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4`4� '- <br /> San Joaquin County <br /> z=g Environmental Health Department Return this form by <br /> 304 East Web er Avenue,3rd Floor,Stockton,CA 95202-2708 the 12th of each month e <br /> Telephone; (209)468-3420 Fax. (299)464-0138 Web_www.sjgov.orglehd <br /> SEPTAGE CLEANER'S REPORT <br /> ry <br /> b <br /> Company Name: UNITED SITE SERMCES Report for fife month of ,TUNE year 2011 <br /> Company Address: 360 N. 10TH ST SACRAMENTO 95814 Signature: <br /> Streetaddress City Zip Cade o <br /> -r, <br /> All inforrnation submitted rnust be completed,accurate and legible <br /> (R) RESIDENTIAL <br /> DATE NAME OF BUSfNESS OR ADDRESS WHERE WORK WAS DONE GALLONS (G)GREASETRAP NAME OF TREATMENT <br /> PUMPED I PROPERTY OWNER PLEASE INCLUDE STREET#, DIRECTION,STREET NAME AND CITY PUMPED (C)CHEMICAL FACILITY <br /> 611612011 MORADA FARMING N OAK ST crrY ACAMPO 10 G OMI THAMES WATER —� <br /> M AND R PACKING COMPANY 21656 N NO LAN ROAD crry ACAMPO 15 C OMI THAMES WATER <br /> MARK MATER W PELTIER RD X N RAY RD orrY ACAMPO 15 C OMI THAMES WATER <br /> TOLEDO FARMS 2525 E CAMPO RD CrrY ACAMPO 230 C OMI THAMES WATER —� <br /> GEORGE REED INC ACAMPO RD X LOWER SAC RD crrY ACAMPO 15 C OMI THAMES WATER <br /> CHAPPELL TRANSPORT 49555 FRONTAGE RD crTr ACAMPO 45 C OMI THAMES WATER <br /> AM MARKET 4579 E ACAMPO RD crry ACAMPO 15 C OMI THAMES WATER <br /> WILLIAMS CUSTOM VINEYARD 15375 E PELTIER RD CITY ACA-MPO 10 C OMI THAMES WATER <br /> TOM H0FFMAN 10112 E WOODBRIDGE,RD CITY ACAMPO 15 C OMI THAMES WATER <br /> MAGNOLIA STABLES 18128 L18ERTY RD aTY CLEMENTS 15 C OMI THAMES WATER <br /> LINDA LALIPER 21356 E ACAMPO RD ciTY CLEMENTS 10 C OM1 THAMES WATER <br /> M AND R PACKING COMPANY 25839 MACKVILLE RD crTY CLEMENTS 15 C OMI THAMES WATER <br /> E BAY MUD-AQUADUCT SECT]HWY88 ciTv HERALD 15 C OMI THAMES WATER <br /> EARL DECKER 28335 N MACKVILLE ST crry LOCKEFORD 10 C OMI THAMES WATER <br /> BRUNS BELMONT CONISTRUCr 19456 N TULLY RD ciTr LOCKEFORD 15 C OMI THAnESWATER <br /> DIEDE CONSTRUCTION 19456 N TULLY RD CITY LOCKEFORD 15 C OMI THA <br /> M AND R PACKING COMPANY HOGAN LN cmr LODI 15 C OMI THA <br /> COLLIGREE FARM MANAGEME 23201 N RAY RD cors LODI 150 C OMI THA <br /> RESTORATION RESOURCES WOODBRIDGE RD aTY WOODBRIDGE 15 C OMI THA <br /> JIM HAWK]NS 111 W WILLOW WOOD DR crry WOODBRIDGE 14 C OMI THAMES WATER <br /> MORADA FARMING 500 N JACK TONE RD crrY LINDEN 470 C. OMI THAMES WATER <br /> CDM 11373 N LOWER SACRAMENTO RD crrY LODI 900 C OMI THAMES WATER a <br /> M.AND R PACKING COMPANY N TRETHEWAY ROAD crrY ACAMPO 125 C OMI THAMES WATER <br /> M AND R PACKING COMPANY E TOKAY CrrY LODI 130 C OMI THAMES—WATER <br /> M AND R PACKING COMPANY 11450 PEARSON RD crrY LODI, 100 C OMI THAMES WATER <br /> M AND R PACKING COMPANY N ALPINE RD crTY STOCKTON 105 C OMI THAMES WATER <br /> M AND R PACKING COMPANY 7515 PEZZI RD crTY STOCKTON 50 G OMI THAMES WATI`R <br /> M AND R PACKING COMPANY W LOWER SACRAMENTO RD crrY WOODSRIDGE 50 G OMI THAMES WATER <br /> MERITAGE HOMES ANDALUSIA WY VIOLA ST crrr MOUNTAIN HOUSE 35 C OMI THAMES WATER V <br /> MERITAGE HOMES IVIOLA+OUESTATRAIL crrr MOUNTAIN HOUSE 15 C OMI THAMES WATER <br /> SF+EA HOMES ANTIGUA TERRACE o ry MOUNTAIN HOUSE 35 C OMI THAMES WATER <br />