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SAN �JOAQUIN Environmental Health Department <br /> COUNTY-- <br /> NOTIFICATION OF HAZARDOUS WASTE DISCHARGE <br /> EHD LOG# <br /> MANDATORY CONTACTS <br /> San Joaquin County Health Officer- y <br /> Care of Environmental Health Departm Linda Turkatte Time: 'I _)pm Date: (41� I le <br /> San Joaquin County Board of Supervisors- t' <br /> Care of Clerk of the Board Mimi Duzenski Time: '. -{�j Date: <br /> HEALTH AND SAFETY CODE25180.7 <br /> b)Any designated government employee who obtains information in the course of his official duties revealing the illegal <br /> discharge or threatened illegal discharge of a hazardous waste within the geographical area of his jurisdiction and who knows <br /> that such discharge or threatened discharge is likely to cause substantial injury to the public health or safety must, within <br /> seventy-two hours, disclose such information to the local Board of Supervisors and to the local health officer. No disclosure if <br /> information is required under this subdivision when otherwise prohibited by law, or when law enforcement personnel have <br /> determined that such disclosure would adversely affect an ongoing criminal investigation, or when the information is already <br /> general public knowledge within the locality affected by the discharge or threatened discharge. <br /> c) Any designated government employee who knowingly and intentionally fails to disclose information required to be disclosed <br /> under subdivision (b) shall, upon conviction, be punished by imprisonment in the county jail for not more than one year or by <br /> imprisonment in state prison for not more than three years. The court may also impose upon the person a fine of not less than <br /> five thousand dollars ($5000) or more than twenty-five thousand dollars ($25,000).The felony conviction for violation of this <br /> section shall require forfeiture of government employment within thirty days of conviction. <br /> SIGNATURE DISCLOSURE <br /> I make this report on behalf of all designated employees of the County of San Joaquin, and the <br /> San Joaquin County Environmental Health Department <br /> Signature: �&- T-- <br /> Printed name: Haza Saeed <br /> Title: REHS <br /> Date: Time: \o .(>o v-wt*-, <br /> P \N� CCS d�,C�-� , LLC <br /> A tfn : Dau, Lu_PO 3c too <br /> P,+esi CCS X10 02- l d3y <br /> `v G�vr x VAS} C�-'C'S-�- Iuc�rs � <br /> PO �Cy ,�09 <br /> Hu Astun TY: -92-5 <br /> Page 2 of 2 <br /> 1868 E. Hazelton Avenue Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />