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. (1� <br /> — I T-- 41 <br /> San Joaquin County Environmental Health Division <br /> Septic Tank and Cesspool Cleaners Report <br /> Company's Name: SRCPumping Co. <br /> Company's Address: 11350 Kiefer Blvd,Sacramento, CL 95830 <br /> Report for the Month Of.- �V <br /> Gallons Where Cleanings <br /> Date Name ofProperty Owner Location C.. Pum ed Were Unloaded <br /> S/r1� <br /> 2zv <br /> ✓r � <br /> A2190 /Vl <br /> A9 A <br /> tr 1( Z-7296 Cely6c L66 I& .( r <br /> 41 wk wrlYo� x <br /> , <br /> Return by the 12th of each month to: <br /> Date Tignature of Applicant Environmental Health Division <br /> 304E. Weber St., 3rd Floor <br /> Stockton, Ca. 95202 <br />