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G,, , MANDATORY ONTACTS San Joaquin County VA -OCT - 4 2006 Environmental Heal h Department: (Contact Name) (Time) (Date) San Joaquin County OCT - 4 2006 Board of Supervisor ./ (Contact Name) (Time) (Date) H. HEALTH AND S FETY CODE S 25180.7 (b) Any designated g vernment employee who obtains information in the course of his official duties revealing the illegal ischarge or threatened illegal discharge of a hazardous waste within the geographical area of is jurisdiction and who know that such discharge or threatened discharge is likely to casue substa tial injury to the public health or safety must, within seventy two hours, disclose such inform ion to the Board of Supervisors and to the local health officer. No disclosure of information is req 'red under this subdivision when otherwise prohibited bylaw, or when law enforcement personn 1 have determined that such disclosure would adversely affect an ongoing criminal investigation or when the information is already general public knowledge within the locality affected by th discharge or threatened discharge. (c)Any designated go ernment employee who knowingly and intentionally fails to disclose information required t the disclosed under subdivision(b) shall, upon conviction, be punished by imprisomnent in the c unty jail for not more tan one year or by imprisonment in state prison for not more than three years. The court may also impose upon the person a fine of not less than five thousand ($5,000) or ore than twenty five thousand dollars ($25,000). The felony conviction for violation of this sectio shall require forfeiture of government employment within thirty days (30) of conviction. I. SIGNATURE DIS LOSURE I make this report on b half of all the designated employees of the County of San Joaquin, and S5c_ Edo (Agency Name) Signature: Print Name: VUTitle: S ` Date: 10- Time: ' nA M P.M. SITE CODE #: cc: Cv V_ Q L 6 Referred To: EHD 22-02-003 Notification of Haz Discharge 10/2/2003