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3 � <br /> San Joaquin County Environmental Health Division <br /> Septic Tank and Cesspool Cleaners Report <br /> ------------- <br /> Company's Name: SRC Pumping Co. <br /> Company's Address: 11350,Kiefer Blvd,Sacramento, Ca. 95830 <br /> Report for the Month Of <br /> Date Name a Pro er Owner Gallons Where Cleanings <br /> Location Qp- Pumped Were Unloaded <br /> 05,t/ <br /> �/ i� i <br /> iC:r�1/iJ / .So6�C c Cr lr L <br /> A <br /> 2e l 5^ J r <br /> ii <br /> ! <br /> v A <br /> Return by the 12th of each month to: <br /> Date Signature of Applicant Environmental Health Division <br /> 309 E. Weber St., 3rd Floor <br /> Stockton, Ca. 95202 <br />