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_ San Joaouln Public Health Services Report for the month of—b °Q rn bw 2 z <br /> d Cnyironmental Health Services <br /> PO Box 2009 (445 N.San Joaquin St.) Septic Tank and Cesspool Submitted by:A& Scaffe, 16c, <br /> Stockton, California,95209 Cleaners Report <br /> Fax.,4640138 Address:j0Sg3 �I(► Oa►'d 41/Qy� A � <br /> Must be submitted by the 12t" of each month <br /> rn <br /> 0 <br /> Date Name of Property Owner Address where work was performed type waste gal. pumped disposal site <br /> CD <br /> 1 (- I r iii z i I ZO C7 <br /> ^fin'^ ry l s cls <br /> W LI tl Ll 11 It 11 <br /> 2-3 r (rI Mail ct RA av- Ct52) t t << a u <br /> I -1--i Rld< Vul1 Sl7<- 95 It 11 Lt a tt 1, <br /> 1Z S E I t S �SZOS <br /> 5 Vee 8f'o5 Zt3 u q 521 <br /> -S c� ro5 <br /> -5--L5ciftc 'S9 5w 7 t " i UU n �I <br /> I L- Mz 0 2- Rnqhfr\d Fc 9523 VKLCL4 0L) �+ 4 <br /> 2`w t3 a C(c u52J <br /> Z v t u <br /> s" h W S 952 15-1 <br /> Lu 2- RICK, N zti 9,H Wil '3M (9'S215- I t u , <br /> ~°o -1 O 2- 0 ' 10 Stk- H 520 20 I Q <br /> Z q 57_I S -e5 tcA�o� a.Q -LO-0 u u <br /> z¢ UIY . Site �i5Z15 tt �t I (aU0 <br /> �V)C 'utSi hc Z2 •" 6VW1j 6xn stit 9S 2 `^ <br /> LU j 2--if KD[ 1 Srtc qsza 2. 1 <br /> U' Gleruto LQ � 5 zo 7 Lt u t t, <br /> 11 <br /> I� Cil rac)rzL S S Wit'S2D t L 1 t (oto(7 <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 /> a company" <br /> 1 certify under penalty of law that this document and all attachments were prepared under my direction or supervision. ~ <br /> v <br /> 13 <br />