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SAN JO,AQUIN COUNTY <br /> Return this forty by the <br /> �NVIh'ONMENTA4 I%AL.�'Ml.�i~PAMTM�N7" � <br /> ;��',, �•,,,Tf��ywrsi, <br /> 1868 Feat Hazelton Avenue, Stooldon, CA 96205••6232 12th of each month <br /> Telephone;(205)468.3420 Fax,(209)464-0933 Web,www.sjgov,,pry/shd <br /> R,"MITIPMly M al»e, _ 1 -� n Report for the month of: �ie Ar,20 <br /> ��'%or�tpa y Address: .__ .,. X ,P500X\ 1�'�GL- Cl ��3 Signature; <br /> Sttvat Addivab JMp Zip Code <br /> 5 01 nYor�atloNLOO -_Ittaaa, U� be VIVIJlocd,_�no 11atm wnd Iey}y7i <br /> �.��lL. :12G.�.^^._....J 3M1Ct �-'�=^'^.�wfJLi •^?`T�::.�t. ^Ufa•'AR^�1i2C1:_•'TRL•/VR:•9Fzt3bs.IfT-. -ss:flCC."2�T M11811fifdlf%Si2R'3d�G'.M ._IIWftaBc�tRJ:�.�'�fL"�.:—..:»Yr^'t.:':�.Fi�':;I <br /> BATE NAME OF MINUS C1F� ADDRESS WPIt5RL WORK WAS pf�N9 GALLONS (R tiealaaNtlAl NANIB QIP TREATMENT <br /> PUMPED PROpF�f�TY OWNER pUMpC?d (p� bR8A88 TRAP FACILITY <br /> PLBAea INULUDB BTp8UT Il, DMOTION, ®TAUNT NANIa AND dITY (R� �}18�gD I, <br /> CU <br /> Ofly � <br /> ptt <br /> QIr <br /> On <br /> at <br /> ,...� <br /> City <br /> Or .J <br /> r <br /> 9 <br /> c <br /> CI <br /> oily <br /> .� pr MAR 2 2018 <br /> DEPARUNIENT <br /> NV11 _ <br /> Cr <br /> J <br /> diA42-04 J Q- c.L.Yn �- �n� e�lo r v a—r-t(� Sep7' w Cl.maR9 REpaiir <br />