Laserfiche WebLink
SAN JOAQUIN COUNTY <br /> NOTIFICATION OF HAZARDOUS WASTE DISCHARGE <br /> HEALTH & SAFETY CODE 25180.7 (v' <br /> A. EMERGENCY LEVEL:F61 I III PHS-EH LOG # <br /> ( ' cle One) <br /> B. SOURCE OF INFORMATION <br /> Name: LA 4av ta.-I Phone: ( 3 Lp 5CZ <br /> Company: Cj�-PJ:E t r-Oyi <br /> Address: S029-C) ���'rvto��" 5L Z5 b T0"v n,ce C,4 20- <br /> Designated Employee Name: Phone: L� <br /> Reporting Agency Name: <br /> Address: <br /> C. LOCATION AND DATE OF DISCHARGE <br /> Location: 401 Pc�r`!'v\ `2LA�L)Lh <br /> (Best Physical Description) C ty r County) Circle One <br /> Date of Discharge: rl <br /> Date Notified: --,pq-mac Time: IO : 3o A--M <br /> D. RESPONSIBLE PERSON/BUSINESS <br /> Name of Business: OS 6 S <br /> Contact Person: Q-.0US Telephone: (4!5)-:�qLi 55 cTZ <br /> Physical Address: C525 M,1 Ktf Sf• 91s4- Roar- 4cfC05-z7r <br /> Mailing Address: -� <br /> E. DESCRIPTION <br /> Type of Discharge: UAKvv-,oJv') <br /> Volume: U V%W v "L/ <br /> Chemicals: TO 2I-yo1ebvwt Hycclvo� bo✓� <br /> Circumstances:_ Reotew c4 resut-t-s -rY- ►m 15tie ,Qepe�d- <br /> l�ec� 814•��{ �d P•-zPcv1.¢d h� CA-RE �'n�1�vo.�r�stnt�t�(� <br /> F. ACTION TAKEN <br /> P'45140JID c u I t ►^2��E �- c.� -f gun 1� r2 w�yJ �_w� <br /> rp4q�gd.cC,i-tc� <br /> SITE STATUS L)5T- 0.w c tto w L Lt W-a doGu Mdjl i w c f-L�, Cwt <br /> 06-9, v po v-t cLy cl Oztd In -Tku 60,.E 5141- ded4ixc�e. <br /> -nte-� �n�estu,ane� 44,irJ r-.ea,-acickfic.cj L"itil {2e res��v-ec( bsr <br /> EH 22 013 (Rev-4/91) <br />