Laserfiche WebLink
IMP, SAN JOAQUIN COUN'T'Y � <br /> NOTIFICATION OF HAZARDOUS WASTE DISCH�ItG f ILE C <br /> HEALTH & SAFETY CODE 25180.7 <br /> A. EMERGENCY LEVEL:©II III PHS-EH LOG <br /> (Circle One) <br /> B. SOURCE OF INFORMATION <br /> Name: 'G,�u, c.r� �S A(6 &MZ 23 Ilye Phone: (_ O 2Q5-/6So <br /> Company: arc �v SSS ti9l &/dA,..T eA <br /> Address: <br /> Designated Employee Name:_°4-bV /,*6&f Phone: (. ) <br /> Reporting Agency Name: <br /> Address: <br /> C. LOCATION AND DATE OF DISCHARGE G � <br /> Location: /��5v0 5. /,lfT�i25n�-rE Fire / <br /> (Best Physical Description) City r County) Circle One <br /> Date of Discharge: UN . ouJ <br /> Date Notified: 7-3/-ff Time: <br /> D. RESPONSIBLE PERSON/BUSINESS <br /> Name of Business: ;�OrSCo /yifl I 16 � �ifsiy <br /> Contact Person: �4-d�� C�¢�ciGLE Telephone: Sig Z • 2335 <br /> Physical Address: ZCOO CRouJ CA66 v <br /> Mailing Address: 4A -e <br /> E. DESCRIPTION <br /> Type of Discharge: <br /> Volume: <br /> Chemicals: 773 <br /> Circumstances: LANd ex) 5 !per <br /> C 7`i d /!O 0 DD ,urs_ <br /> F. ACTION TAKEN - As-6�5� O&--6wr->7e 14A <br /> 577NG 11S N iow r PezaA E 4Jlc � <br /> _ cd ,�/,er� t CU,eu�Q Cf3 oTr <br /> sh Ec — Alf~ <br /> SITE STATOS <br /> N6 vJ 5tT�57 A.r/.v45V-C 72aSGo At bee/ s>--,05D Ah; E,t�1•s <br /> ou. dv <br /> V5 rS . <br /> EH 22 013 (Rev-4/91) <br />