /> O� d txe-1 keAaw- %fl k&dl OCLI.VY44 -avZ <br /> v S a T J4�i r t S�, y—► .! Er GlSK1 Tx K �++ <br /> In.�. <br /> ',F d���».�,�ed d ¢rt•�� � j � Ss;o � t '1l he• tneulsu..� . <br /> 'F <br /> V4Q� ,l�wMl,.1 �: .4 �n-.t 'l t,t,« vtPu.ZeCA <br />