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SIGNATURE DISCLOSURE <br />I make this report on behalf of all designated employees of the County of San Joaquin, and <br />A Li A 1.0)zeiAI "--1-egAr <br />(Agency Name) <br />I. <br />Signature: <br />Printed Name: <br />Title: <br />Date: ro-/A2- Time: /0 '00 <br /> <br />EHD LOG# - 0-4 .7_ <br /> <br />G. MANDATORY CONTACTS <br />ZuF <br /> <br />San Joaquin County Public Health Services — <br />Contact - Environmental Health Department <br />Donna Heran Time: 0 0, 1207i, Date: —ICFIZ <br />San Joaquin County Board of Supervisors — <br />Contact —Office of Emergency Services • <br />-Ron-Berkiwin <br />Aft 1 te-4._.• C We- re 1 t <br />Time: 9 , Pori Date: <br />L4.-q--1-Z <br />H. HEALTH AND SAFETY CODE 25180.7 <br />(b) Any designated government employee who obtains information in the course of his official duties revealing the <br />illegal discharge or threatened illegal discharge of a hazardous waste within the geographical area of his <br />jurisdiction and who knows that such discharge or threatened discharge is likely to cause substantial injury to the <br />public health or safety must, within seventy-two hours, disclose such information to the local Board of <br />Supervisors and to the local health officer. No disclosure if information is required under this subdivision when <br />otherwise prohibited by law, or when law enforcement personnel have determined that such disclosure would <br />adversely affect an ongoing criminal investigation, or when the information is already general public knowledge <br />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 <br />be disclosed under subdivision (b) shall, upon conviction, be punished by imprisonment in the county jail for not <br />more than one year or by imprisonment in state prison for not more than three years. The court may also impose <br />upon the person a fine of not less than five thousand dollars ($5000) or more than twenty-five thousand dollars <br />($25,000). The felony conviction for violation of this section shall require forfeiture of government employment <br />within thirty days of conviction. <br />,4 <br />cc: DTSC <br />CVRWQCB <br />P 6- 6- i-e.022- • Con MFR. <br />erOPer41 OvJAP--e— Ain-eirori Tin c Referred: <br />I 0 (0 CZ'L ca +h; Sluoll*I) E1 ee t-rdfiC CtICIMOC9) CA . <br />Site Code: <br />Yes No