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RECEIVE® <br /> n � <br /> APR o s 2011 <br /> 4€66 Se k! <br /> '�I Sery s Report for the month of ©t <br /> Po Box 2009(445 N.San Joaquin st,) <br /> Stockton,California, 95209 Septic Tank and Cesspool Submitted by: f <br /> Fax:4640138 Cleaners Report -- <br /> Must be submitted by the 12a`of each month Address: 0 S r� Q <br /> 0 <br /> 0 <br /> Date Name of Property Owner Address where work was performed <br /> C) �fl�� type waste gal. pumped disposal site <br /> �� <br /> _ <br /> J4 1L cr <br /> -[ 1A �� <br /> _ � t <br /> 7 r YT ` 4 <br /> 2-1 D- t „� �y r ci. I txnti <br /> 00 4 <br /> i 7 Lt <br /> — <br /> /� tc it <br /> VV <br /> 52 <br /> W <br /> o - <br /> o � _ y� z if r <br /> LU <br /> U) y D 5 rte tT cl524 <br /> The following excerpt from the code of Federal Regulatlo�s Section 403"Report must be signed LA <br /> company" g d by a corporate officer who can legally bind the <br /> CL I certify under penalty of law that this document and all attachments were prepared under my direction or supervision. <br />