Laserfiche WebLink
SAN JOAQUIN COUNTY <br />C NOTIFICATION OF HAZARDOUS WASTE DISCHARGE <br />HEALTH & SAFETY CODE 25180.7 <br />A. EMERGENCY LEVEL: I II III <br />(Circle One) <br />PHS-EH LOG # ___ (-) 73 <br /> <br />B. SOURCE OF INFORMATION <br />Name: 1, e -h' <br />Company: <br />Address: <br />Designated Employee Name: ii,e7#‘4_.— J Phone: QthJ 4,4•4", 3 <br />Reporting Agency Name: <br />Address: <br />/ <br /> <br />(Best Physical Physical Description) Cvr County) Circle One <br />Date of Discharge: <br />Date Notified: 4, Time: / <br />RESPONSIBLE PERSON/BUSINESS <br />Name of Business: S e e / 4_,/ a- 7 <br />Contact Person: E. v 0-74..rotaptler. / Telephone: (.51_4_3) <br />Physical Address: <br />Mailing Address: <br />DESCRIPTION <br />Type of Discharge: <br />Volume: irzpt,l',}-2,4-t <br />Chemicals: 6, <br />Circurnstan <br />- 12)C-03,./44,14J g <br />ACTION TAKEN Fi}-r...0-c—/ 6-L S ; • *-1" <br />C(' ‘-v / &Y-.174 fr4&z,c21 <br />- V -1--7 <br />SITE STATUS h ,-61-e.,s,frz.., AL' .01-c) rnmazt, <br />Ta.kt,k ,. 0_ 0 P) <br />Phone: (07&) <br />C. LOCATION AND DATE OF DISCHARGE <br />Location: ,;Y Ff4 S7L, <br />EH 22 013 (Rev.4/91)