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riC w AN,. . �. <br /> San Joaquin Cou nty'Environmental Health Division <br /> NSSeptic Tank and Cesspool Cleaners Report,wV ., VIM"r, <br /> J >� I <br /> 13 � yy k7 <br /> y. <br /> ami: SRC Pumping Co. <br /> any rs Address: 11350 Kiefer Blvd,Sacramento, Ca.- 95830 <br /> Report for the Month Of �� <br /> `'o Gallons Where Cleanings <br /> Date Name o Pra ert OwnerLocation 3, <br /> C Pum ed Were Unloaded <br /> 19 ��'�'� ' vv <br /> Aw 99 �p <br /> a o&A <br /> ?3c , <br /> o9l NT, <br /> v <br /> La — - C'lZc�414--/L <br /> 'I T <br /> 13w,/0 Ulf VOL) .c ✓I <br /> Ile <br /> / Return by the 12th of each month to: <br /> Date ' <br /> Signature of Applicant Environmental Health Division <br /> + 304E. Weber St„ 3rd Floor <br /> Stockton, Ca. 95202 <br />