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SAN JOAQUIN COUNTY <br /> RECE ¢/E-9 NOTIFICATION OF HAZARDOUS WASTE DISCHARGE <br /> HEALTH & SAFETY CODE 25180.7 <br /> tt1P.'f i 1991 <br /> �00tial:€GM&P1;;'1 VEL: l�I II III S-EH LOG # / Oy <br /> 1�n a AvkA County ircle One) 4"l � <br /> B. SOURCE OF INFORMATION <br /> Original Source: GgrAt TEG[ Zme: (ft 43;5- 3`16 Z- <br /> 3017 X4t-6vRE12vAD atI1D �(hfGt�a CaR-dav/{ C,{ gs7�I L <br /> Reporting Agency Name: <br /> Agency Contact: Telephone: 2y�7 <br /> Address: [f� xl. AN a4 4Ui[J ns`T S7K4-*-' v4 UQ- 4 S zv 2— <br /> C. "LOCATION AND DATE OF DISCHARGE GLFikF-�! T <br /> - Location: <br /> (Best Physical Description) (City or County) <br /> Date of Discharge: <br /> Date Notified: fII6(/Qq/ Time: �� '"� <br /> _D. RESPONSIBLE PERSON/BUSINESS <br /> Name of Business �EZG[-� E/1T Somal <br /> Telephone: (311 ) -7 <br /> _ Contact Person: 04K f34:281=2 — p <br /> Physical Address: <br /> - E. DESCRIPTION <br /> Type Release: n/A�'RhaQlz <br /> - Volume: LIN New <br /> Chemicalsi L' <br /> eere,e + et1: V�Csy /e5✓['ki'd So.� feS�IH�-e�ofn7K ✓/'�Ne� iJ 5'T(�wovn ( <br /> F. ACTION TAKEN <br /> " 50[L i?.°S�UisF,do.� TiAdJ�!2E.4ov.�L rant 5<l/�Tl4v �i�lr![c,�TF <br /> SaIL ccr[ztFi*iN�TionlysTCo��vl`��nl Tigt/ cute /3E /Ju�t�r6H� <br /> Gvi 7N v.B/� /2E/��T�ND Aa9iJ 7Z, Gg^CT e/l�iNdTE� s?rE <br /> J��Tid- BASE FtiR-TNE.Q 2"-1J vESTfc�i-T�t�C/ �� RF�`tEozA--rioN <br /> �f i3F RGOv<REO 13Y E</ 4ua�/�vGv/�wc✓c.K <br /> ..1 <br /> EH 22 013 (Rev. 02/90) <br /> �S2 2'7 <br />