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SAN JOAQUIN COUNTY <br /> NOTIFICATION OF HAZARDOUS WASTE DISCHARGE �� Q <br /> HEALTH & SAFETY CODE 25180.7 <br /> A. EMERGENCY LEVEL: II III PHS-EH LOG <br /> (Circle One) 1 <br /> B. SOURCE OF INFORMATION YY .3Y� � <br /> Name: So sa Phone: GO s" <br /> Company: ri c wi C y s <br /> Address: <br /> Designated Employee Name: r G 1 :^ 3.==--- <br /> Phone: (2o) y ccY 3 ti `t <br /> Reporting Agency Name:-S T'� ��' , <br /> Address: vvs S 3vcx�c u S-to k .4 , r^9 s--'52-Q ±!-r <br /> C. LOCATION AND DATE OF DISCHARGE <br /> Location: 6k,) / o County) Circle One <br /> (Best Physical Description) <br /> Date of Discharge: ce u (-r1 C� � <br /> Date Notified: 4Z2a/y3 Time: 3/9rz� <br /> D. RESPONSIBLE PERSON/BUSINESS <br /> Name of Business: C^��uvOn L SA Telephone: siu <br /> Contact Person: A,P fi` !1u r P (-�— <br /> Physical Address: Su H <br /> Mailing Address: sk�x <br /> E. DESCRIPTION <br /> Type of Discharge: <br /> Volume- <br /> Chemicals /o c12 BP, r <br /> Circumstances: c', / M „/c Hp s�fS" C,/ <br /> yte-( allJ,o G G/P /P G✓iC - <br /> F. ACTION TAKEN Ta In <br /> SITE DISPOSITION Fur/Gw 5'4 as r Me trsa<5 /o e ek m" ' <br /> /i/� O f � .G L .7l r0 �+' ' uL 1ly�'+ S vP ••.•/ �i. �.... G/l?a/J. GLS <br /> L <br /> O ril�/✓ 45 r /N <br /> O <br /> EH 22 013 (Rev-4/91) <br />