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' SAN JOAQUIN COUNTY <br /> NOTIFICATION OF HAZARDOUS WASTE DISCHARGE <br /> HEALTH & SAFETY CODE 25180.7 <br /> A. EMERGENCY LEVEL: IO II III P S=EH.L-OG-# <br /> (Circle One) <br /> B. SOURCE OF INFORMATION v V <br /> � <br /> Original Source: Telephone: of O5 ) r�3g^ 3507 <br /> e.Q12�Setauo o <br />' Reporting Agency Name: lrn � <br /> Agency Contact---RAdi- i0AA- v-L Telephone: 2( oy' ) _ __`144-34 y/ <br /> Address: 1601 <br /> C. LOCATION AND DATE OF DISCHARGE <br /> Location: ZVu.d-e. Q/-Icx+a. Ae <br /> (Best Physical escription) (City or County) <br /> 'k Date of Discharge: lib e-vx vu9-w <br /> Date Notified: Time: /l ioet K <br /> I <br /> D. RESPONSIBLE PERSON/BUSINESS <br /> Name of Business I �wu ./a4tu9 - CLS�oc� oma. <br /> Contact Person: SCO&tiTelephone: oZ( 09 <br /> Physical Address: do& �_� S/oc��e c✓ <br /> E. DESCRIPTION <br /> Type Release: <br /> Volume: <br /> r / <br /> Chemicals: -_ A,eO .u01 �jtt oa Qi kti <br /> F. ACTION TAKEN <br /> LbtJ— Cox t-9 A.e o2 UA, PA p 6'T #��- 0090 <br /> e,d Io d ukt , Cev la r+u tiaek . a ooQi� c? o0o b <br /> _3 00 02 U <br /> 1 �7 rw- ✓ or' leu c r l,O� Q p WL Ali f2 -xu x�i1t Ze fo�Jrx�rt� <br /> EH 22 03 (Rev 7/89) <br /> --b /1RPotc� ,ie� vx� <br />