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Ci San Joaquin Public Health Services_ _,�___r_ Report for the month of�'�}y(,(( LLL <br /> Environmental Health Services 1 <br /> PO Box 2009 (445 N.San Joaquin St.) Septic Tank and Cesspool Submitted by: Inc. <br /> Stockton,California, 95209 Cleaners Report c <br /> Fax:4640138 Address: 16S-93 'S)ArWr�� <br /> Q, Must be submitted by the 12th of each month <br /> 0 <br /> Date Name of Property Owner Address where work was performed type waste gal.pumped disposal site <br /> FC 2571 -A)-SYjtentk,4 2-00-0 <br /> 2 c c' > C)e; 2 tti ti <br /> ElfLU <br /> 0 <br /> 0 <br /> 0 <br /> 0 <br /> z <br /> 0 <br /> F- <br /> d <br /> LU <br /> The following excerpt from the code of rederal Regulations,Sectlon 403 "Report must be signed by a corporate officer who can legally bind the <br /> company' <br /> b I certify under penalty of law that this document and all attachments were prepared under my direction or supervision, <br /> v 7 <br /> n , <br /> U) <br /> U) <br />