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SAN JOAQUIN COUNTY <br /> NOTIFICATION OF HAZARDOUS WASTE DISCHARGE <br /> r HEALTH & SAFETY CODE 25160. 7 <br /> A. EMERGENCY LEVEL: IIfIII. HEALTH D I LOG # -pp <br /> .(Circle One) <br /> B. SOURCE OF INFORMATION f, <br /> Original Source: -I pyelephone: (Z ) <br /> rn A/Z - <br /> Reporting Agency Name: LCK. I 7 �fS <br /> Agency Contact: LA- 5,,J1g' Telephone : ( Z- �`3 y <br /> Address: <br /> C. LOCATION 'AND DATE. OF DISCHARGE ' <br /> Location: �� 5 .1 VCfROK <br /> (Best Physical. Description) (City o County ) <br /> Date of Discharge: UN lc v\o w A <br /> Date Notified: Time: r <br /> ' 30 A-m <br /> D. RESPONSIBLE PERSON/BUSINESS <br /> Name of Business F 1G <br /> Contact Person: ��jCF_ Woo/ . I'elephone : <br /> Physical Address : S3 !jf Ei �FE C c �Zo-� <br /> E DESCRIPTION <br /> Type Release: re- <br /> volume : <br /> e- <br /> volume : `} N KOo,,j +j <br /> Chemicals : <br /> F- ACT I0N TAKE''N <br /> nit cJ� O Wn 6 r ✓� (e 5c <br /> - " <br /> ve <br /> 94 ��/a �e X�� o y ce !-j 7/;-m r N �`T e' !V' C,( L4 C �n �/ <br /> k. Fo L Low - is P Z-ry s�&c-7/,;i Vb a-de 1;7 <br /> P <br /> .S- ZC1/-- 8f, <br /> i <br />