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RECEIVE® <br /> COP MAR 10 2011 <br /> San Joa uin Public Health Services Report for the month of EN .-- 1 t <br /> a vi1 Health Se <br /> PO Sox 2009(445 N.San Joaquin St.) Septic Tank and Cesspool Submitted- . :tom C <br /> Stockton,California,95209 Cleaners Report ..4_,7, <br /> Fax:4640138 Address: <br /> Must be submitted by the 12''of each month Q <br /> rn <br /> 0 <br /> Rate Name of Property Owner Address where work was performed <br /> type waste gal.pumped disposal site <br /> s p ,-21 <br /> 2— O Q5 k Vl <br /> VlS P'A LL�I't L <br /> 273 Lm Co) –aa oeyLa br <br /> G. 2Z <br /> LOLL. SG't t t , - i'rt S St- ti [r <br /> �/ Y1 c� 4 <br /> ~ IL <br /> U Cha t t <br /> -Tono L0907i' <br /> ry tc 0 t< <r <br /> O( tL Lr <br /> o <br /> Z� rr <br /> Q Q cc <br /> r K LL <br /> A 10 r ` r k k c �( <br /> If <br /> LILL .� <br /> �/ <br /> The# (lowing excerpt from the code of Federal Regulations.Section 403 "Report must be signed by a corporate officer who can=Iagally"Wl—ndthe <br /> company„ <br /> oI certify under penalty of law that this document'and all attachments were prepared under my direction ar supervision. <br /> 0 <br /> co <br /> Q <br /> L? �� �1 <br />