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SAN JOAQUIN COUNTY P{ <br /> :'•.G <br /> 4VIRONMENTAL HEALTH DEPAK-_.LENT <br /> 600 E. Main Street, Stockton, CA 95202-3029 <br /> Telephone:(209)468-3420 Fax:(209)468-3433 Web:www.sjgov.org/ehd U B <br /> NOTIFICATION OF HAZARDOUS WASTE DISCH P7-\,: Ply <br /> California Health & Safety Code, Section 25180.7 <br /> EHD LOG#: 0?-001 <br /> A. EMERGENCY LEVEL-J/1II III <br /> (Circle One) <br /> B. SOURCE OF INFORMATION <br /> Name: E h L oV z twd Phone: ems) <br /> Company: S4-L5LAI ,Ptn P� - <br /> Address: City: Zip Code: <br /> Designated Employee Name: <br /> Reporting Agency Name: <br /> Address: City: Zip Code: <br /> C. LOCATION AND DATE OF DISCHARGE t_, <br /> Location: VD VJ, w� � d'1 sDv 6► \ / Ci r Count <br /> (Best Physical Description) ircle One) <br /> Date of Discharge: d Date Notified: 1I Time: /0 /1 A.M. P.M. <br /> D. RESPONSIBLE PERSON BUSINESS <br /> Name of Business: �I?•LD (/6 P <br /> Contact Person: M Ito , joc'+ r 0-\ Phone: <br /> Physical Address: 2.701) VJ• W401f� h& �'F, City: D-gsc,/6, Zip Code: Y7,6? <br /> Mailing Address: City: Zip Code: <br /> E. DESCRIPTION <br /> Type of Discharge: r L' ,)p MekI�- <br /> Volume: 1 1 2 S-D •Ut iexv(e� <br /> Chemicals: I ? "-\ g r `o L I-j <br /> Circumstances: OA,/ Iv— <br /> F. <br /> ` 1tri-F. ACTION TAKEN: C �C,1, cJtJ a,n t-4 14/tl <br /> SITE DISPOSITION: Qr4n t-04 k T'tMK..., 19W44- kyi 6 1 <br /> EHD 22-03 Notification of Haz Discharge <br /> 11/26/2007 <br />