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San Joaquin County Environmental Health Division <br /> `` Septic Tank and Cesspool Cleaners deport <br /> fj <br /> Company's Name: SRC Pumping Co. <br /> Company's Address: 11350 Kiefer Blvd,Sacramento, Ca. 95830 <br /> Report for the Month Of.- y� a v 5 <br /> Gallons Where Cleanings <br /> Date Name o Pro ert Owner Location Cid Pum ed Were Unloaded <br /> �ago <br /> � <br /> A <br /> ,?6 s <br /> 0 U ll0 A, <br /> mac! Sio6T �/ —ZL ati- <br /> 0 <br /> ;t </ <br /> � '• 02 yy tiff- r <l.�JrlrF�/ </ <br /> Irrl. </ rU� <br /> it <br /> 4V;74 �/ <br /> lm/ ✓ C V / <br /> zdl <br /> GIJ 41 <br /> dd A-- <br /> <~ <br /> Return by the 12th of each month to: <br /> Date Signature of Applicant Environmental Health Division <br /> 304E. Weber St., 3rd Floor <br /> Stockton, ca. 95202 <br />