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SAN JOAQUIN COUNTY <br /> NOTIFICATION OF HAZARDOUS WASTE DISCHARGE <br /> HEALTH & SAFETY CODE 25180.7 <br /> A. EMERGENCY LEVEL: I II III PHS-EH LOG # cf l-- ! 3 <br /> (Circle One) <br /> B. SOURCE OF INFORMATION <br /> Original Source: <br /> Telephone: ( (�) <br /> Reporting Agency Name: -l_do"U411d <br /> ��,,.1 ��lt�S�ISrJ�/►it.�x/}�g.� <br /> Agency Contact: �'(�s�/Ls� ' ,ti,) Telephone: ( ?.(�j ) 4(0 - 1 '0��' � • <br /> Address: ti `� r <br /> C. LOCATION AND DATE OF DISCHARGE <br /> Location: <br /> (Best Physical Description) (City or County) <br /> Date of Discharge: <br /> Date Notified: /.2 l qn Time: ___UlieudW X/ <br /> D. RESPONSIBLE PERSON/BUSINESS <br /> Name of Business A2CAA C,QC.Y3- �Zf r\1 C, Crrt c pyla <br /> Contact Person: VI CVC MC Cowl(( u Telephone: 415 wlo7 305 <br /> Physical Address: _ I 60 tj, ( qe-4)a W � <br /> E. DESCRIPTION + <br /> Type Release: U14i ALand mA.r? <br /> Volume: u(fit 6 rI <br /> Chemicals: Psn?.t�t Lsi��viiZ"�Cwt R[r�.(S <br /> F. ACTION TAKEN <br /> —L 09"—brt.Lora uyn 1 - Lx�mw /�.s�aca�-�►� «s�, tt� c c�s r►n,►u . <br /> -(.tall; k�C. �t�['�' erg A8 rUn4-r U l tt, 1?--� <br /> ti.(Psrn�/1f V�nr�l t�`IC, .�.tT'' O�K•'�l�t,S 0.S/�6»sr+n�^1 A'S uPt� <br /> f � p,Ao2�rau r Qc t, WXUA - <br /> EH 22 03 (Rev. 7/89) <br />