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San Joaquin County Environmental Health Division <br /> Septic Tank and Cesspool Cleaners <br /> :Port'� <br /> . <br /> Company's Name: SRC Pumping Co. . <br /> Company's Address: 11350 Kiefer Blvd,Sacramento, Ca. 95830 <br /> Report for the Month Of <br /> P <br /> Gallons Where Cleanings <br /> Date' Name ofPr2perte Owner Location <br /> C�y't ' Pum ed Vere Unloaded <br /> -D l /6'/X2v!/a <br /> ' 61157 G 4) �r r ' <br /> 7 / F J 79 r. �e lfu Ci/ a l�U �1 <br /> �jt, 3 - — S <br /> % _Sl44 L <br /> ads <br /> ..JZ 2el?rI c o i 1 9� r 1 <br /> (12ZI16 <br /> 4 �Z-' Ro i <br /> Z� <br /> `. > / <br /> ,Return by the 12th of each month to: <br /> Date Signature of Applicant Environmental Health Division <br /> 1304E. Leber St., 3rd Floor <br /> Stockton, Ca. 95202 <br />