Laserfiche WebLink
:':0 <br /> 4._sSAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT Return this form by the <br /> 600 East Main Street, Stockton, CA 95202-3029 12'of each month <br /> ?: Telephone:(209)468-3420 Fax:(209)464-013B Web:wwwsjgov.arglehd m <br /> TAGS CL ANER'S REPORT N <br /> Company Name: F /v"U Report for the nth of: year,:;, w <br /> Company Address: cpe 77 Signature: <br /> sl�Adm . cay zip Code ' <br /> All Information submitted must be Complete. accurate, and legible 0 <br /> N <br /> GATE NAME OF BUSINESS OR ADDRESS WHERE WORK WAS DONE GALLONS (R) NAME OF TREATMENT 3 <br /> PUMPED PROPERTY OWNER PUPPED (G) TRAE FACFACILITYD <br /> PIEASE INCLU E STREET F, DIRECTION, 6iNEET NAME AND CITY L tliEux:1N[pl r <br /> N <br /> 93 <br /> � H <br /> d s a 73. v <br /> / 0 <br /> A <br /> sOnOza C' G �- ,((77 /J0�/ <br /> EK: 1Q� (� /- Q (l <br /> m <br /> a L <br /> z r <br /> Cty <br /> 0 <br /> Cly <br /> Cay cr <br /> (19 <br /> 0 <br /> in <br /> m <br /> F- <br /> I V It w <br /> cby CD <br /> in <br /> Cft <br /> CG W <br /> rft <br /> ENVIRONMENTAL HEAL <br /> I 11c <br /> Cay 0 <br /> CAYN <br /> N <br /> ED <br /> w <br /> A <br /> Cty <br /> m <br /> Y <br /> W <br /> C. <br /> C <br /> city <br /> EFM 42.0 SFPTAGE CLEANERS REPORT <br /> 1orM7 <br />