Laserfiche WebLink
SAN JOAQUIN COUNTY , <br /> NOTIFICATION OF HAZARDOUS WASTE DISCHARGE <br /> HEALTH & SAFETY CODE 25180.7 <br /> A. EMERGENCY LEVE : I III PHS-EH LOG # <br /> (Circle One) <br /> B. SOURCE OF INFORMATION / <br /> Original Source: �' tgrIt*-(, t1 ,IN _ Telephone: (2(1� 3��� <br /> Reporting Agency Name: A) c s U/C P-S <br /> Agency Contact: Telephone: <br /> Address: Ile-oe wi <br /> C. LOCATION AND DATE OF DISCHARGE <br /> Location: 20W <br /> (Best Physical Description) (City or County) <br /> Date of Discharge: AA-tQ&A10 <br /> Date Notified: �/ � <br /> Time: — o PM <br /> D. RESPONSIBLE PERSON/BUSINESS <br /> Name of Business . 6-ci� <br /> Contact Person: I iJWR 11P Telephone: ( <br /> Physical Address: <br /> E. DESCREMON <br /> 7pe Release: ) <br /> Volume: �JV N <br /> Chemicals: f' on1S <br /> F. ACTION TAKEN <br /> ^,+Li 41-e <br /> ti <br /> EH 22 013 (Rev. 02/90) <br />