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'O.) <br /> SAN JOAQUIN OUNTY <br /> NOTIFICATION OF HAZARDOUS WASTE DISCHARGE <br /> HEALTH & SAFETY CODE 25180.7 <br /> A. EMERGENCY LEVEL: I II -111 HS-EH LOG # <br /> ucle One) <br /> B. SOURCE OF INFORMATION <br /> Original, Source: Telephone: <br /> „ <br /> Reporting Agency Name: i <br /> Agency Contact: Telephone: (_Z0j)— �L,2F7-342y <br /> Address: � , <br /> C. LOCATION AND DATE OF DISCHARGE } <br /> Location: <br /> (Best Physical Description) (City or County) <br /> Date of Discharge: U r <br /> Date Notified: {'? Sj OTime: jOco ry, <br /> D. RESPONSIBLE PERSON/BUSINESS <br /> Name of Business <br /> Contact Person � s � ., - Telephone: 2944 -S <br /> Physical Address: S Tnr-,Es-To�d <br /> E. DESCRIPTION <br /> Type Release: <br /> ,r [ ..i r'e 1-20L 2=()\[n( <br /> Volume: <br /> Chemicals: 7 <br /> F. ACTION TAKEN <br /> ,tz, Q, f— 11 beG r 2 clYtl�F <br /> �4- r G'ti� C C cs <br /> l I LkI3 <br /> Y <br /> I <br /> k: <br /> EH 22 013 (Rev. 02/90) <br />