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r u / <br /> San Joaquin County Environmental Health Division <br /> Septic Tank and Cesspool Cleaners Report <br /> Company's Name: SRC Pumping Co. <br /> Company's Address: 11350 Kiefer Blvd,Sacramento, Ca. 93830 <br /> Report for the Month Of.- u <br /> '1 Gallons Where Cleanings <br /> t Date Name o Pra er Owner Location C� .Pumyed Were Unloaded <br /> & <br /> J <br /> d ( SCJc'J /c .t <br /> r /✓ <br /> Return by the 12th of each month to: <br /> Date ignature of Applicant Environmental Health Division <br /> 304E. WeberSt., 3rd Floor <br /> Stockton, Ca. 95202 <br />