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ol3 <br /> San Joaquin County Environmental Health Division <br /> Septic Tank and Cesspool Cleaners Report <br /> Company's Name: SRC Pumping Co. <br /> Company's Address: 11350Kiefer Blvd,Sacramento, Ca.' 95830 <br /> Report for the Manth Of. Q LO <br /> �t <br /> ' Gallons Where Cleanings <br /> Date Name 0Paverty Qwner Location Ci Putrt ed Were Unloaded <br /> a' - Z <br /> i/ t�13�' r�m 071tFdI /7) <br /> l� <br /> aJI/-G � /1 121° 0 ��/77 �� ,S"U <br /> �d C5t / rnl L o[' �✓ i c <br /> �0� FiiGur1 �i °, da <br /> .32 33 LL&2222,al Z-zV <br /> 3 GtJ �r <br /> &ya-A zV) <br /> 3 /'=cl/o Z)Lo O r- �� Com/ r r . 11 <br /> 4q./49 <br /> / Return by the 12th of each month to: <br /> Date licant o Signature A <br /> -° g f pp EnvtronmentaI Health Division <br /> 304E. Weber St, 3rd Floor <br /> F <br /> Stockton, Ca. 95202 <br />