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r 1 � <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, 95830 <br /> Report for the Mon th Of <br /> DateGallons Where Cleanings <br /> Name o Pro ert Owner Location Pu_ ned Were Unloaded <br /> W » //V. A0 <br /> Return by the 1211,of each month to: <br /> Date Signature of Applicant Environmental Health Division <br /> 304E. Weber St, 3rd Floor <br /> Stockton, Ca. 95202 <br />