Laserfiche WebLink
SAN JOAQUIN COUNTY ; <br /> NOTIFICATION OF HAZARDOUS WASTE DISCHARGE <br /> HEALTH & SAFETY CODE 25180.7 <br /> A. EMERGENCY LEVEL: II III PHS-EH LOG # ��'�—D <br /> (Circle One) <br /> B. SOURCE OF INFORMATION <br /> Original Source: 1.o}e �,� oil Telephone: <br /> U <br /> Reporting Agency Name: oq �.� p�,7 P S �' ✓� <br /> Agency Contact;�� Telephone: 2�! �16� ^ 3 VsY <br /> Address: rq <br /> Z ,,a,2 5 <br /> C. LOCATION AND DATE OF DISCHARGE <br /> Location: 1 SCIS' <br /> (Best Physical Description) (City or County) <br /> Date of Discharge: _ /�,��dc✓ <br /> Date Notified: <br /> Time: <br /> D. RESPONSIBLE PERSON/BUSINESS <br /> Name of Business <br /> Contact Persoi,: Telephone: <br /> Physical Address: 05/' <br /> L✓ �,� �� � ���--�3 <br /> E. DESCRIPTION <br /> Type Release: <br /> Volume: �l� r�ar✓r� l <br /> Chemicals: v�Crif/ /Oc�/,G�✓�S <br /> F. ACTION TAKEN <br /> �-> weir. <br /> /7 S //7 U� T/� C, pr, yG Yom' <br /> ef Ui'I <br /> v I <br /> 00,lipcx- <br /> EH 22 03 (Rev. 7/89) 6 S �c v,',•� <br /> A <br />