Laserfiche WebLink
r � r <br /> ��,....� SAN JOAQUIN COUNTY �•� <br />- NOTIFICATION OF I-IAIARDOUS WASTE DISCHARGE <br /> HEALTH & SAFETY CODE 2S180:3-, D <br /> A. EMERGENCY LEVE II ` I'I PHS-EH LOG # <br /> (Circle One) <br /> B. SOURCE OF INFORMATION <br /> Original Source: .-�. I Telephone: ( l/�j3g 7 <br /> Reporting Agency N me: Fl+ � <br /> Agency Contact: ffTelephone: O 7i <br /> Address; <br /> C. LOCATION AND DATE OF DISCHARGE <br /> Location: J3 - -o-W-A-- / 15Tb ant7D <br /> (Best Physic Description) (City or County) <br /> Date of Discharge; <br /> Date Notified: (v rTime: ono <br /> D. RESPONSIBLE PERSON/BUSINESS <br /> Name of Business <br /> Contact Person: c" Telephone: &D <br /> [a ,J <br /> PbysicalAddress:;Ly—/j2 ! � 4,►„4„� �}VS'��3 <br /> E. DESCRIEMON <br /> Type Release: '�^- - � dd U:is—Aj <br /> Volume: <br /> Chemicals: <br /> F. ACTION TAKEN <br /> EI3 22 013 (Rev. 02/90) <br />