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EHD LOG# <br /> G. MANDATORY CONTACTS <br /> San Joaquin County Environmental Health Donna Heran Time: '' Date: <br /> Department <br /> San Joaquin County Board of Supervisors— Michael Cockrell Time: J�cM Date:` <br /> Contact—Office of Emergency Services <br /> H. HEALTH AND SAFETY CODE 25180.7 <br /> (b) Any designated government employee who obtains information in the course of his official duties <br /> revealing the illegal discharge or threatened illegal discharge of a hazardous waste within the <br /> geographical area of his jurisdiction and who knows that such discharge or threatened discharge is <br /> likely to cause substantial injury to the public health or safety must,within seventy-two hours, disclose <br /> such information to the local Board of Supervisors and to the local health officer. No disclosure if <br /> information is required under this subdivision when otherwise prohibited by law, or when law <br /> enforcement personnel have determined that such disclosure would adversely affect an ongoing <br /> criminal investigation, or when the information is already general public knowledge within the locality <br /> affected by the discharge or threatened discharge. <br /> (c) Any designated government employee who knowingly and intentionally fails to disclose'information <br /> required to be disclosed under subdivision (b) shall, upon conviction, be punished by imprisonment in <br /> the county jail for not more than one year or by imprisonment in state prison for not more than three <br /> years. The court may also impose upon the person a fine of not less than five thousand dollars <br /> ($5000) or more than twenty-five thousand dollars($25,000). The felony conviction for violation of this <br /> section shall require forfeiture of government employment within thirty days of conviction. <br /> I. SIGNATURE DISCLOSURE <br /> make this report on behalf of all designated employees of the County of San Joaquin,and <br /> San Joaquin County Environmental Health Department <br /> (Agency Name) <br /> Signature: <br /> Printed Name: Garr e ackus <br /> Title: Senior Registered Environmental Health Specialist <br /> Date: Wednesday, September 4, 2013 Time: 8:41 am <br /> cc: DTSC Site Code: <br /> a CVRWQCB <br /> 4'C.. °`TtN rl�lar�ln V�ncievll -CJ Con MFR Yes No <br /> PC, )� ,a'1 � C y � ' Referred: <br /> IA 1 lnf� ,R+i N= �n��C( 1 'nes <br /> w►Illur iy�-, i rllie Cewrs sir'. ` -kil C .{ �j'SZI�b <br /> 227A u:.3ne:- 'Fr-cnl=$ kal-f-Lq ZoCKa 23j2.5 E Lanz irIt "Zi F-Xcc.101r Ca 9532-0 <br /> owner 1eFF j2e4: LUIi 2.2c%3� Marlpc'�� �t� � Corr Ca <br /> 2z4{u`� o+Jge� wrtlrarn & SA r�lrmocks Pow �1/l0, �scc��on Ca �1S32C) <br /> Revised 08/02/12 Page 2 of 2 NOTIFICATION OF HAZ WASTE DISCHARGE <br />