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SAN JOAQUIN COUNTY <br /> 1 NOTIFICATION OF HAZARDOUS WASTE DISCHARGE <br /> HEALTH & SAFETY CODE 25160 . 7 <br /> A. EMERGENCY LEVEL: ( Z/II III HEALTH DISTRICT LOG # Q�v <br /> (Circle One) ll.. <br /> B. SOURCE OF INFORMATION <br /> Original Source: <br /> Sr ✓``--S'' �S S Telephone: (7�)9�/j-ZljCjlJ <br /> Reporting Agency Name:-�i�_y'lAultri <br /> Agency Contact: /✓'//'�- L1.f/A elephone: (2W)- li -3s/ <br /> Address: <br /> C. LOCATION ANDDATE <br /> ,,OFF DISCHARGE / f -� <br /> Location: �yOQ �' �'}�/L�1 J%�'N / ��/CN. ��7— if <br /> (Best Physical escription) (Cit} or County) <br /> Date of Discharge: cr-z z--AK <br /> Date Notified: 972 QO Time: <br /> D. RESPONSIBLE PERSON/BUSINESS <br /> Name of BusinessS? �� dh/S //JJst�ir <br /> Contact Person: ��'%L L2/0, <br /> 1ieRISyn/ Telephone: f ) �C3Q <br /> Physical Address: <br /> E. DESCRIPTION //� <br /> Type Release: (�f/ Crvr �viZe,0 AD Sdi' <br /> Volume: S- <br /> Chemicals : _ IDLf<e 1r7,4 a <br /> F. ACTION TAKEN <br /> L <br /> ruh�s 7'z) ,dam kiula <br /> Lear ,r <br /> � p C � u r'>'e c� -�/-o <br /> (l. hZ4 C6 S Co 11 11 e C_4--c. c( '-/, l o 5 ja , nn <br /> CGI -/ A j1l ✓10. •G� SG / ( / <br /> ('f /1,C)v Cd <br />