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U <br /> San Joaguin Pubic Ffealtft Senricmo <br /> Report€or the month of_�ew by r <br /> I&d[2MnenW_jjukh Seuv <br /> kes <br /> PO Bax 2009(445 N.San Joaquin St.) Septic rank arni 0 <br /> l3 Cesspool submitted bv= C{ If'!C. <br /> Stotkton,Califorriia,95209 cleaners Report <br /> Fax 4640138 Address:_16S$3 19 A-0 <br /> Must be submitted by the 226 of each month <br /> W . <br /> Date I Name of Property Owner Address where work was perfortmed type waste gal.pumped disposal site <br /> 12-2 �ti j QQ �S1n !? D <br /> 1-Y-12-2 <br /> c et I(xC)O <br /> 1 Z'2- _ <br /> S <br /> 12 i m 2' '2, A? gyres i t Z c?O i� �t <br /> Y2 EO hG C Q V1Q �1 ct` { ti l y tt r� a n <br /> 0 <br /> C T ► 32� �oci�t-►�► Sic- as�v �� ,� l c�U a� <br /> lZ-� Yl i rI _ �o' W RS2c� <br /> 15(m S1k 0520 GYeq_-5z 1p oo <br /> - moose ' (- CID <br /> Vis 5qoo u <br /> 1D °t `��Y,- r a <br /> klz 11 <br /> �2- <br /> e 0 <br /> l 7 Gi g521 1t 0 Lti Ll <br /> Z—Q ti Y�4t- �a55 Hovada Gn Sty- cv5 mz_ k� <br /> `I 2DDO U <br /> 2 _70-t$ ftwlai 6t- COSu L� q <br /> Solt Q51 L_95209 w <br /> 2-l3 <br /> -2-4 Clue St(-- 9524 u 2000 <br /> o C 5kszt <br /> The falbwirrg excerpt from the code of Federal Reg Section 403"Report must be signed by a corporate officer who can legally bind the <br /> company" <br /> I certify under penalty of law that this document and all attachments were prepared under my direction or supervision. <br /> ro <br /> W <br />