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` _ ------ — - -- - -- - - <br /> San Joaquin County'Environmental Health Division <br /> Septic Tank and Cesspool Cleaners Report 1. <br /> iz <br /> Company's Name: SRC Pumping Co. <br /> Company's Address: 11350 Kiefer Blvd., Sacramento, Ca. 95830 <br /> Report for the Month Of <br /> Sr <br /> Gallons Where Cleanings <br /> Date Name o Pra ert Owner Location Pum ed Were Unloaded <br /> .,i,7zC <br /> el, <br /> D It 'r r/3 /1'A/� k1141 <br /> V / 4 GrlT7�Ilf /l !.� I <br /> V4 4! <br /> ? .. <br /> r 3 1A1 /i <br /> div << <I <br /> IR <br /> A LIZ <br /> (o/ !ti'C' wT�L <br /> ���/ # �` ✓ Return by the 12th of each month to: <br /> Date .Signature of Applicant Environmental Health Division <br /> ' 904E. Weber St., 3,dFloor <br /> Stockton, Ca. 93202 <br /> F <br />