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(Agency Name) <br />iA/ a/24/71 <br />426,c...cy-f._ <br />Time: /70 0 <br />Signature: <br />Typed/Printed Name: / <br />Da:e: 5—/— <br />MANDATORY CONTAL <br />Public Health Services <br />of San Joaquin County <br />Environmental Health Division: A. "6-male,=„e-- <br />(Contact Name) (Time) (Date) <br />1 San Joaquin County. <br />Board of Supervisors: <br />(Contact Name) (Time) (Date) <br />H. HEALTH AND SAFETY CODE S 25180.7. <br />Any designated government employee who obtains information in the course of his official <br />duties revealing the illegal discharge or threatened illegal discharge of a hazardous waste within <br />the geographical area of his jurisdiction and who knows that such discharge or threatened <br />discharge is likely to cause substantial injury to the public health or safety must, within seventy- <br />two hours, disclose such information to the local Board of Supervisors and to the local health <br />officer. No disclosure of information is required under this subdivision when otherwise prohibited <br />by law, or when law enforcement personnel have determined that such disclosure would adversely <br />affect an ongoing criminal investigation, or when the information is already general public <br />knowledge within the locality affected by the discharge or threatened discharge. <br />Any designated government employee who knowingly and intentionally fails to disclose <br />information required to the disclosed under subdivision (b) shall, upon conviction, be punished <br />by imprisonment in the county jail for not more than one year or by imprisonment in state prison <br />for not more than three years. The court may also impose upon the person a fine of not less than <br />five thousand dollars ($5,000) or more than twenty-five thousand dollars ($25,000). The felony <br />conviction for violation of this section shall require forfeiture of government employment within <br />thirty days (30) of conviction. <br />1. SIGNATURE DISCLOSURE <br />I make this report on behalf of all the designated employees of the County of San Joaquin, and <br />cc: <br /> <br />SWEEFS#/SITE CODE#: <br />CONMF6/ N <br />REFERRED TO: lel‘•..0 C(5 e • <br /> <br />uec_Qc,i (2) <br /> <br />EH 22 013 (Rev,4/91) <br />