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EHD LOG# IO <br /> G. MANDATORY CONTACTS <br /> San Joaquin County Environmental Health <br /> rtment Donna Heron Time: ,Jl) Date:Depa <br /> San Joaquin County Hoard of Supervisors- Michael Cockrell Time: 1/: Date: - <br /> Contact-Office of Emergen Semmes <br /> H. HEALTH AND SAFETY CODE 25180.7 <br /> (b) Any designated government employee who obtains information in the course of his official duties <br /> revealing the illegal discharge or threatened illegal discharge of a hazardous waste within the <br /> geographical area of his jurisdiction and who knows that such discharge or threatened discharge is <br /> likely to cause substantial injury to the public health or safety must,within seventy-two hours, disclose <br /> 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 <br /> enforcement personnel have determined that such disclosure would adversely affect an ongoing <br /> criminal investigation,or when the information is already general public knowledge within the locality <br /> affected by the discharge or threatened discharge. <br /> (c) Any designated government employee who knowingly and intentionally fails to disclose information <br /> required to be disclosed under subdivision(b) shall, upon conviction, be punished by imprisonment in <br /> the county jail for not more than one year or by imprisonment in state prison for not more than three <br /> years. The court may also impose upon the person a fine of not less than five thousand dollars <br /> ($5000) or more than twenty-five thousand dollars($25,000). The felony conviction for violation of this <br /> section shall require forfeiture of government employment within thirty days of conviction. <br /> I. SIGNATURE DISCLOSURE <br /> I make this report on behalf of all designated employees of the County of San Joaquin, and <br /> San Joaquin County Environmental Health Department <br /> Nc�wr nit <br /> Signature: <br /> Printed Name: <br /> Title: <br /> Date: !�7- / �3 Time: =stn <br /> cc: DTSC Site Code: <br /> CVRWOCB A�{-t// � G / •t4"�/� Con MFR Yes No <br /> �fTf5f0cl�Ionr . 7 ^^ <br /> A"m e ,��. Oa b . 4l.IP7�� Refereed: <br /> Pp !"^ <br /> t.15;54' Fresno' 4 <br /> f K A (Zt,-m 5 LL-C.t {resna,1_4 <br /> Oa1nAi`• � 2D�o s. Eas �, <br /> Revised 08102/12 Page 2 of 2 NOTIFICATION OF HAZ WASTE DISCHARGE <br />