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G•-,_MANDATOR Y-CON TAC S- <br /> San Joaquin County <br /> Local Health District: <br /> Contact Name Time Date <br /> San Joaquin County <br /> Board of Supervisors: <br /> Contact Hame / <br /> Time Date - <br /> H. HEALTH AND SAFETY CODE 5 25180.7. <br /> (b) Any designated government employee who obtains. Inform <br /> tion in the <br /> threatened illegal discharge or threatened <br /> CO -se of his official duties revealing the illegal discharge or hazardous waste within the geographical are illegal discharge of a <br /> knows that such discharge or threatened I <br /> a of his Jurisdiction and who. <br /> discharge is likely to cause <br /> substantial injury to the public health or safety must. within . <br /> seventy-two hours. disclose such informmtion to the local Board. of , <br /> Supervisors and to the local health officer. •, ko disclpsure of <br /> information is required under this subdivision when clpsu e o prohibited <br /> by law. or when law enforcement personnel have when pined .that prohibited <br /> disclosure would adversely affect an ongoing 'crimier investigation. or <br /> such 1 <br /> when the information is already general public knowledge within the.' <br /> locality affected by the discharge or threatened discharge. <br /> (c) Any designated government employee who knowingly and intenttona!lly <br /> fails to disclose information required to be disclosed under subdivision <br /> (b) shall . upon conviction. be punished by imprisonment in the county <br /> jail for not more than one year or by imprisonment to state prison for <br /> not more than three years. The court may also impose upon the person a <br /> fine of not less than five thousand dollars ($5.000) or more than <br /> twenty-five thousand dollars ($25.000). The felony conviction for <br /> violation of this section shall require forfeiture of government <br /> employment within thirty days of conviction. <br /> i <br /> I. SIGNATURE DISCLOSURE <br /> i make this report on behalf of all the designated employees of the I <br /> County of San Joaquin. and the San Joaquin County Local Health District. <br /> and <br /> Agcncy Name <br /> Signature: <br /> Typed Name: n eff,MLS (��iy,44 <br /> Title: <br /> SL aC� riClilt� f7i iLiw <br /> Date: Time: %•CT(J fiy <br /> Revised 11_LI87 <br /> mac.. � _ ---- - -_- --. .•p <br />