Laserfiche WebLink
as 4u� o SAN JOAQUIN COUNTY <br /> VIRONMENTAL HEALTH DEPAR'.x,, ENT <br /> 600 E.Main Street,Stockton,CA 95202-3029 �� <br /> �P Telephone:(209)468-3420 Fax:(209)468-3433 Web:www.sjgoy.org/ehd/�" �',•� � '�\� �'�? <br /> NOTIFICATION OF HAZARDOUS WASTE DISCHARGE <br /> California Health & Safety Code,Section 25180.7 <br /> EHD LOG#: og- <br /> A. EMERGENCY LEVEL,:I II III <br /> (Circle One) <br /> B. SOURCE OF INFORMATION <br /> ( ) <br /> Name: f JA 01 H�;.1 Phone: <br /> Company: 1' <br /> Address: <br /> Designated Employee Name: ✓ <br /> Reporting Agency Name: <br /> Address: City: Zip Code: <br /> C. LOCATION AND DATE OF DISCHARGE <br /> Location: Citybr County <br /> (Best Physical Descripti ) "(Circle One) <br /> Date of Discharge: fA" Wit`'- Date Notified: k'�fv" L':, Lr'jI'ime: i,D'�- A.Nt <br /> D. RESPONSIBLE PERSON/BUSINESS <br /> Name of Business: kwl N.th ty0d. l �i <br /> Contact Person. .tn (,P„ +r-t�i (A ig <br /> Phone: �'i <br /> Physical Address: 41, City: f Zip Code: '. ct 0-t; <br /> Mailing Address: City: Zip Code: <br /> E. DESCRIPTION <br /> Type of Discharge: <br /> Volume: <br /> Chemicals: l' `i✓1� ,J <br /> Circumstances: i'Y! p'yL'a v!lW". i f `L .ei <br /> F. ACTION TAKEN: cZ d f i�- . [tiles Ak/fl?, <br /> SITE DISPOSITION: Vtf'/Ij, IA'Ct ((ZI <br /> !rec: 47�i111.1 l/i(l1:>r <br /> EHD 22-03 Notification of Haz Discharge <br /> 11/26/2007 <br />