Laserfiche WebLink
r <br /> SAN JOAQUIN COUNTY <br /> NOTMCATION OF HAZARDOUS WASTE DISCHAR <br /> w w HEALTH & SAFETY CODE 25180.7 <br /> r <br /> A. EMEEGENCY Ll ATL: iII III PHS-EH LOG <br /> ( 'ircle One) <br /> B. SOURC;3 C-1~' Il' F-'01kK TION <br /> Mune:_. Phone: <br /> Cc)mparty:____.___.____ <br /> Address: <br /> Designated Emp10:y-::e Ni nne: Phone: <br /> Reporting Agency Idarne: satin =Z'�, r C.,u.w.d(. ._<«rvr,y.a, A p � 3 �� •.._ __ <br /> -SOL <br /> s` <br /> C. LOCATION AND. DATE OF DISCHARGE <br /> Location:. ,.;_�..�:.�! r'. / <br /> (Best Phy.:i.cal Description) or County) Ci cele One <br /> Date of Discha g(-:: <br /> Date lgodfied: .__ _.��� .S" Time: //: t/U �)✓1 <br /> D. RESPONSIBLE E'I:.-r>ON/BUSINESS <br /> Name o1` Biisin.c. _ ._�_ l c� Gv, <br /> Contact Person: _a « Telephoner (LAW 6 y,. <br /> Physical Addre;as: ... �.:r __ <br /> MEdlir.g Address:: 0._ /3 --'— '7— 6 <br /> E. DESCIUFTION <br /> ,ry:pe of Dischar�,(!: .�_.._i d s c. �.. vriu. IZ�B.p�s�w• .�__,_. �. <br /> Volume: <br /> Circupisr:ances: cJc'�rc _ <br /> P. A:. ON .AAKE1`1.___..,�?:,a -Sc-�'�— Vic,►. 'Z" �^""�� <br /> ,;[T'E C ISl'O SITIO V__. �� ue-r- scr�t, a.�,5 ►,..,t.... _ .�_ <br /> E.H 22 013 (Rev.4i 91; <br />