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San Joaquin County'Environmental Health Division <br /> Septic Tank and Cesspool Cleaners Report <br /> Company's Name: SRC Pumping Co. i <br /> Company's Address: 11350 Kiefer Blvd,Sacramento, Ca.' 95830. <br /> Report for the Month Of <br /> 4 Date Name o Pro er_tg Owner Gallons Where Cleanings <br /> Location Cy. PWm rimed Were Unloaded <br /> r )gz 4,1� <br /> �t 1 r i <br /> S —�Z ; <br /> it <br /> - <br /> f <br /> i <br /> Return by the 12th ofeach month to: <br /> Date Signature of Applicant Environmental Health Division <br /> 1304-E. Weber St., 3rdFloor <br /> Stockton, Co. 95202 <br /> t. <br /> �1 <br />