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Ar <br /> RECOVED <br /> OCT 3 -2013 <br /> � Sanloaguin Public Health Services <br /> a EgWronrnental Health Services EWRONMENTAL HEALTH Report for the month of <br /> PO Box 2009 (445 N.San Joaquin St. PERMITISER�t10ES <br /> Septic Tank and Cesspool Submitted by: _,SelYf1C� <br /> Stockton, California,95209 Cleaners Report <br /> Fax:4640138 Address:_(OS$3 lYfbt f W <br /> Must be submitted by the 12''of each month <br /> rn <br /> 0 <br /> Ln o Date Name of Property Owner Address where work+oras <br /> performed type waste gal.pumped disposal site <br /> 00 g- h F FC-lZ�' <br /> zit <br /> 1 IL r iI Co' L{ ff t L C. <br /> f <br /> (�sNt, {� u <br /> 5TH C� Doc) ti &4 <br /> 1 Ls I 2-OD <br /> �- iA c 72)� kirn u <br /> �-� f 7 t 4q <br /> S ti.t tl ,L y <br /> Sty Lt 0 <br /> ti Ll <br /> O <br /> ooc) <br /> H �oaclf� <br /> w 267 �k �14 <br /> Z I 07 C+ I��S t 1 Z�C7 L l s< <br /> ' ti Ci 00 q N <br /> C "zo a �0 (� �► <br /> M q5 --et{ <br /> 3 2 I i t ,, m <br /> O12-42 0 <br /> ll �Q <br /> The following excerpt from the code of Federal Regulations.Section 403"Report�52s5 l ' L l l <br /> 0 <br /> ,-+ <br /> companymust be signed by a corporate officer who can legally bind the <br /> CD — <br /> c11 I certify under penalty of law that this document and all attachments were prepared urger my direction or supervision. ~ <br /> (Y) <br /> 0 <br /> Y U <br /> U <br /> 0 <br />