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MANDATORY CONTACTS <br /> Public Health Services <br /> of Snn Joaquin County <br /> 17mironmental Health Division: �� �/V VAI /J e.r/ <br /> (Contact Name) (Time) (Date) <br /> San Joaquin County ,board of Supervisors: K0 IJ 15A L, V41 N il _i 2 <br /> (Contact Name) (Time) (Date) <br /> 1 MALTH AND SAFETY CODE S 25180.7. <br /> (b) Any designated government employee who obtains information in the course of his omclal <br /> dbities revealing the illegal discharge or threatened illegal discharge of a hazardous waste within <br /> the geographical area of his jurisdiction and who knows that such discharge or threatened <br /> discharge is-likely to cause substantial injury to the public health or safety must, within seventy- <br /> two hours, disclose such information to the local Board of Supervisors and to the local health <br /> officer. No disclosure of information is required under this subdivision when otherwise prohibited <br /> by law, or when law enforcement personnel have determined that such disclosure would adversely <br /> affect an ongoing criminal investigation, or when the information,is already general public <br /> knowledge within the locality affected by the discharge or threatehed discharge. <br /> (c) Any designated government employee who knowingly and intentionally fails to disclose <br /> information required to the disclosed under subdivision (b) shall, upon conviction, be punished <br /> by imprisonment in the county jail for not more than one year or by imprisonment in state prison <br /> for not more than three years. The court may also impose upon the person a fine of not less than <br /> rive thousand dollars ($5,000) or more than twenty-five thousand dollars ($25,000). The felony <br /> conviction for violation of this section shall require forfeiture of government employment within <br /> thirty days (30) of conviction. <br /> SIGNATURE DISCLOSURE <br /> 1 make this report on behalf of all the designated employees of the County of San Joaquin, and <br /> (Agency Name) <br /> C.t�til lc.a.-,�- <br /> Signature: /C�,��.( <br /> TyTed/Printed Name: <br /> Title: <br /> fate:? Time: �;OU�/�/�-► <br /> i <br /> A � SL SWEEPS#/SITE CODE#: <br /> L B CONMFR�Y�/ N <br /> REFERRED TO: <br /> 013 (Rev.4/91) s <br /> s <br />