Laserfiche WebLink
• ';AN JOAQUIN COUNTY ^•p <br /> NOTIFICATION OF HAZARDOUS WASTE DISCHARGE <br /> HEALTH & SAFETY CODE 25180.7 <br /> A. EMERGENCY LEVEL: (D II III PHS-EH LOG # <br /> (Circle One) <br /> B. SOURCE OF INFORMATION <br /> Original Source: (16�",2/ p Telephone: Zo9l ) V( e-3 V&,S' <br /> Reporting Agency Name: <br /> Agency Contact: - ��„o/ O Telephone: 2,579 ) <br /> Address: <br /> C. LOCATION AND DATE OF DISCHARGE <br /> Location: k�o E.ina.;, ,514. <br /> (Best Physical Description) (City or County) <br /> Date of Discharge: <br /> Date Notified: o 3 -f z> Time: <br /> D. RESPONSIBLE PERSON/BUSINESS <br /> Name of Business Gtr,401e- <br /> Contact Person: i/y �./cam , �.,�/. �� Telephone: -9, -7 7 -6/s 7 <br /> Physical Address: �yOY �o��/� oaE ��- SfFn CI 95-.207 <br /> E. DESCRIPTION <br /> Type Release: <br /> Volume: 3C <br /> Chemicals: e,`Xv/��, <br /> F. ACTION TAKEN <br /> All <br /> _ew <br /> U (/ <br /> vee- <br /> EH 22 013 (Rev. 02/90) <br />