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SAN JOAQUIN COUNTY t=- ) <br /> NOTIFICATION OF HAZARDOUS ti <br /> (�p <br /> WASTE DISC <br /> HEALTH & SAFETY CODE 25180.7 <br /> A. EMERGENCY LEVEL& II III PHS-EH LOG # JLD Q Z 2 <br /> (Circle One) <br /> B. SOURCE OF INFORMATION <br /> Original Source: jgrlaa , Telephone: I6�- vyU <br /> Reporting Agency Name: A'ou, &h,; 1.M c �- <br /> Agency Contact: chqlle,5 , Telephone: (Ieq ) <br /> Address: 2P 0 c C <br /> C. LOCATION AND DATE OF DISCHARGE <br /> Location: <br /> (Best Physical Description) (City or County) <br /> Date of Discharge: fAn,1���XA.. j <br /> Date Notified. 1 AI/90Time: t Q1 pM <br /> D. RESPONSIBLE PERSONMUSINESS <br /> Name of Businesstra,a �. a, - <br /> Contact Person: Telephone: —952– 30r?O <br /> Physical Address: a �- <br /> a <br /> E. ,DESCRIPTION <br /> e <br /> Type Release: <br /> Volume: 62 <br /> Chemicals: 9I d arkw <br /> F. ACTION TAKEN <br /> N ' i <br /> Sir .J d� <br /> 'lPPCAle- <br /> OC <br /> EH 22 03 (Rev. 7/89)' <br />