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San Joaquin County Environmental Health Division <br /> Septic Tank and Cesspool Cleaners ReportGWEINVED <br /> HP 4 ur1 <br /> Company's Name: SRC Pumping Co. <br /> Company'sAddress. 11350 Kiefer Blvd., Sacramento, Ca 95830 ENVIRONM&Fi L HEALTH <br /> Report for the Month Of.- pERgmlm VICES <br /> Gallons Where Cleanings <br /> Date <br /> Name-4f Proaerty Owner Location Ci Pumped Were Unloaded <br /> / �7CflCP'a ' C . /9Gu'N�2F,'I'L'�w <br /> S-e 1 G 4,J ✓1'SS <br /> LGI�%.ST94)'c4rr/ U� .SElfus S%/u�' /r i, it <br /> s2. L- Ln/ <br /> LnI1-5051A�-IMRA)TIW A). <br /> � u LG �y/ G f Zi'✓rr l/ // / <br /> / ,.c- i/ <br /> Return by the 12th of each month to: <br /> Date Signature ofApplicanl HnvironmentatHealth Division <br /> 304H. WeberSt.,3rd Floor <br /> Stockton,Ca. 95202 <br />