Laserfiche WebLink
i <br /> t <br /> L SAN JOAQUIN COUNTY <br /> NOTIFICATION OF 11ALARDOUS WASTE DISCHARGE <br /> HEALTH & SAFETY CODE 7S1ftT } P <br /> A. EMERGENCY LEVE II I'I PHS-EH LOG # —�- 1 <br /> (Circle One) —'"""_" <br /> B. SOURCE OF INFORMATION <br /> Original Source: r7T. T Telephone: 7 <br /> Reporting Agency N e: F[+S � <br /> Agency Contact: ffTelephone: ( ) 7-- <br /> Address: P.O. 13 or 7-00 2 <br /> C. LOCATION AND DATE OF DISCHARGE <br /> Location: 13 c5 _ / 6 <br /> (Best Physical Description) (City or County) <br /> Date of Discharge: <br /> Date Notified: �I & A-1) Time: :On <br /> D. RESPONSIBLE PERSON/BUSINESS <br /> Name of Business <br /> Contact Person: ct, Telephone: (, � 8 2—S<-�' <br /> Physical Address:Z yl �(,` <br /> E. DESCRII''I'iON <br /> Type Release: <br /> Volume: <br /> Chemicals: <br /> F• ACTION TAKEN <br /> /1 <br /> 1-:1-122 013 (Rev. 02/90) <br />