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Y <br /> San Joaquin County Environmental Health Division <br /> Septic Tank and Cesspool Cleaners Report gmwn"Tin <br /> Company's Name: SRC Pumping Co. <br /> Company's Address: 11350.,£Ciefer Blvd,Sacramento, Ca. 95$30 <br /> Report for the Month Of.• u,¢n (]� <br /> > Gallons Where Cleanings <br /> d Date Name ofProperty;Owner Location. C.. Pumped Were Unloaded <br /> 49. /SWk, l irlD lZo d B vF.i9�4lFsS <br /> re <br /> rr <br /> LW <br /> 073Al,. C04br ZX1 <br /> -;?0 �un� 2 �� SGS - • if�o / it arJ �� <br /> �► _ '' - - <br /> 7-16V A g ��c.`%� <br /> 4vow A % <br /> /0 <br /> /e--O <br /> 6-210 <br /> N .s vt p is a �sa&7 <br /> 17 <br /> } Return by the 12th of each month to: <br /> Date Signature of Applicant Environmental Health Division <br /> 304 B. Weber St., 3rd Floor <br /> Stockton, Ca. 95202 <br />