Laserfiche WebLink
° V 7 coy <br /> SAN JOAQUIN COUNTY FD � h'E <br /> r ?, ENVIRONMENTAL HEALTH DEPARTMENT Return this form by <br /> 600 East Main Street, Stockton,CA 95202-2708J 20�� the 12"`of each month <br /> Telephone:(209)468-3420 Fur:(209)464-0138 Web:www.sjgov. g/ehd <br /> HClPC) <br /> SEP GE CL NER'S REPORT ENVIRONMENT HEA H <br /> Company Name: 1 PERN11IT/SERVICES <br /> Report for the nth of yeau, <br /> Company Address: l I <br /> Jd Sign 'ture• I <br /> treet Address a City Zip Code I <br /> All information submitted must be complete, ae,eurate, and legible �'114fMT4"� ; <br /> DATE NAME OF BUSINESS OR ADDRESS WHERE WORK WAS DONE �' GALLONS R) RFSL�@�N�tAL X NAi4IE OF TREATMENT <br /> PUMPED PROPERTY OWNER GREASE TRAP <br /> PLEASE INCLUDE STREET p, DIRECTION, STREET NAME AND CITY=!. PUMPED FACILITY <br /> C CHEMIcic <br /> p SWA" cityQ J <br /> {' AzAlManist C V. city o ek r6L. 1 {f <br /> t �0 kr Cit C C ' 7 4 <br /> city c <br /> Y9,7 city l7 <br /> &0-01 } Ci $ <br /> f Oli0 P I 15-50Cit b cl <br /> a <br /> 0 <br /> cii a D C. -11f <br /> o 2 Q*it /d <br /> aaa A-1... k ci r <br /> cit <br /> "OP ` <br /> Ci c- <br /> , n60 <br /> City EtTlc <br /> 5,166 1L). wi (�"7�]-1 city - � Z 0 Q. <br /> r City6 <br /> 9-010 <br /> �Q U ci C 7,0 Ll C <br /> W,; I <br /> QS 6 r �� Ci ,5 oC I <br /> � I <br /> City C&ze f <br /> EHL)42-04 ,r <br /> Septic/Cesspool Report <br /> r' <br />