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t i <br /> SAN JOAQUIN COUNTY <br /> NOTIFICATION OF HAZARDOUS WASTE DISCHARGE <br /> HEALTH & SAFETY CODE 25180.7 <br /> A. EMERGENCY LEVEL: II III PHS-EH LOG # �lD"/ �{ <br /> (Circle One) <br /> B. SOURCE OF INFORMATION <br /> Original Source: Loyi s '3- Sc�'."-p 77r• Telephone: /5 R) <br /> Reporting Agency Name: ?. ,q S. �' ✓,. ,�.�A �/s`1•'�<7 ,�_.,�„� <br /> Agency Contact: LL',-3, _E C_ C yq,� Telephone: <br /> Address: x a?o o <br /> C. LOCATION AND DATE OF DISCHARGE <br /> Location: G 5'( 3, nl ,Z 2L d <br /> (Best Physical Description) (City or C nty) <br /> aF- Date of Discharge: yh ew o-,—Aj -. <br /> Date Notified: /0 • 910 Time: <br /> D. RESPONSIBLE PERSON/BUSINESS <br /> Name of Business C�5,e,2, <br /> Contact Person: ,e,4� Telephone: <br /> Physical Address: <br /> E. DESCRIPTION <br /> Type Release: 1 - <br /> Volume: �J/��-+�� •�� <br /> Chemicals: <br /> F. ACTION TAKEN <br /> EH 22 03 (Rev. 7/89) <br />