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MID <br /> JUL o 9 010 ENTERED <br /> ENVIRUNNIENT HEALTH <br /> i <br /> a San Joaquin Public Health _services „ „._ PERMIT/ <br /> Report for the month of <br /> Uir ea t <br /> I PO Box 2009(445 N.San Joaquin St.) Septic Tank and Cesspool Submitted by: <br /> Stockton, California, 95209 Cleaners Report '`- <br />�. Fax:4640138 Address: <br /> Must be submitted by the 12'h of each month <br /> rn <br /> 0 <br /> C Date Name of Property Owner Address where work was performed type waste gal. pumped disposal site <br /> G) 3-0 N'UnL kLOden - lee st Ll le} 5 ;� C <br /> K � �, <br /> I CD <br /> If <br /> Cr it it l <br /> L , <br /> It <br /> LP� <br /> �j G'c /' �ii f x - <br /> OY'alou11 � � :,1 `�' <br /> z <br /> rK <br /> E�'el <br /> Q <br /> U <br /> a <br /> w <br /> W <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 /> Q company" <br /> m <br /> `n . I certify under penalty of law that this document and all attachments wer repared under my direction or supervision. <br /> Q <br /> f' ;.�. <br /> ' OL <br />