Laserfiche WebLink
SAN JOAQUIN COUNTY <br /> NOTIFICATION OF HAZARDOUS WASTE DISCHARGE <br /> HEALTH & SAFETY CODE 25180 . 7 <br /> A. EMERGENCY LEVEL: 1II III HEALTH DISTRICT LOG <br /> (Circle One) <br /> B. SOURCE OF INFORMATION <br /> Original Source: f a6(iA1 ZC7C} Telephone: <br /> Reporting Agency Name: D U�i✓ Lo SAG /T�I�C(f/ <br /> Agency Contact: �iI/ ,� `/� Telephone: -2} -3y <br /> Address : , e , /c �Q,✓ �¢ ` <br /> C. LOCATION AND DATE OF DISCHARGE <br /> Location: l3"7aw <br /> (Best Physical Description) (City or C unty) <br /> Date of Discharge: U�v vrrvi✓ <br /> Date Notified: /ate Time: <br /> D. RESPONSIBLE PERSON/BUSINESS <br /> Name of Business <br /> Contact Person: //Telephone: <br /> Physical Address : lam(/ , �•!l-c' f�e.e �1 % js !� � <br /> E. DESCRIPTION <br /> Type Release: i✓f�7il%��D/e/� ��/ S� ___..._..,._ <br /> Volume: <br /> Chemicals : <br /> F. ACTION TAKEN <br /> Ax,e Gt �d ripJ C <br />