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04/11/21103 111:0/ 2094b83433 FIFTH FLOOR PAGE 93 *Moed3 - 0 G. MANDATORY CONTACTS Public Health Services of San Joaqu County APR 1 2003 Environmental Health Division: �� /1 U b$ .4.M (Contact Name) (Time) (Date) San Joaquin County 7 2003 Board of Supervisors: P t/ t��r�� / 11: U S 1 .11, APR (Contact Name) (Time) (Date) H_ HEALTH AND SAFETY CODE 23180.7 .. b) Any designated government employee who obtains information in the course of his official duties revealing the illegal discharge or threatened illegal discharge of a hazardous waste within the geographical area of his jurisdiction and who knows that such discharge or threatened discharge is likely to cause substantial injury to the public health or safety must, within seventy-two hours, disclose such information to the local Board of Supervisors and to the local Health Officer. No disclosure of information is required under this subdivision when otherwise prohibited by law. or when law enforcement personnel have determined that such disclosure would adversely affect an ongoing criminal investigation, or when the information is already general public knowledge within the locality affected by the discharge or threatened discharge. C) Any designated government employee who knoMngly and intentionally fails to disclose information required to the disclosed under subdivision(b)shall, upon conviction, be punished be imprisonment in the county jail for not more than one year or by imprisonment in state prison for not more than three years. The court may also impose upon the person a fine of not less than five thousand dollars (53,000) or more than twenty-five thousand dollars ($23,000). The felony conviction for violation of this section shall require forfeiture of government emplovolent witbin _ thirty days(30)of conviction. L SIGNATURE DISCLOSURE I make this report on behalf of all the designated employees of the County- of San Joaquin, and (Agency/Name) Signature: Typed/Printed Name: Tide: 'Q� Date: �'G /� 3 Tiiae: cc: SWEEPS#/SITE CODE#: CONMFR Y I N PT S G- REFERRED TO: . ( rVz c(3 — Nov us! EH 22 013(Rev.MOM)