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I <br /> EHD LOG# 13 4)(0 <br /> G. MANDATORY°CONTACTS <br /> Denartmenit County Environmental Health Donna Heran Time: {Q3 Date: �� y� <br /> i <br /> San Joaquin County Board of Supervisors— Michael Cockrell Time: I Date: (� �} <br /> Contact—Office of Emergency Services <br /> H. HEALTH AND SAFETY CODE 25180.7 <br /> (b) Any designated government employee who obtains information in the course of his official duties <br /> revealing the illegal discharge or threatened illegal discharge of a hazardous waste within the <br /> geographical area of his jurisdiction and who knows that such discharge or threatened discharge is <br /> likely to cause substantial injury to the public health or safety must,within seventy-two hours, disclose <br /> such information to the local Board of Supervisors and to the local health officer. No disclosure if <br /> information isirequired under this subdivision when otherwise prohibited by law, or when law <br /> enforcement personnel have determined that such disclosure would adversely affect an ongoing <br /> criminal investigation, or when the information is already general public knowledge within the locality <br /> affected by the discharge or threatened discharge. <br /> (c) Any designated government employee who knowingly and intentionally fails to disclose information <br /> required to be;disclosed under subdivision (b) shall, upon conviction, be punished by imprisonment in <br /> the county jail for not more than one year or by imprisonment in state prison for not more than three <br /> years. The court may also impose upon the person a fine of not less than five thousand dollars r <br /> ($5000) or more than twenty-five thousand dollars($25,000). The felony conviction for violation of this. x <br /> section shall require forfeiture of government employment within thirty days of conviction. <br /> I <br /> I <br /> I. SIGNATURE DISCLOSURE <br /> I make this report;on behalf of all designated employees of the County of San Joaquin, and <br /> San Joaquin County Environmental Health Department <br /> (Agency Name) <br /> Signature: <br /> Printed Name: M(Ar}I>"p A fy� _ <br /> Title: QL S <br /> Date: Time: Oc),ry� <br /> f <br /> cc: DISC Site Code: <br /> CVRWQCB I <br /> Con MFR Yes No <br /> Ll�Ol� r �T�L�Ck�L �T7 Referred: <br /> Q lQ 5 5 !d <br /> �'}r!] �cCJ 5t Ci'U"ri Vi 5 1 <br /> A, ��� led,Com, C/-f r <br /> Revised 08/02/12 Page 2 of 2 NOTIFICATION OF HAZ WASTE DISCHARGE <br />