SITE INFORMATION AND CORRESPONDENCE

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G• INT`►-NDA.TORY CONTACTS O a San Joaquin County Environrnental Health Department: Un ti4 hj � San Joaquin County - Board of Supervisors: H HEALTH AND SAFETY CODE S 25180.7 (b) Any designated government employee tivho obtains information in the course of his official revealing the illegal discharge or threatened illegal discharge of hazardous wastefhi l duties geo�aphical area of his jurisdiction and who know that such discharge or threatened discharge is likely to casue substantial injury to the public health or safety must, within seventy rivo hours disclose such information to the Board of Supervisors and to the local health officer. i\ro disclosure o inf�rmatlon is required under this subdivision when othertivise prohibited bylaw, or when law enforcement personnel have determined that such disclosure would adversely affect an ongoi ng crimir:a] investigation, or when the information is alread` locality affected by the discharge or threatened discharges general public kno��Iedgc within the (c) Any designated government employee who knowing ly and infonr.anon required to the disclosed under subdivision (b) hall,tentionally uponn convfctionobesctznish impris)nment in the county jail for not ,more tan one year or by �mprisonnlent in state prison eded bfor not more t,ian three years. The court may also impose upon the person a fine ie not less than five thousa:ld (55,000) or more than twenty five thousand dollars (525,000). The felony convict; violation of this section shall require forfeiture of government employment on for conviction. p yment �i;thin thirty days (30) of I• SIGN'xTUR.E DISCLOSURE I make his report on behalf of all the designated employees of the County of San Joaquin, and (Agency Name) Signature: Print Na ne: M' 00— Title: Date: 2 !lam Time: 4•��c� a�r p.tir. SITE CODE #: cc: C k) Q G Referred 'Fo: EHD 22-02-003 10.212003 hotifcatron of Her Dischsrge