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SAN JOAQUIN COUNTY <br /> NOTIFICATION OF HAZARDOUS WASTE DISCHARGE <br /> . Health & Safety Code 4 25180.7 <br /> A. EMERGENCY LEVEL.-O II III Health Di strict Log # <br /> (Circle one) <br /> B. SOURCE OF INFORMATION <br /> Original Source: `d^Avdg-ev g Telephone: (qlb ) 361 - s6�2 <br /> Reporting Agency Name: ��`' +�`� '0� Rts®Vous ��✓d <br /> Agency Contact: Telephone: (q'e ) 322 "6030 <br /> Address: 1•aNk •v•i•'� v svw-f S oovd O• <br /> P• <br /> cA 4S'8/2 <br /> C. LOCATION AND DATE OF DISCHARGE <br /> � <br /> Date(s): - <br /> Location: oN « va..d �e w«sk htr oMd: @ Sy r county) <br /> (Best ys caDescription) AN� c}r+,M� <br /> D. RESPONSIBLE PE NAUSINESS <br /> . Nv <br /> Name of Business: S S �'► �Vv <br /> Contact Person: ,:1l ..vves l _N^°^� J Telephone: (Z®'1) aFZ" r <br /> Physical Address: 1®s'/ c,A 95'tob <br /> E. DESCRIPTION <br /> Type Release: w� �"'s �•'"°'' s s s vs�� «�:,;i.). - <br /> Volume: ? <br /> Chemicals: <br /> F. ACTION TAKEN <br /> 1 <br />