SITE INFORMATION AND CORRESPONDENCE

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G. MANDATORY CONTACTS Public Health Services,. -- of San Joaquin County Environmental Health Division: (Contact Name) (Tine) (Date) San Joaquin County Board .f Supervisors. 'ay� 13adwL4� l (Contact Name), (Time.) (late) 11. HEALTH AND SAFETY CODE S 25180.7. (b Any des'8rxateti gcavernment emrnployee whet b.tains information in the course of his;afficiat duties revealing the. illegal discharge or threatened illegal discharge of a kiazan3+aus erste. within the geographical area of his jurisdiction;and who knows that such discharge or threatened discharge .is likely to cause substantial injury tor the public health:or safety must within seventy-two hours, disclose such information to the local Board of Supervisors and to. the local health officer. No disclosure of information is required under this subdivision when otherwise prohibited by law, or when law enforcement personnel`have determined that such disclosure would adversely affect an ongoing criminal investigation, or when the inkrmation is alre.ady,general public knowledge within the locality:affected by the discharge or threatened discharge. c Any designated government employee who knowingly and ntentionallrfails to: disclose ( ) ir�;fnrmation required to the disclosed: under subdivision fib) shall, upon c4rwvictian,. be punished by imprisonment in the county jail for not more than one year o by`iirnptisonment to stat- :prisonl for not more than three years. The court may also impose upon the person a fine of not less than ;five thousand dollars ($5,000) or more than twenty-frve thousand dollars: ( 25,000). The felony conviction for violation of this section shall require forfette�re of getvernrnerit employment within thirty days of conviction. t. SIGNATURE DISCLOSURE T make this report o behal of all the designated employees cif the County of an Joaquin►. Andjr (A encyName) Signature Typed Name: Title: Date. 1 c-`t Time: /C? r 6,4 41 CC• CA c c v�, CB ,.�. --` Ste' EH 22 03 (Rev. 7189)