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+,R <br /> 7 <br /> San Joaquin County Environmental Health Division <br /> ` Septic Tank and Cesspool Cleaners Report; <br /> Company's Name: SRCPumping Co, <br /> Company's Address: 11350 Kiefer Blvd.,Sacramento, Ca 95830 . <br /> Report for theMonth Of. <br /> 0 Gallons Where Cleanings <br /> Date Name o Pro er Owner Location ON "'Pum ed Were Unloaded <br /> AI DSI,Bum'� - D %�, d v >, I <br /> # <br /> .~ <br /> G /� /. �J lr G! <br /> d �u oZ /✓ <br /> Return by the 12th of each month to: <br /> Date ignature ofApplicant Environmental Health Division <br /> 304 E. Weber St., 3rd Floor <br /> Stockton,Ca. 95202 <br /> i <br />