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San Joaquin County Environmental Health Division <br /> Septic Tank and Cesspool Cleaners Report <br /> Company's Name: SRC Pumping Co, <br /> Company's Address: 11350 Kiefer Blvd,Sacramento, Ca 95830 <br /> Report for the Month Of. - a / <br /> Gallons Where Cleanings <br /> Date Name a Pro ert Owner Location C Pum ed Were Unloaded <br /> a � - <br /> G�r� T� L = S> <br /> S R C <br /> C U U <br /> d Gf Gi A eve) <br /> r <br /> r I� 6d 1 i/ <br /> � i <br /> r Return by the 12th of each month to: <br /> Date Signature of Applicant Environmental Health Division <br /> 304E. Weber St., 3nd Floor <br /> Stockton, Ca. 95202 <br />