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SAN JOAQUIN COUNT <br /> NOTIFICATION OF HAZARDOUS WASTE DISCHARGE <br /> HEALTH & SAFETY CODE 251 <br /> A• EMERGENCY LEVE ; I II III PHS-EH LOG '# <br /> (Circle One) <br /> B. SOURCE OF INFORMATION <br /> Original Source: Telephone: WO <br /> Reporting Agency Name: ✓ca, °uli <br /> � SP�rrr,�c Vis_s <br /> Agency Contact: u,�,`f" Telephone: `3 0 <br /> Address: I E. a � �cle, S�©��Cf`r�► (',,q q�-.2G� , <br /> C• LOCATION AND DATE OF DISCHARGE <br /> (Best Physicalliescription) (City or County) <br /> Date of Discharge: W ti j A , 1 <br /> Date Notified: �2p 90 Time; <br /> jC D M, <br /> ..�._ <br /> D. RESPONSIBLE PERSON/BUSINESS <br /> Name of Business a 0 <br /> Contact Person: JoA+� Telephone: Q27J <br /> Physical Address: `J v Ccr� <br /> E. ,DESCRIPTION <br /> Type Release: (I AIZ <br /> Volume: ®cvrr <br /> Chemicals: P6llfrt1WJAAA <br /> F• ACTION TAKEN <br /> 0� ra-4A <br /> r a <br /> EH 22 03 (Rev. 7/89) <br />