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9© -i� 1 G. MANDATORY CONTACTS , Public Health Services r - of San Joaquin County �q,•,� Environmental Health-Division: �y � / UD / - 3 c, -90 w (Contact Name) r (Time) (Date) 1 San Joaquin County . _ h Board of Supervisors: (Contact Name) - (Time) (Date) H. HEALTH AND SAFETY CODE S 25180.7. (b)' Any designated government employee who obtains information in the course 7of his official duties revealing the illegal discharge or threatened illegal discharge of a hazardous waste within. j the geographical area of his jurisdiction and who knows that such discharge or threatened discharge is Iikely 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 S officer. No -disclosure of information is required under this subdivision Nhen otherwise a 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 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 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 i 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 of conviction. 1. SIGNATURE DISCLOSURE 'I,_make this report on behalf of all the designated employees of the County of San Joaquin, - i and gency Name,) Signature: TypedY Name: Title: - Date: � �G/O Time: EH 22 013 (Rev. 2/90) �:_