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ff- ` San Joaquin County <br /> Environmental Health Department RAYWmMisform try <br /> ' �:' 304 East Web er Avenue,3rd Floor,Stockton,CA 952U2-27083 the 12th of eadh month <br /> �+ TeJepharre: (209146&342 Jaz: (209)464-0538 1Ne11: wvrw_sjgay.nrg/ehd <br /> SEPTAGE CLEANER'S REPORT'. <br /> Company Name: UNITED SITE SERVICES Report for the month of MAY year 2011 <br /> Company Address: 364 N. 10TH ST SACRAMENTO 95814 Signature: <br /> o Street address 'City Zip Code <br /> Ail information submitted must be completed,accurate and legible <br /> (R)RESIDENTIAL <br /> DATE NAME OF BUSINESS OR ADDRESS INHERE WORK WAS DONE GALLONS (G)GREASE TRAP NAME OF TREATMENT <br /> PUMPED PROPERTY OWNER - PLEASE INCLUDE STREET#,DIRECTION,STREET NAME AND CITY PUMPED (C)CHEMICAL FACILITY <br /> 51152011 MORADA FARMING 500 NJACK TONE RD Cin LINDEN 406 C OMI THAMES WATER <br /> CITY <br /> CITY <br /> CITY <br /> CITY <br /> CITY <br /> CTTr <br /> Crr <br /> Cmr <br /> cn-Y <br /> orrY <br /> r.TY <br /> _. GiTY <br /> r CITY <br /> cn Wy <br /> C1TY <br /> w - <br /> CITY <br /> =FEZ C�Ty <br /> CITY <br /> CRY <br /> CRY <br /> `~ CRY <br /> b <br /> r e'firy <br /> 01TY <br /> CITY <br /> O <br /> c� <br /> CITY <br /> ori <br /> CITY <br /> CITY <br /> CITY <br /> CITY <br /> CITY <br />