SITE INFORMATION AND CORRESPONDENCE

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G. MANDATORY CONTACT . Public Health"Services of San Joaquin County. Environmental Health Division: G/A,977, / (Contact Name) (Time) (Date) 1 San Joaquin County' - Board of Supervisors: i�0A1 23k��.O/A/ / h (Contact Name) , (Tune) (Date) H: - ---HEALTH-AND SAFETY CODE S 25180.7. ` Y (b) "Any designated government employee who obtains information in'the course of his official 4. - -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 of threatened -7-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 A affect °an ongoing criminal investigation, or when the information is already-general public knowledge within the locality affected by the discharge or threatened discharge. 7. r (c) Any designated government employee who knowingly and intentionally fails to disclose information required to the disclosed under subdivision (b) shall, upon'conviction, be punished - by imprisonment in the county jail for not more than ane year.or by imprisonment in state prison L'for not,more than three years. The court may also impose upon the person a fine of not less than •• five thousand'dollars ($5,000) or more than twenty-five thousand dollars ($25,000). The felony conviction for violation of this section shall require forfeiture of government employment within thirty days (30) of conviction. _ I. SIGNATURE DISCLOSURE r I.make this report on behalf of all the,designated employees of the County of San Joaquin, and (Agency Name) -..- Typed/Printed Name: /l(tCff f�� ?. IW AA Ise• - .. ¢ cG. f�Jie. S' Tithe: R ---- -- . - . . ,.., ...,.,_,....,..�._.. Date: Time: - //.307f , S w � 6G± Y _2 .. .� . —SWFEPS#/SITE CODE#: IMf �: .. 1. a ... _ w .CONMFRY / N REFERRED.TO. 60 EH 22 013 (Rev.4/91)