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SAN JOAQUIN COUNTY Q <br /> NOTIFICATION OF HAZARDOUS WASTI. DISCIIARCE <br /> 111 ALT11 &_ .SAV 1."1'Y COD1: 2`018U .7 <br /> S <br /> I A. EMERGENCY LEVEL: �I II IIT IIIiALTt-i DISTRICT LUG <br />'I> (Circle One) <br /> B. SOURCE OF INFORMATION <br /> Original Source. +`Y',�^,�Illi.�i1 N:OldG�i`rx; elephone: # Y-. <br /> Reporting Agency Name: ��n i1.":k r;:.. `'' �; --r, ~� •__ter„ -T. <br /> Agency Contact: f; ? Telephone <br /> Add�esis . -+f���?�+ +y �/f.{✓� �T/siJ_,_ �r�1 <br /> 1 <br /> C. LOCATION AND DATE OF DISCHARGE <br /> C= <br /> Location: <br /> - <br /> (Best Physical Description) (City ' Or CuuriLy) <br /> Date of Discharge: 0-88 <br /> Date Notified: -7-?-���' Time: <br /> D. RESPONSIBLE PERSON/BUSINESS <br /> Name -of Business r'i-r"✓� f� _ <br /> Contact Person: � '; ?-`�"i_ l ii (� ��v, .� Tel.cphonc : <br /> - Physical Address . l`' <br /> R. DESCRIPTION <br /> Type Release: 1 i?rl i".V-1 Ka <br /> Volume.: <br /> Chemicals : <br /> F. ACT.I ON=-TAKEN <br />