Laserfiche WebLink
C-Q) jl --T� <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> (209)468-3420 • Fax:(209)464-3433• Web:www.sioov.org/ehd <br /> r[...O ryx. <br /> NOTIFICATION OF HAZARDOUS WASTE DISCHARGE <br /> A. EMERGENCY LEVEL ❑x I ❑ II ❑ III JEHDLOG# -0 O <br /> B. SOURCE OF INFORMATION <br /> NAME: C-rq e-e4 g 1 PHONE: <br /> COMPANY: San Joaquin County Environmental Health Department CITY. Stockton <br /> ADDRESS: 1868 E. Hazelton Ave.. ' <br /> DESIGNATED EMPLOYEE NAME: er--rre-lg PHONE: <br /> REPORTING AGENCY NAME: San Joaquin County Environmental Health Department <br /> ADDRESS: 1868 E. Hazelton Ave., Stockton, CA 95205-6232 <br /> C. LOCATION AND DATE OF DISCHARGE <br /> LOCATION: oqq7 Orw y rTje' Inco orated <br /> Best Physical /+ /n� CITY <br /> Description ❑ Unincorporated <br /> DATE OF DISCHARGE: <br /> DATE NOTIFIED: 1 TIME: %0 A#.---- <br /> D. RESPONSIBLE PERSON/BUSINESS <br /> NAME OF BUSINESS: <br /> CONTACT PERSON: * C2. [_� �I �� PHONE: <br /> PHYSICAL ADDRESS: 5 .tee h Cerr� O <br /> MAILINGADDRESS: <br /> E. DESCRIPTION <br /> TYPE OF DISCHARGE: �701 <br /> VOLUME: G'-'r v e_ q <br /> CHEMICALS: <br /> CIRCUMSTANCES: G�tzr Je..e� I--Pg oa^S� <br /> F. ACTION TAKEN <br /> ,ntirX Cl � Yi�i�{+..-r7�,eY�i..¢L/' I^n'?7..--_ �N^�C� L.!�.�1•'vim. C.�TYbv.v.rK�j✓0.-('2�- 1�.7 <br /> Ir04 e>nA' Yvot� G'7 -7"7ni5 �DGq'{"f�r� r us'fh- '.��rir ire cQr....rt^ O.�sr <br /> SITE DISPOSITION <br /> �arr� -Pi-J �i6- cFWA'A1 , svc o v <br /> cKa9�1i � , A5nofrt 4t 2 n7o q r t So rt= e 595a� +_- <br /> J <br /> Revised 08/02112 Page 1 of 2 NOTIFICATION OF HAZ WASTE.DISCHARGE <br />