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San Joaquin County Environmental Health Division <br /> I Septic Tank and Cesspool Cleaners Report i <br /> 1 . <br /> Company's Name: SRC Pumping Co. <br /> Company's Address: 11350 Kiefer-Blvd,Sacramento, Ca. 95830 <br /> Report for theMonth Of.• aU <br /> Gallons Where Cleanings <br /> Date Name o(Ropertv Owner Location C Pic__ mped Were Unloaded <br /> I `aZ J -C)G �cJ�0�1 q .5^ ii i' v✓L r G l <br /> t " <br /> Lir/ <br /> 6,22 <br /> j /l!�1e l iQ2 // 4 <1 <br /> P <br /> Thu(r JO // _Z/'�w <br /> r <br /> Q Return by the 12th of each month to: <br /> Datei ignature of Applicant Environmental Health Division <br /> 304 E. Weber A, 3rd Floor <br /> Stockton, Ca. 95202 <br /> f <br /> 4' <br />