SITE INFORMATION AND CORRESPONDENCE

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G. MANDATORY CONTACTS Public Health Services of San Joaquin County a Environmental Health Division: 6Y► 8/K� San Joaquin County (Contact Name) (Time) • (Date) . Board of Supervisors: J_ 22v (Contact Name) (Time) (Date) bl• HEALTH AND SAFETY CODE S 25180.7. (b) Any designated government employee who obtains information in the course duties revealing the illegal discharge or threatened illegal discharge of a hazy dous whir official within the geographical area of his jurisdiction and who knows that such dischar a aste threatened discharge is likely to cause substantial injury to the public health or safety or within seventy-two hours, disclose such information to the local Board of Supervisors must, the local health officcr. No disclosure of information is required under this ubd� and to otherwise prohibited by law, or when taw cnforccmegt personnel have determine that when disclosure would adversely affect an ongoing criminal investigation, or when the in that such already general public knowledge within the locality affected by the discharge or t formation is discharge. g threatened (c) Any designated government employee who knowingly and intentionally fail s to disclose information required to the disclosed under subdivision (b) shall, upon convictio by imprisonment in the county jail for not more than one year or by imprisonment� be punished prison for not more than three years. The court may also impose upon the person in state not less than five thousand dollars (35,000) or more than twenty-five thousand dollars (525,000). The felony conviction for violation of this sections p on a fine of government employment within thirty days of conviction, hall require forfeiture of )• SIGNATURE DISCLOSURE I make this re tjn behalf of all the designated employees of the County and of San Joaquin, Agency Name) Signature: ' c, Typed Name: I-e �7 `/,`� oqpS L Title: r Date: 02 a % 44n CC., Time: rH 22 03 (Rev. 7/89)