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MANDATORY CONTACTS <br /> Public Health Services <br /> of San Joaquin County ; f �, r <br /> Environmental Health Division: <br /> (Contact Name) {'Iirr: (Date) <br /> 1 San Joaquin County. <br /> Board of Supervisors: n- ��c•.Cw1� /__ i; .:/.._� 1..L�. <br /> (Contact Name) CMne) (Date) <br /> H.. HEALT-i AND SAFETY CODE S 25180.7. <br /> (b) Any designated government employee who obtains information in &ie cowse: of his official <br /> duties revealing the illegal discharge or threatened illegal discharge cif a hazzrd;au; waste within <br /> the geographical area of his jurisdiction and who knows that such discharge or threatened <br /> discharge is likely to cause substantial injury to the public health or saJety m°1st, v thiia seventy- <br /> two hours, .disclose .such.inf_o=ation to_the_1o�1_3oard of SuPerc 301's :end_ to the local :health <br /> officer. No disclosure of information is required under this subdivision..,vlhm cthervri.se prohibited <br /> by law, orwhen law enforcement personnel have determined that such t1;srios,ire wouId adversely <br /> affect an ongoing criminal investigation, or when the informatio;rz 's ;Axeadir ;;;eneral public <br /> knowledge within the locality affected by the discharge or threatened, di;chaxu. <br /> (c) Any designated government employee who knowingly and ix;sc:ad(anally fails to disclose <br /> infornuition required to the disclosed under subdivision (b) shcdl, upwi romrict.on, be punished <br /> by imprisonment in the county jail for not more than one year or by iml')nsonne:it in state prison <br /> for not more than three years. The court may also impose upon the person a Eint of not less than <br /> five thousand dollars ($5,000)or more than twenty-five thousmid dcAhirs The felony <br /> conviction for violation of this section shall require forfeiture of goverranent employment within <br /> thirty days (30) of conviction. <br /> I. SIGNA CURE DISCLOSURE <br /> I n this re ort on behalf of all the designated emp oye of)l e t qu.rity caf an Joaquin, and <br /> (Agency Name) <br /> SignatLxe: <br /> Typed/Print'. Name: <br /> Title: _ �, �nr• /Z. ,� ,1 �r✓a�rDr • .! �� '��._.,.= � :�.__.__ - <br /> Date: _ S"—,�-SS Time:___,�r�:SS __��'r-�.___.__ <br /> cc: �i e - I Cl..� b>PA SWEEPS /SITE' CODE,#: <br /> lL CONMFR ;N <br /> r <br /> REFERRED TO:.,,,_�:r f' Ja� U"i <br /> EH 22 013 (Rev.4/91) <br />