Laserfiche WebLink
SAN JOAQUIN COUNTY <br /> NOTIFICATION OF HAZARDOUS WASTE DISCHARGE <br /> HEALTH & SAFETY CODE 25180 . 7 <br /> A. EMERGENCY LEVEL: ( IJ II III HEALTH DISTRICT LOG �( <br /> ( Circle One ) �� <br /> B. SOURCE OF INFORMATION <br /> Original Source: _ P,,LP— c- C�Er�Fy Telephone: (e4) � <br /> Reporting Agency Name: <br /> Agency Contact: P� Lr C K C,(A. Telephone: <br /> Address : �v?G �/ 6z- <br /> C. LOCATION AND DATE OF DISCHARGE <br /> Location: 69yzq.L_ L,00-r( l A4 <br /> (Best Physichl Description) (City or County) <br /> Date of Discharge: <br /> Date Notified: � /�� Time• "Iq . <br /> D. RESPONSIBLE PERSON/BUSINESS <br /> Name of Business <br /> Contact Person: Telephone: ( ) <br /> Physical Address: <br /> E. DESCRIPTION <br /> Type Relea Corr i'LiL�UI� ,� %B�(_- FouAil) Dyk 1&j , WA-Ti�-(Z L-INE <br /> !LV-57-A LLATioN <br /> Volume: Cf lCl" o ulM U TZL-AI=TJEr <br /> Chemicals: OIL <br /> F. ACTION TAKEN <br /> _EN,VX0/UP''1_ 7� S� -7�4-i�(-T <br /> 9lG m ab►Bcl�� �� �''?9A� L2 � g=TD rzo�� <br />