Laserfiche WebLink
SAN JOAQUIN COUNTY � . <br /> NOTIFICATION OF HAZARDOUS WASTE DISCHARGE. <br /> Health & Safety Code § 25180.7- <br /> , <br /> A. EMERGENCY LEVEL01 II III Health District Log5�7 <br /> (Circle one) <br /> B. SOURCE OF INFORMATION <br /> Original Source: Telephone: <br /> Reporting Agency Name: <br /> Agency Contact: Telephone: } 4 Sv <br /> Address: <br /> C. LOCATION AND DATE OF DISCHARGE <br /> Date(s): jZ—/3 ,.Z Time: Vii!' <br /> Location: <br /> Best PhysTtal Description) qty or ounty <br /> D. RESPONSIBLE PERSON/BUSINESS <br /> Name of Business: ' <br /> Contact Person: Telephone: <br /> Physical Address: <br /> E. DESCRIPTION <br /> Type Release: <br /> Volume: <br /> Chemicals: f <br /> F. ACTION TAKEN <br />