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JOAQUIN COUNTY <br /> CA SAN iLk <br /> 'LA2-A.RDOUS WASTE <br /> PEALTH & SAFETY CODE :• <br /> A. 1 ' at u • <br /> •. - <br /> B. SOURCEOF INFORMA71ON <br /> Name: I / ,,,,.�� <br /> Phone: C207 <br /> Designated n • • _ _ Wu ' / i� c//Ism" � • •• . - � L <br /> - •• • . • Agency Name: / <br /> Address: <br /> C. LOCATION AND, DA= OF M / <br /> •r. ••• /�.. WE • I . / �• 'i <br /> CBest ' • 4�sc •• •• (Nbr County) - One <br /> Date of ._ ./L <br /> Da-ce Notified: Time: <br /> D. RESPONSIBLE PERSON/pUSINESSt <br /> Name of Busine <br /> / <br /> a• • •• �. . <br /> DES=TION <br /> • n ' <br /> Chemicals: <br /> F. A=1 ON TAKEEN <br /> STIZ STATUS <br /> EH 22 <br /> 013 <br />