Laserfiche WebLink
TANK —� <br /> �. SAN JOAQUIN COUNTY --� <br /> NOTIFICATION OF HAZARDOUS WASTE DISCHARGE <br /> HEALTH & SAFETY CODE 25180.7 <br /> A. EMERGENCY LEVEL: (D II III H LOG # OT " 4 <br /> (Circle One) COPT <br /> B. SOURCE OF INFORMATION <br /> Name: Mark Phone: (4i5)_ s"�Z-CnQ33 <br /> Company: H K-- <br /> Address: <br /> Address: \-74-S l t-..c,sl <br /> Designated Employee Name: JERRY YOSHIOKA Phone: G_L9) 468-0335 <br /> Reporting Agency Name: SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH <br /> Address: 304 E. WEBER AVE. <br /> C. LOCATION AND DATE OF DISCHARGE <br /> Location: <br /> (Best Physical Description) <ZCor County) Circle One <br /> Date of Discharge: U nkn o <br /> Date Notified: 3/zs/g-4- Time: 142-4t' hones <br /> D. RESPONSIBLE PERSON/BUSINESS <br /> Name of Business: C-z�cd �:qea� e &-' Rubbc✓- <br /> Contact Person: Telephone: C�) F-:W-Coci00 <br /> Physical Address: <br /> Mailing Address: <br /> E. DESCRIPTION <br /> Type of Discharge: Zlv�au Hwa z_eC� neleQSe� <br /> Volume: UV)kv e)O QQ N <br /> Chemicals: \I a s F O <br /> Circumstances: t-1 z 'tTwI k <br /> F. ACTION TAKEN 11v�ce� ^c u�d �t'c. vcrr <br /> SITE DISPOSITION t=uc, lnc - s. Fc ti m b <br /> -TTS Gt cam- v\ <br /> EH 22 013 (Rev.4/91) <br />