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(TY) (F3eQ-j_4' (1'1 <br />e) (Date) (Contact Name) <br />r <br />Signature: <br />Typed/Printed <br />Title: < ^ <br />Date: - <br />ame: Le- ti`e-4.-' y 5 <br />R. e <br />61 7 Time: <br />FliCONTAC111L <br />tizServices <br />of San Joaquin County <br />Environmental Health Division: ^41 (1 / <br />(Contact Name) (Time) (Date) <br />1 San Joaquin County• <br />Board of Supervisors: <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 thar- <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 />I. SIGNATURE DISCLOSURE <br />I make this report on behalf of all the designated employees of the County of San Joaquin, and <br />(Agency Name) <br />cc: Ri0 Ca () () <br />yq- C-r.fi-71) <br />&•a/ :_C-K? cif <br />d <br />SWEEPS#/SITE CODE#: 3 /..3 17/-• <br />CONMFR\e/ N <br />REFERRED TO: <br />EH 22 013 (Rev.4/91)