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NECEVEDD <br /> San Joaquin County Environmental Health Division 2G08 <br /> Septic Tank and Cesspool Cleaners Report `' t' ~.,IW EN i HEALTH <br /> VICES <br /> Company's Name: SRC Pumping Co. y l <br /> Company's Address: 11350 Kiefer Blvd,Sacramento, Ca. 95830 fi <br /> Report for the Month Of, l] #k= <br /> r <br /> Gallons Where Cleanings <br /> Date Name o Pro ert Owner Location <br /> QF. Pump Were Unloaded <br /> 07 1C2 S I <br /> 0; ZA1 "J - <br /> itU �� • ,1 <br /> �s . , r <br /> 6i <br /> -33 <br /> - <br /> f <br /> Retum by the 12th of each month to: <br /> Date ? signature of Applicant Env1ronmenta1 Health Division <br /> 304E. Weber St.,3rd Floor <br /> Stockton, Ca. 95202 <br /> j <br />