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SAN JOAQUIN COUNTY 10 It <br /> NOTIFICATION OF HAZARDOUS WASTE DISCHARGE <br /> HEALTH & SAFETY CODE 25180.7 � • D� n <br /> Cep <br /> A. EMERGENCY LEVELS I ) II III PHS-EH LOG # <br /> (Circle One) �/ <br /> B. SOURCE OF INFORMATION <br /> Original Source: Z Telephone: (lei-) Li8 -350 <br /> Reporting Agency Name: la� a D`Vi. SOJ jkC &w. <br /> Agency Contact: Telephone: ( `g22 ) 4o,;� <br /> Address: SQ a- N <br /> C. LOCATION AND DATES OF DIS GE <br /> Location: LII / <br /> (Best Physical Description) (City or County) <br /> Date of Discharge: UJk k� <br /> Date Notified: —Ll-+- 1 Time: ! I bfl 4wV <br /> D. RESPONSIBLE PERSON/BUSINESS/' <br /> Name of Business �1,uj-p-, �kw4o4_4 ��Nll�Ani — ��o l CI YN0 n 9- CO <br /> Contact Person: Ln j Ywao- Telephone: <br /> Physical Address: 2`f31 Nn 1e �0K o <br /> E. DESCRIPTIONn II nn �I I <br /> Type Release: _PQ,�Y�rn..- LCYioraL&fxq hdyv\ o �nn nn� rLu�/ara9s+��d AaaeP�uQ ��le <br /> Volume: JI A-klu� — <br /> Chemicals: OA k-+i eu� <br /> F. ACTION TAKEN II J <br /> LI LUMD II'•-- OhEf1k C� (AA1��1IGn ca("1(Y 12D1,tio bke��r k a -"+LQ CLUn9y�I A <br /> UL wkLAUL q�j- (Ara <br /> tt nn <br /> �1Px.(I1 oAl.�' V(�l�Q�ANV� <br /> EH 22 03 (Rev. 7/89) <br />