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San Joaquin County Environmental Health Division <br /> .4UL Septic Tank and Cesspool Cleaners Report <br /> ENVIRON N r4 <br /> Company's Name: SRC Pumping,Co. <br /> Company's Address: 11350 Kiefer Blvd,Sacramento, Ca., 9583o <br /> tLI <br /> Report for the Month Of 17U-A�& a <br /> Gallons Where Cleanings <br /> ✓ Date Name OfProiyertv Owner 1' Location Ci Pum 'ed <br /> �a���+ � � Were Unloaded <br /> '9a✓ 0LM-,4A2nZZf <br /> t � <br /> /Uri <br /> i.r <br /> �lJ .�Se J �JL ST A,3 'y l t s <br /> J <br /> oZ 00 l� Z <br /> z� ��f �`� T /lit/ O <br /> Return by the 12th of each month to: <br /> Date Signature of Applicant Environmental Health Division <br /> 304E. WeberSt., 3rd Floor <br /> Stockton, Ca.` 95202 <br /> i <br />