Laserfiche WebLink
SAN JOAQUIN COUNTY C <br /> NOTIFICA4TON OF HAZARDOUS WASTE DI,GN.ARGE <br /> HEALTH & SAFETY CODE 25180.7 <br /> t <br /> A. EMERGENCY LEVEL II III PHS-EH LOG # <br /> (Circle One) <br /> B. SOURCE OF INFORMATION <br /> Name: ("�Ofr- C5. <br /> Phone: n7 YES- 3yyc� <br /> Company: S PHs -1E142 <br /> Address: P a t�?--z :ce)'? - <br /> Designated Employee Name: CL-arks Phone: ^ � Wo_ <br /> Reporting Agency Name: J RNs -rgp <br /> Address: P.O. aooq <br /> C. LOCATION AND DATE OF DISCHARGE <br /> Location: 3G3o S, F( Doric/a <br /> (Best Physical Description) Ci r County) Circle One <br /> Date of Discharge: 1&-,,osv,J <br /> Date Notified: 7/,-g/,rt Time: S:3cAM <br /> D. RESPONSIBLE PERSON/BUSINESS <br /> Name of Business: 1c+Nk v-P Slnck4 <br /> Contact Person: r/r^1�a Q rre41L Telephone: ,,;o 91,/i -- 137 - <br /> Physical Address: 30/ !--- N'%NPr- Av s'roc k4" CA <br /> Mailing Address: P. o. Aw 810 g�A01 <br /> E. DESCRIPTION <br /> Type of Discharge: (,IAP— <br /> Volume: IAVolume: <br /> Chemicals: e lau w. kf c, �-N�c <br /> Circumstances: -16,4.5 re,,rov.-- , <br /> y..�-/ �atv�tssrriivo-fiuN . <br /> F. ACTION TAKEN Arc 65- uA& i5nAj i,,rE7 <br /> SITE DISPOSITION <br /> G'C'��L'f,ll Net�rJ1 ..n �rt'?n pT �t �'rGl r .vibe i � .J a�c� `ic C'c••c�aerS <br /> EH 22 013 (Rev.4/91) <br />