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SAN JOAQUIN COUNTY NOTIFICATION OF HAZARDOUS WASTE' DISCHARGE 0O [Ply <br /> HEALTH & SAFETY CODE 25180 . 7 <br /> A. EMERGENCY LEVEL: �TI III IIE'ALT14 DISTRICT LUG # <br /> ( Circle One ) <br /> B. SOURCE OF INFORMATION <br /> Original Source : Telephone: <br /> Reporting Agency Name: / Ta6y-6 Z &xw iL �yLy1.� G� <br /> Agency Contact: /M�, ��V� Telephone :// jS![iL <br /> Address : /�D BU J%�f/�� <br /> C. LOCATION AND DATE OF DISCHARGE <br /> Location: %� / L4fli�0� JS33/ <br /> (Best Physical Description) (City or County) <br /> Date of Discharge: t-�- 2 -e�(� <br /> Date Notified: 61 - -5=e`f Time: /. <br /> • D. RESPONSIBLE PERSON/BUSINESS <br /> Name of Business z P"e'p / S p <br /> r'nni- ter T. T,,,r•-nn • Tel ep{fon Cj 120/ 1 <r2l ,20 c77 <br /> Physical Address : <br /> v <br /> E. DESCRIPTION <br /> Type Release: <br /> Volume: 1� J� �a^-P 5� <br /> Chemicals : / <br /> F. ACTTIIO-N TAKEN <br /> k sib /1� �atir / ALL <br /> ati� 7J0-1YL2 <br /> ��'i�7 0� C'dlr�T�/iw�iiov � %r�,u� gY <br />