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LJ <br /> RECEIVE® <br /> JU- 10 2012 <br /> San Joaauln Public Health Services ENVIRONMENTAL HEALTH Report for the month o <br /> CL Environmental Hef�( <br /> alth Services PERMIT/SERVICES <br /> PO Box 2009 (445 N.San Joaquin St.) Septic Tank and Cesspool Submitted by: sPp �f7r <br /> Stockton, California, 95209 Cleaners Report <br /> Fax:4640138 <br /> Must be submitted by the 12th of each month Address;-&Tgi— S ,�tr-ppf=F U/a � <br /> r <br /> rn <br /> 0 <br /> Date Name of Property Owner Address where work was performed type waste gal.pumped disposal site <br /> CD IS , <br /> N <br /> L Q 021 w Ct c{ r it u u 0 <br /> 3 re(M07f7 <br /> I I D Ic a <br /> PS 27X8 u <br /> e 0. <br /> - r .t II ZQQ cl 4 <br /> LU t <br />°o I�V1C�( � . s 1l1 u <br /> 5 SurJnt S ��u reSI ✓t I <br /> aA.Vid(GVj <br /> L< o <br /> w l��t <br /> �C o 4'Gt b u,� -e <br /> r 8 c, <br /> i e s is �estcLerrfit <br /> The following excerpt fro the code of Federal Regulations.Section 403 "Report must be signed by a corporate officer who can legally bind the <br /> company" e <br /> I certify under penalty of law that this document and all attachments were prepared under my direction or supervision. ~ <br /> D <br /> ` 7-y <br />�ti��r <br />