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'O PqulN 'CO SAN JOAQUIN COUNTY VIRONMENTAL HEALTH DEP ENTram <br /> 600 E. Main Street, Stockton, CA 95202-3029 � � <br /> c Telephone:(209)468-3420 Fax: (209)468-3433 Web:www.sjgov.org/c �. lr/�\ 1 <br /> NOTIFICATION OF HAZARDOUS WASTE DISCHA 6E1 <br /> California Health & Safety Code, Section 25180.7 <br /> EHD LOG <br /> A. EMERGENCY LEVEL II III <br /> (Circle One) <br /> B. SOURCE OF INFORMATION <br /> Name: f-reo O� Phone: (20r1) CILE- 736q <br /> Company: <br /> br. City: S U(PJ ZipCode: GS <br /> Address: 201W7 Nay <br /> Designated Employee Name: <br /> Reporting Agency Name: <br /> Address: City: Zip Code: <br /> C. LOCATION AND DATE OF DISCHARGE ' i,_ I <br /> Location: ?'01C-C7 o w'4 br, i /�� If/ D^' / City r County <br /> (Best Physical Description) ircle One) <br /> Date of Discharge: a 0 Date Notified: Time: 81/ 11 A.M. P.M <br /> D. RESPONSIBLE PERSON/BUSINESS <br /> Name of Business: L. -all ef– AA'hL )2 <br /> Contact Person: :Er-6r\ b Vq-b v Phone: &n 165— 736 <br /> Physical Address: 2 o �1 1 br-, City: 91l-b&Vft1\ Zip Code: Zf`� <br /> Mailing Address: orb -t-et,✓l *f ,E! , ate,. City: GO-Zip Code: q2�g66 <br /> E. DESCRIPTION <br /> Type of Discharge: SO FL <br /> Volume: 1 ekf llnl m a r4lt^ <br /> Chemicals: h t e a <br /> Circumstances: R� 0 6 u&l Ac-4 00 4 4 rti � <br /> J <br /> F. ACTION TAKEN: l r 4 V q' esus u47 40 <br /> n( " f^k r)rur-16 k_ <br /> SITE�D� ISPOSITION: or,L&F�,i .,tA-- i C . At-'4lI �– n � 4004'-/L<rL 5r\A L /L F c- 6 pn ZY 64n,.a <br /> EHD 22-03 Notification of Haz Discharge <br /> 11/26/2007 <br />