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Milk <br /> SAN JOAQUIN COUNTY <br /> NOTIFICA-17ON OF HAZARDOUS WASTE D SCHARGE <br /> HEALTH & SAFETY CODE 25180.7 <br /> A. EMERGENCY LEVEL: I Ii III PHS-EH LOG # <br /> ircle One) <br /> D. SOURCE OF INFORMATION <br /> Original Source: ()1vo C'�L— Telephone: <br /> Reporting Agency Name: M5- E7/-/,D <br /> Agency Contact: <br /> Telephone: <br /> Lq!5-P—y I*&,-;- <br /> Address:—t/qg Ah. ar7 �ra ut 5FCKfTn <br /> C. LOCATION AND DATE OF DISCWGE <br /> Location: (0 01 e- KE.A4LLMOX Ln / Lod I <br /> (Best Physical Description) (City or County) <br /> Date of Discharge: )N KN C)W j L14 //:0 0 A-M <br /> Date Notified: Z5�q I Time: <br /> D. RESPONSIBLE PERSON/BUSINESS <br /> Name of Business U N D 0j ML- <br /> ,, 't, .. <br /> Cr,�je,j ' -`� 1 ) <br /> Contact Person: 6-mnK 2 - .-: Telephone: (�� <br /> Physical Address: X00LMLA,) Cc,-n\'I 6n Plac"— I+- Llco <br /> E. DESCRIPTION �San 9,0-YY'°Y'\ CtL45IB3 <br /> Type Release: �EE <br /> Volume: <br /> Chemicals: <br /> F. ACTION TAKEN <br /> nl +aw In 6L . <br /> a5 vres4aiye-J, bV -Rl &0,0r0gr,(&P- <br /> EH 22 013 (Rev. 02/90) <br />