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DEC 6 24io Ems <br /> San Joa ui P alth Services <br /> I e <br /> a Report for the month of 2ZI 0 <br /> (445 N.San Joaquin St.J <br /> Stockton,California,95209 Septic Tank and Cesspool Submitted by: <br /> Fax:4640138 <br /> Cleaners Report <br /> Must be submitted by the ffh of each month Address:, 4 Q <br /> 1 � <br /> Date Name of Property Owner Address where work was performed tyco pe waste gal.pumped disposal site <br /> rn X52(}? Ypl S� (ILS <br /> CC0 <br /> IL.Warms Meat MA.r <br /> 2 r` <br /> I V-n n STS �U r� y <br /> 100 it t( . <br /> M Pacheco- UU rr u <br /> U rt <br /> 4-5312 ch= 5tL- it lot <br /> 4, <br /> r <br /> W <br /> 0 <br /> z <br /> t= <br /> it <br /> The following excerpt from the code of Federal Regulations.Section 403"Report must be signed by a corporate officer who can legally bind the <br /> company" <br /> U9 I certify under penalty of law that this document and all attachments were prepared under my direction orsuPervision. <br /> := <br /> o <br /> 0 <br /> U <br /> N <br /> ❑ <br />