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r yor <br /> Salt Joaquin County Environmental Health Division <br /> Septic Tank and Cesspool Cleaners Report <br /> Company's Name: SRC Pumping Co. <br /> Company's Address: 11350 Kiefer Blvd, Sacrantento, Ca. 95830 <br /> Report for the Month Of• f(L oZ U <br /> Gallops Where Cleanings <br /> Date Nante ofProaerty Owner Location Cite Punt ed Were Unloaded <br /> U _ ^ <br /> — lr/- C'Co a? <br /> s W s E <br /> a� cis; �6rert- �. <br /> �s— 1064 MCleZ & <br /> Return by the 11th of each month to: <br /> Date Signature ofApplicad Hnvironnimial Health Division <br /> 60® COS'r fA/ 5W67- <br /> . Ca. <br /> E. Ca. 95101 <br />