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r <br /> l <br /> SANJ0AQUIN Environmental Health Department <br /> COUNTY <br /> NOTIFICATION OF HAZARDOUS WASTE DISCHARGE <br /> EHD LOG# �� U <br /> MANDATORY CONTACTS <br /> San Joaquin County Health Officer- <br /> Care of Environmental Health Department Jasjit Kang Time:, . Date: <br /> San Joaquin County Board of Supervisors - <br /> Care of Clerk of the Board Rachel DeBord Time: Date: <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: Md V <br /> Printed name: Paul Nso <br /> Title: EH Specialist <br /> Date: 0-1 9 Ito 2"L Time: 1)`{• 2Lt PA, <br /> CAssA--IjbtZA GINrvL 1 <br /> Cc Modesto <br /> e- 0 - 9ox 4o6o <br /> Mo ks-b, C6 gE352 <br /> �L ihcx.t�T�1►J `C�+rj� Ix G y GC L G <br /> �775 1iSbM 8i_V STtE a0o <br /> S►�Q Ar rnev o, CA �5� � <br /> Page 2 of 2 <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 F 209 464-0138 1 www.sjgov.org/EHD <br />