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SAN 10 A Q U I N Environmental Health Department <br /> COUNTY <br /> NOTIFICATION OF HAZARDOUS WASTE DISCHARGE <br /> EHD LOG# <br /> MANDATORY CONTACTS <br /> San Joaquin County Health Officer- s <br /> Care of Environmental Health Department Wayne Fox Time:2}jM Date: <br /> San Joaquin County Board of Supervisors- <br /> Care of Clerk of the Board Rachel DeBord Time:�.,�m Date: q 1312 <br /> HEALTH AND SAFETY CODE25180.7 <br /> b) Any designated government employee who obtains information in the course of his official duties revealing the illegal <br /> discharge or threatened illegal discharge of a hazardous waste within the geographical area of his jurisdiction and who knows <br /> that such discharge or threatened discharge is likely to cause substantial injury to the public health or safety must, within <br /> seventy-two hours, disclose such information to the local Board of Supervisors and to the local health officer. No disclosure if <br /> information is required under this subdivision when otherwise prohibited by law, or when law enforcement personnel have <br /> determined that such disclosure would adversely affect an ongoing criminal investigation, or when the information is already <br /> general public knowledge within the locality affected by the discharge or threatened discharge. <br /> c)Any designated government employee who knowingly and intentionally fails to disclose information required to be disclosed <br /> under subdivision (b) shall, upon conviction, be punished by imprisonment in the county jail for not more than one year or by <br /> imprisonment in state prison for not more than three years. The court may also impose upon the person a fine of not less than <br /> five thousand dollars ($5000) or more than twenty-five thousand dollars ($25,000).The felony conviction for violation of this <br /> SIGNATURE DISCLOSURE <br /> I make this report on behalf of all designated employees of the County of San Joaquin, and the <br /> San Joaquin County Environmental Health Department <br /> Signature: <br /> Printed name: Elianna Florido <br /> Title: REHS G <br /> Date: I I3I 2-021-0 Time: 1--2 3 PM <br /> k US pvh s i b U_ Po 0 : f JrUperlif ©wAO-r: <br /> p��C 6as S Tvacf i uvt dun publi� j'�/�r�s <br /> A+- n A f V x 6+60-6 Road -4 T�FF► � /t-t�n f-.enure� <br /> I /0 �- l wrph y s G-„rnade- P/. IJivls ion <br /> 0 <br /> ,S�ct-f-oh, Gf9- q SZvS <br /> Page 2 of 2 <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />