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if fTI l 1 N1 <br /> San Joaquin County Environmental Health Division <br /> Septic Tank and Cesspool Cleaners Report71 Lim" <br /> SUED <br /> Company's Name: SRC Pumping Co. <br /> Company's Address: 11350 Kiefer Blvd,Sacramento, Ca. 95830 (`r. five Nl_ HEALTH <br /> Report for the Manth Of.• lJv PENIIT/ RVtS <br /> � . <br /> GaUons Where Cleanings <br /> Date . Name of Property Owner Location C Pum ed Were Unloaded <br /> f.::5-Qj u ass. <br /> " <br /> nf� 2� 71/.x" LDS: v <br /> 2�nm _ / -S <br /> wl1 <br /> -E P <br /> . `r el <br /> d <br /> Return by the 12tH of each month to: M <br /> Date <br /> ignature of Applicant Environmental Health Division <br /> 304E. Weber St, 3nj Floor <br /> Stockton, Ca. 95202 <br /> l <br /> p <br /> r 4 <br />