Laserfiche WebLink
SAN JOAQUIN COUNTY <br /> NOTIFICATION OF HAZARDOUS WASTE DISCHARGE OD <br /> ( HEALTH & SAFETY CODE 25180,7 <br /> A. EMERGENCY LEVEL: 0 <br /> II III <br /> (Circle One) HEALTH DISTRICT LOG <br /> B. SOURCE OF INFORMATIO <br /> Original Source: _ Telephone: } <br /> �Q <br /> Reporting Agency Name : S•-S . �./� . �, <br /> Agency Contact: Telephone: (Z ) <br /> Address : <br /> C. LOCATION AND DATE OF DISCHARGE <br /> Location: UA(Best <br /> ysics escription) (City or County) , <br /> Date of Discharge: <br /> Date Notified: Time: <br /> ` D. RESPONSIBLE PERSON/BUSINESS <br /> Name of Businessvvyyl1 /64h,-�- 4X.L. ffz <br /> Contact Person: n1,1,A4e I1,. v Telephone: V16"[ ) �Q_ 3 6 1 J <br /> Physical Address: q2-9 W <br /> E. DESCRIPTION <br /> Type Release: U A. <br /> Volume: <br /> Chemicals : <br /> F. A TION TAKEN <br />