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M. 0 61 ao— C(P5 <br /> ANIIAT, ,ORY CONTACTS <br /> San Joaquin County x:59 A•t'�/SEP — $ 2006 <br /> Environmental Health Department: r)6f'J I.+� �CNr,� / <br /> (Contact Name) (Time) (Date) <br /> San Joaquin County — B <br /> Board of Supervisors: kal' ) 941q W9 of / g•'59 A•M /SSP 2006 <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: /n <br /> Print Name: 2 4 ' &4 a#,J tldA.l �(l�e , Title: <br /> Date: I l 8`0(' Time: .O S A.M. P.M. <br /> SITE CODE M r <br /> CC: DTd L <br /> CJ2 WQ ��� <br /> Referred To: <br /> EHD 22-02-003 Notification of Haz Discharge <br /> 10/2/2003 <br />