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Z-/San Joaquin County Environmental Health Division <br /> Septic Tank and Cesspool Cleaners Report <br /> i <br /> Company's Name: SRC Pumping Co. <br /> Company's Address: 11350 Kiefer Blvd., Sacramento, Ca. 95830 <br /> Report for the Month Of-- J Q <br /> r. Gallons Where Cleanings <br /> Date Name o opertV (honer Location C. Pum ed Were Unloaded <br /> 02 _�' •1 (P vv �t 1 1 <br /> �j <br /> —Aa7�7 r i1�t�hN I � v 1 r /1 <br /> �l lrt S �f v /r <br /> Zv <br /> 6-61 6 <br /> 1w 8 X 1� P <br /> a/ 6?U3 S. <br /> io�Y5` - � i lit' / aS <br /> Return by the 12th of each month to: <br /> Date r Signature of Applicant Environmental Health Division <br /> 304E. Weber St., 3rd Floor <br /> Stockton, ca. 95202 <br /> 'r <br /> ! tf <br /> l }: <br />