Laserfiche WebLink
. . ................. .. .. . ... .... . . . . . . . . . . . . . . . ................... . .. .......................... . . . . .. �-+ <br /> SAN JOAQUIN COUNTY <br /> Return this form b the <br /> Y ra;; :T t r•^'::�.y. ENVIRpNMENTAL HEALTH DEPARTMENT '� <br /> r. <br /> 1868 hast Hazelton Avenue,.Stockton,CA 95205-6232 12 of each month <br /> �-`. � ` •? <br /> Telephone: 209 .468=3420 Fax:(20,9)..464-0138 Web:www.sjgov.org/ehd <br /> •.�r:.: <br /> LL SEPTAGE CLEANER'S REPORT <br /> Company Name: r��t JYl I . . report for the month of year-�Z.6 <br /> Signature:Cotan Address: � a ` <br /> s-- <br /> SueetAddress 1 city zip coda <br /> All information submitted must be corn leis, a.cctirats and le y ible <br /> (R) RESIDENTIAL <br /> DATE NAME OF BUSINESS OR ADDRESS WHERE WORK WAS DONE. GALLONS NAMEOF TREATMENT <br /> P+UtPJIPfiELI f� PROPERTY.OWNER (G) GREASE.TRAP P L E A..S E t Nt C L'U o E S T,REf F T M, DIRECTION, E T R E E.T NAME AND CITY PUMPED C CHEMICAL FACILITY <br /> � <br /> Ci <br /> 11 u—T- V&I ?t �{ .� 1 �' x n S fit, i • ci 1 r 121 ` (red w <br /> -14 <br /> 19 to Ad <br /> E (�( T✓CM!YQZ", 47('o 7 ` L CityY!y tJCU l f <br /> f <br /> .�UA Alum <br /> � <br /> lalzt��' <br /> t <br /> (V � t �112 <br /> :�OU2A. �1 - 1t° A 'wr R. city Tk"akaz':C if <br /> vau <br /> v { � <br /> m <br /> o C� '' - i tier - , -1 i." ,%t-- city <br /> E.s \s'Z �J t iL- ' �1' 1 <br /> N t`r m <br /> �J <br /> ' 11 -- cit <br /> z <br /> LL CLL-EA Ci(Y. X,t :� , <br /> Z54 ciM <br /> city <br /> O <br /> City- <br /> CI <br /> city <br /> cityO <br /> cit. <br /> m <br /> city, <br /> o v <br /> EL EHT)42-04 SEPTAGE CLEANERS REPORT m <br /> 1014/07 K <br /> 6 <br />