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DO <br /> k�'E WIE© <br /> JUN U 7 'cu+d ENTERED <br /> San Joaquin Public Health S ices CRQNMENT HEALTH Report for the month of f(� <br /> a nv a nta ce PERMITfSERVICES <br /> p0 Box 2009 (445 N.San Joaquin St.) Septic Tank and Cesspool Submitted by; c�- <br /> Stockton, California,95209 Cleaners Report <br /> Fax:4640138 Address: () $ <br /> Must be Submitted by the 12�"of each month <br /> S Date Name of Property Owner Address where work was performed type Waste <br /> gal•pumped disposal site <br /> _t_�O i?i 7rs? ZED - rrd e 5 <br /> Q e '1�r7`1cz& /SAO( S c4=fo <br /> Y C'a , <br /> es�rs j Za <br /> 2L g <br /> La—ctmg �LE7 � �SZ1D a �� <br /> t Q Com- i � S� <br /> /Z&O <br /> t <br /> - D uvc� brei? a Gs re i lUnv rr <br /> f �t rn c frL S Zl r+ �d Uv lc u <br /> r rlo !r? 1- Qil 5 y-�- A 0 0, r JCGt <br /> t 9 <br /> W ar Ut tivD <br /> o Sfr � r� , it Iv <br /> c� L <br /> o 96 24 L <br /> � 5 j. 9 D <br /> ❑ a ti <br /> 97295 D (f <br /> h <br /> Q <br /> w <br /> The followingfrom the code of <br /> excerpt rp Federal Regulations.Section 403"Report must be signed by a corpora <br /> company" te officer who can legally binr the <br /> I certify under penalty of law that this document and all attachments were prepared under my direction or supervision, <br /> o <br /> CD <br /> F � <br />