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s <br /> f,. G• MANDATORY CONTACTS <br /> s.,F San Joaquin County <br />�s <br />µ• local Health Oistrirt: <br /> i; <br /> Contact Name <br /> time <br /> Oa to <br />`r San Joaquin County <br /> Board of Supervisors: B� - �r/i�Y <br /> Contact Name <br />• Time Oa to <br /> H• HEALTH AND SAFETY CODE § 25180.7. <br /> fbI Any designated government employee <br /> co -se of his ho obtains <br /> official duties revealing the Illegal dischargeInformation to the <br /> threatened illegal discharge or threatened illegal disch <br /> hazardous waste within the rge of or <br /> knows that such discharge geographical area of his Jurisdiction naand who <br /> substantial Injury or threatened discharge t <br /> sevent t J y to the public health or safety Is to cause <br /> Y- wo hours. disclose such. information to the locaWithhin o <br /> Supervisors and to the local health officer <br /> infO"M tion is required under this subdivisionKwhe�salpsure of f <br /> by law. or when law enforcement • <br /> disclosure would adversely affect an ongoin criminal therwise Prohibited <br /> Personnel have determined that such <br /> : •. � - . -----••when....the+,iq.fortiaation. .is�lread 4 _ t—urinal t�vestigation o <br /> locality affected by the dischargenorathpublic knowledge"wit.hIf"the: •- ""'�----threatened discharge. <br /> fcI Any designated <br /> falls to disclose information <br /> employee who knowingly and intentionally <br /> fat shall u required to be disclosed under subdivision <br /> fail for �otpoA conviction. be punished b <br /> not more more than one year or y imprisonment in the county .�- <br /> re than three years. Y imprisonment in state <br /> fine of not less than five thousand court <br /> may also imposePrison for <br /> twenty-five thousand dollars 000) upon the Person a <br /> violation of this section shalj2S'000 • ff long or more than <br /> I The felony conviction for <br /> employment within thirty require forfeiture of <br /> Ys of conviction. government <br /> I SIGNATU D <br /> 0l l E <br /> I 'y <br /> make this report on behalf of all the designated <br /> County of San Joaquin. <br /> and q . and the San Joaquin Count employees of the <br /> Y local Health District. <br /> Agency Name <br /> G� Signature: <br /> / d Name: <br /> f <br /> Title: ..T i <br /> O <br /> Date: <br /> 0 T i me: <br /> Revised 11-87 <br />