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San Joaquin County Environmental Health Division <br /> fi Septic Tank and Cesspool Cleaners Report <br /> Company's Name: SRC Pumping Co. <br /> Company's Address: 11350 Kiefer Blvd,Sacramento, Ca, 95830 �z <br /> Report for the Month Of <br /> ly <br /> �1 <br /> jf <br /> � M1 <br /> ` Gallons Where Cleanings <br /> Date Name a Pro ert Ow>ier Location C Pum ed Were Unloaded <br /> lye ✓l <br /> � All <br /> Return by the 12th of each month to: <br /> Date Signature of Applicant Environmental Health Division <br /> 304 E. Weber St., 3rd Floor <br /> Stockton, Ca. 95202 <br /> �� I <br />