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0 <br /> _ SanJoaauln Public Health Services II,, <br /> d EnvironMnW Health 5ery — Report for the month of <br /> PO Box 2009 (44S N.San Joaquin St.) Septic Tank and Ces ool <br /> Stockton, California, 95209 sP Submitted by: a <br /> Fax:4640138 Cleaners Report <br /> Must be submitted by the 121"of each month <br /> m <br /> 0 <br /> Ce) Date Name of Property Owner Address where work was erformed <br /> o S P type waste gal. pumped disposal site <br /> PI)OS n IC� I LouveSQc I a� 4-00 � <br /> " r <br /> C7- S" 521p 200 n u <br /> Su r Z]�Iciulctr Q S tk 95 <br /> 7 v 19g- �SL Il <br /> p_ _ Q521a l2oc� u u <br /> 5 A h e 91 1 <br /> I l I l i i U <br /> QY I S� . 2QS <br /> 7 -i ✓ .� . �'� 120 ii �� <br /> 0 9x215 re a li �, <br /> u 1 R <br /> r .tet 5 u 1 < <I u <br />_' , Chdrjerr 9- zco <br /> 2 <br /> Y D_ ViS �fk i 2(x re$ of 0 0 <br /> P rshin <br /> i G r see— ZOO « <i <br /> YD I I cin Gel 7 u a SSD k i� o <br /> lX GS21Z it II �� tr 11 > <br /> The following excerpt from the code of Federal Regulations.Section 403"Report must be signed by a corporate offl er who can legally bind the z <br /> IL <br /> company' <br /> 1 <br /> I certify under penalty of law that this document and all attachments were prepared under my direction or supervision. <br /> V <br />'}.Yti <br />