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y ©may <br /> --------------------- <br /> San Joaquin Counop Environmental Health Division <br /> Septic Tank and Cesspool Cleaners Report <br /> Company's Name: SRC Pumping Co. <br /> Company's Address: 11350 Kiefer Blvd, Sacramento, Ca. 95830 <br /> Report for the Month Of: d <br /> Gallons Where Cleanings <br /> Date Name o(Prbnerty Owner Location City Porn ed Were Unloaded <br /> -0472- / 5-1)() "/, <br /> /1 i• i � <br /> u 3 a t1 r. N <br /> oZ dl 0?5— �� // <br /> 3J �,?vd w t, <br /> !C i/ /v() If <br /> 1 rl ALO 1 i 15W t( <br /> 4 <br /> U Gzbtuz stir o <br /> fil" Return by die 11th of each month to: <br /> Date 1gnature ofAp licaut Environmental Health Diviston <br /> 60® _ s?" N E <br /> Stockton. Ca. 95202 <br />