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G. MANDATORY CONTACTS <br /> Public Health Services <br /> of San Johquin County <br /> Environmental <br /> Health Division: P O N VA L r N o-Ti p <br /> (Contact Name) (Time) - (Date) <br /> San Joaquin County <br /> Board of Supervisors: N 6A t, <) W t M � �� �6 <br /> (Contact Name) (Time) (Date) <br /> f . <br /> H. HEALTH AND SAFETY CODE S 25180.7. <br /> (b) Any'designated government employee who obtains information in the course of his ofGci <br /> duties revealing the illegal discharge or threatened illegal discharge of a hazardous waste al <br /> within the bcographical area of his jurisdiction and who knows that such discharge or <br /> threatened discharge is likely to cause substantial injury to the public health pr safety must, <br /> within seventy-two hours, disclose such information to the local Board of Supervisors and to <br /> the local health officer. No disclosure of information is required,under this subdivision when <br /> otherwise prohibited by law, or when law enforcement personnel have determined <br /> disclosure would adversely affect an ongoing' criminal investigation, or when e information is <br /> already general public knowledge within <br /> discharge, the locality affected by the discharge or threatened <br /> - ' <br /> (c) Any designated government employee who knowingly and intentionally fails to disclose <br /> - information required to they disclosed under subdivision (b) shall, upon conviction, be punished <br /> by imprisonment in the county jail for not-more than one year or by imprisonment in state <br /> prison for not more than three years. Tl a court may also impose upon the person a floc of <br /> not less than five thousand dollars ($5,000) or more than twenty-five thousand dollars <br /> ($25,000). The felony conviction for violation of this section shall require forfeiture of <br /> government employment within thirty days of conviction. <br /> I. SIGNATURE DISCLOSURE <br /> I make.this report on beha f of all the designated employees of the County ' <br /> and ty of San Joaquin, <br /> lnf <br /> (Agency Name) <br /> LC. 7 . <br /> Signature: ' , f2 <br /> Sh <br /> Typed Name: Y <br /> i <br /> Title: <br /> G <br /> Date: Y <br /> Time: ` (go F <br /> cc: QTS G <br /> v 2 (�` C. e> <br /> G, a or-- i2. <br /> EH 22 03 (Rev. 7189) <br />