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.l <br /> SanJoaquin Publi Health Services <br /> a Environmental Hp�Ith ervi a Report for the month of � ZUl2 <br /> PO Box 2009(445 N.San Joaquin St.) -r— <br /> Septic Tank and Cesspool Submitted by: <br /> Stockton,California, 95209 <br /> Fax:4640138 <br /> Cleaners Report <br /> Must be submitted by the 22'^of each month Address:��S A rwd— 4Y <br /> 0 <br /> Mpate Name of Property Owner Address where work was performed <br /> m --12- •1 type waste gal.pumped disposal site <br /> SZIS <br /> 2_3 � -0 - <br /> Z <br /> i -Z. S-tu-r a L1 7lJU It r <br /> IL „ o „ u <br /> S e <br /> u a LL k a �. <br /> c <br /> LU — P q45 <br /> o a h G Sfit_ �5 <br /> Z Vt ( W Lt Lt <br /> L� a <br /> �D <br /> ,h . 15910 VUU LI <br /> LLJ <br /> 20 7 U lL �t <br /> ��t7a tL t( L2u0 1 �, <br /> sidle=4' USI 2- i �S� , <br /> The following excerpt from the code of Federal Regulations.Section 403"Report must signed by a corporate officer who can legallyiLbind the <br /> compare' <br /> Lo I certify under penalty of law that this document and all attachments wer repared under my direction or supervision. <br /> 0 <br /> v <br /> 0 <br /> a __ <br />