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vF <br /> San Joaquin County Environmental Health Division <br /> Septic Tank and Cesspool Cleaners Report i', <br /> Company's Name: SRC Pumping Co. <br /> Company's Address: 11350 Kiefer Blvd,Sacramento, Cm 95830 <br /> Report for the Month Of.. �, <br /> Gallons Where Cleanings <br /> Date Name ofPronerty Owner Location Cir Pumped Were Unloaded <br /> �/�/- ��c-r��✓ 5 5 �n 2b <br /> 46 )d <br /> /5.21 <br /> 3 sic9 t r111�59 X31 L — /� (20 >i i l <br /> 'D12 ' u <br /> .Lia✓ ^. � SU ti ii <br /> Remm by the 17th of each month to: <br /> Date Signature of Applicant 8nvirvnmentallfwlth Division <br /> 3048• WeberSt., 3niFloor <br /> Stockton, Ca. 95701 <br />