Laserfiche WebLink
INUtIPI[�ATION OF 1 iA ARDO US w `T'� DISCI3A.RGIr y <br /> 1-11.ALTH & SAFETY CO 2 4 40,7 <br /> a. EMERGENCY LEVEL; r.. u IIT <br /> (Circle One) PHS-Er-i LOC .0 <br /> -- r <br /> B. SOUR <br /> CE Or INFORMATION ' <br /> Original Source: rU C 1 Telephone: �' <br /> e. �� <br /> 7 <br /> p <br /> 'S <br /> Reporting Agency Name: LrL - v n-`zJ <br /> f <br /> Agency Contact: Telephone: (U? I ) <br /> Address: •' <br /> C. LOCATION AND DATE OF DISCHARGr, <br /> Location: . `7 K) F « ,.S 4n <br /> (Best Physical Description) (City or County) <br /> Date of Discharge: t <br /> Date Notified: 1 C� Time: <br /> D. RESPONSII3LE P , o /BUSINESS <br /> Name of Business :4 5- J <br /> Contact Person: <br /> ' Telephone: 11< <br /> Physical Address: O <br /> E. DESCRIPTION <br /> Type Release: <br /> Volume: <br /> B! L� <br /> r• ACTION TAKEN X -r e 6:ey n <br /> n' <br /> 57 <br /> C <br /> - i <br /> EII o13 ( ev. 02/90) <br />