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" 1tNDXTORY CONTACTS <br />San Joaquin County?r <br />Environmental Health Department: 4-�f�A`( 2 5 <br />(Contact Name) (Time) (Date) <br />San Joaquin County�n- <br />Board of Supervisors: K9 J 6*6 W til F:4 6 A, ►M./ <br />(Contact Name) (Time) (Date) <br />H. HEALTH AND SAFETY CODE S 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 know that such discharge or threatened discharge is <br />likely to casue substantial injury to the public health or safety must, within seventy two hours, <br />disclose such information to the Board of Supervisors and to the local health officer. No disclosure <br />of information is required 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 <br />locality affected by the discharge or threatened discharge. <br />(c) Any designated government employee who knowingly and intentionally fails to disclose <br />information required to the disclosed under subdivision (b) shall, upon conviction, be punished by <br />imprisonment in the county jail for not more tan one year or by imprisonment in state prison for not <br />more than three years. The court may also impose upon the person a fine of not less than five <br />thousand ($5,000) or more than twenty five thousand dollars ($25,000). The felony conviction for <br />violation of this section shall require forfeiture of government employment within thirty days (30) of <br />conviction. <br />I. SIGNATURE DISCLOSURE <br />I make this report on behalf of all the designated employees of the County of San Joaquin, and <br />(Agency Name) <br />Signature: <br />Print Name: W"t <br />Date: S % 2A % n� <br />SITE CODE #: <br />CC: <br />Referred To: <br />Title: �n ' 24' "' J <br />Time: l(: S.S A.M. P.M. <br />EHD 22-02-003 Notification of Haz Discharge <br />10/2/2003 <br />