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JOAQUIN <br /> AN <br /> UNTY <br /> NOTIFICATIONS OF HAZARDOUSOWASTE DISCHARGE ~ <br /> Health b Safety Code § 25180.7 <br /> A. EMERGENCY LEVE61 I1 III <br /> (Circle one Health District Log I <br /> B. SOURCE OF INFORMATION <br /> Original Source: <br /> ePhone: <br /> Reporting Agency Name: <br /> - Agency Contact: � <br /> Telephone• <br /> Address: 162 Z) <br /> )' ' <br /> C. LOCATION ANO DATE OF DISCHARGE <br /> Date(s): �77— Time: '�zJ <br /> Location: <br /> Best Physical Descr pt o C k / !-� <br /> 4cyor *01y <br /> D. RESPONSIBLE PERSON/BUSINESS <br /> Name of Business: /ef MA.rT <br /> Contact Person: <br /> Telephone: (26EQ). <br /> Physical Address: (p <br /> E. DESCRIPTION <br /> Type Release: <br /> S ' <br /> Volume: <br /> Chemicals: <br /> F. ACTI N TAKEN <br /> r <br /> A <br />