SITE INFORMATION AND CORRESPONDENCE

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G. MANDATORY CONTACTS Public Health Services Qyl of San Joaquin County Environmental Health Divisc= D0 ni N Pl- / /0 Y 15� (Contact Name) (Time) (Date) 1 San Joaquin County- Board of Supervisors: tq� V D / ,�'�l a-.mac / /U S- (Contact Name) (Tune) (Date) H. HEALTH AND SAFETY CODE S 25180.7. (b) Any designated gover=---.r employee who obtains information in the course of his omcial duties revealing the illegal �-, arae or threatened illegal discharge of a hazardous waste within the geographical area of Hs jurisdiction and who knows that such discharge or threarened discharge is likely to cause sz�ndal injury to the public health or safety must, within seventy- two hours, disclose such in_--rmto the local Board of Supervisors and to the local health officer. No disclosure of inrc�tion is required under this subdivision when otherwise prchfoited by law, or when law enforce—e r personnel have determined that such disclosure would adversely affect an ongoing criminal �avestigadon, or when the information is already general public knowledge within the local-L-7 affected by the discharge or threatened discharge. (c) Any designated gover=r employee who knowingly and intentionally fails to disclose information required to &,e diseased under subdivision (b) shall, upon conviction, be perished by imprisonment in the cox=7 jail for not more than one year or by imprisonment in state prison for not more than three ye--. The coup may also impose upon the person a fine of not less than five thousand dollars ($5,0N) or more than twenty-five thousand dollars ($25,000). The felony conviction for violation of:� section shat require forfeiture of government employment within thirty days (30) of convicti-..- I. SIGNATURE DISCLOSURE I make this report on beh—i—of all the designated employees of the County of San Joaquin, and (Agency Name) Signature: K Typed/Printed Name: U ti--- P-- Title: `Title: S Date: Ot— Time: /D % 3, J cc: SvvEEPS7'r/SITE CODETr: C U — Q C�j— CONMFRIN 1�0 (% S'�D G��-`�d�` REFERRED TO: EH 22 013 (Rev.4/91)