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a <br /> 64C=3 d �/ <br /> San Joaquin County Environmental Health Division <br /> t Septic Tank and Cesspool Cleaners Report <br /> Company's Name: SRC Pumping Co. <br /> Company's Address: 11330Kiefer Blvd, Sacramento, Ca. 93830 <br /> Report for the Month Of (J <br /> Gallons Where Cleanings <br /> Date Name o ,Pro ertV Owner Location C9 Pum ed Were Unloaded <br /> —q/z) n c/a '� �,D O��Cld �l/�. G,�92 7 d <br /> rs <br /> G�ai <br /> �j IV <br /> S Dd2 cJ Lvtti�it .So I �, ,� <br /> ISE/1 le- r !I <br /> %NCI <br /> 42 <br /> /I/ <br /> i5 fL C <br /> trS /fes !• i/ <br /> 1)ZV ih Le �4 r / p () r�/IQ // <br /> S J 4 1 1Return by the 12th of each month to: <br /> Date Signature of Applicant Environmental Health Division <br /> 304H. Weber St.,3rd Floor <br /> Stockton, Ca. 95202 <br />