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EHD LOG# (� <br /> G. MANDATORY CONTACTS <br /> San Joaquin County Environmental Health <br /> Department Donna Heran Time: <br /> San Joaquin County Board of Supervisors— <br /> Contact—Office of Emergency Services Michael Cockrell Time: <br /> H. HEALTH AND SAFETY CODE 25180.7 <br /> revealing the illegal discharge or threatened illegal discharge of a hazardous waste within <br /> (b) Any designated government employee who obtains information in the course of his official the <br /> such information to the local Board of Supervisors and to the local health officer. -t duties <br /> geographical area of his jurisdiction and who knows that such discharge or threatened disharge is <br /> likely to cause substantial injury to the public health or safety must,within seventy-two houcrs, disclose <br /> disclosure if <br /> information is required under this subdivision when otherwise prohibited by law, or when law <br /> enforcement personnel have determined that such disclosure would adversely affect an ongoing <br /> criminal investigation, or when the information is already general public knowledge within the locality <br /> affected by the discharge or threatened discharge. <br /> (c) Any designated government employee who knowingly and intentionally fails to disclose information <br /> required to be disclosed under subdivision (b)shall, upon conviction, be punished by imprisonment in <br /> the county jail for not more than one year or by imprisonment in state prison for not more than three <br /> years. The court may also impose upon the person a fine of not less than five thousand dollars <br /> ($5000) or more than twenty-five thousand dollars ($25,000). The felony conviction for violation of this <br /> section shall require forfeiture of government employment within thirty days of conviction. <br /> I. SIGNATURE DISCLOSURE <br /> I make this report on behalf of all designated employees of the County of San Joaquin, and <br /> San Joaquin County Environmental Health Department <br /> (Agency Name) <br /> Signature: " / Gd�P/Jda12- <br /> Printed Name: Nuel Henderson <br /> Title: Engineering Geologist <br /> Date: April 11, 2014 Time: 3:OOPM <br /> cc: DTSC <br /> CVRWQCB �^"A � Site Code: <br /> G �� ' G �� clf Con MFR Yes <br /> n '� No <br /> QM� G A4 IV}i�sL� lnc, /H� A: r`�/QL(ftferred: <br /> 0.t{ W <br /> IIwCw �a55 r�fi�r r�ll t�✓4 <br /> /U �v50t) M550ad- C c //�I9'h 1�;G�211e CBa�I,Qr-irzz/J <br /> aminev aoa Tod-U5i-61 INY , c0L;, 41 <br /> Revised 08/02/12 Page 2 of 2 NOTIFICATION OF HAZ WASTE DISCHARGE <br />