SITE INFORMATION AND CORRESPONDENCE_FILE 1

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a. MANDATORY CONTAC, Public Health Services of San Joaquin County Environmental Health Division: ,// 64 ead 'Co Name) (Time) — �- 1 San Joaquin County . (Date)/J Board of Supervisors : (Contact Name) (Time) H• HEALTH AND SAFETY CODE S 25180. 7. (Date) (b) Any designated government employee who obtains duties revealing the illegal discharge information in the course of � official the geographical g oe or threatened illegal discharge of a hazardous waste within g BmPlikel area of his jurisdiction and Yvho knows that such discharge or discharge is likely to cause substantial .injury to the public health or safe must, within two hours g threatened disclose such information to the local Board of Supervisors to thelal health officer. No disclosure of informations required under this subdivision when otherwise calprohibitedhealth by law, or when law enforcement personnel have determined that such disclosure would adversely affect an ongoing criminal investigation, or when the information i ahead knowledge within the locality affected by the discharge or threatened discharge general public (c) Any designated government employee who know in 1 information required to the disclosed under subdivision g y and intentionally fails to disclose by imprisonment in the county jafi for not more �) Shy upon conviction, be punished for not more than three ears• than one year or by imprisotunent in state prison five thousand dollars y The court than may also five upon the person a fine of not less than conviction for violation thousand this sections require five thousand dollars ($251000) . The felony thirty days (30) of conviction. equine forfeiture of government employment within I• SIGNATURE DISCLOSURE I make this re ore on behalf of all the designated em to ees of the County p y of San Joaquin, and (Agency Name) Signature: Typed/'P red Name: �J Title: Date: _ Time: cc: C V �` SWEEPS /SITE COD E#: 2 0 C CONMFR Y( N oG —r7cC/C�r�„ REFERRED TO: EH 22 013 (Rev. 4/91 )