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San Joaquin County Environmental Health Division - <br /> Septic Tank and Cesspool Cleaners Report <br /> Company's Name: SRC Pumping Co. <br /> Company's Address: .1.1350 Kiefer Blvd., Sacramento, Ca. 95830 <br /> Report for the Month Of. <br /> Gallons Where Cleanings <br /> Date Name offropertE Owner Location CC. Pumped Were Unloaded <br /> � <br /> rsGt/RZ s y�,7iYeiclE�i/F <br /> 3 L�,�64iY1i7I GAJ /1 <br /> 3.233 LV Z41 <br /> e <br /> Return by the 12th of each month to: <br /> Date Signature ofApplicant Environmental Health Division <br /> 304 E. Weber St., 3rd Floor <br /> Stockton, Ca. 95202 <br /> I <br />