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' Say`+ JOAQUZ`i+ COUNTY e � COPY <br /> -NOTIFICATION OF g.ZARDOUS W.kSTE DIScEL L <br /> gFkLTH & SAFETY CODE 25130.7 <br /> r PE-IS-�-I LOG T <br /> A. EMERGENCY LEVEL I III <br /> ircle one) <br /> g. SOURCE OF TNFOR-AATTON <br /> Name: /lfic°GY1. Yl li l u f Gem 1?s. �. phone: (yo 7,?S <br /> Company: <br /> v <br /> Address: Phone X04 ''!F' g—�'Sf'lo <br /> Designated Employer Name._j..� <br /> Reporting Agency Name: <br /> Address: <br /> C. LOC-kTION SVD DATE OF DISCH-kRGE <br /> 301�. �Descr�-,paon�, f2� fo Location: 301X (Citi o ounty Circle one <br /> {Best Phvsica <br /> Date of Dische: Tune: ;O O <br /> Date Noticed: <br /> D. RESPONSIBLE PERSON/BUSINESS <br /> Name of Business: "� Phone: Cgzy,l Ar? <br /> Contact Parson: <br /> Phvsicai address: <br /> S 4 <br /> Viailing _address: <br /> E. DESCRIPTION <br /> Type of Discharge: Ltd'+-tom <br /> Volume: <br /> Chemicals: vc C= <br /> C 1rcurstanct:s: A-AAA-0 12 <br /> F. ACTION T.�KEN <br /> SITE ISPOSITION <br /> A aQ- <br /> aQ— <br /> EH 22 0 l3 (Rev. 03/20/93) <br />