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San Joaquin County Environmental Health Division <br /> Septic Tank and Cesspool Cleaners Report <br /> Company's Name: SRCPuin Ca. <br /> Company's Address: 11350 Kiefer Blvd, Sacramento, Ca. 95830 <br /> Report for the Month Of. �N �CJ�C° <br /> Gallons Where Cleanings <br /> Date Name ofProperty Owner Location Citi, Pum ed Were Unloaded <br /> 3" 40� S�t,✓�vl � C�.� Sm = � S(,t/, S irk / � <br /> / ,4 S7f�,oMm �SGt��i iii // Ur1 /I J/ <br /> Eby 3c? /1 j rr ii <br /> -C IWO Loe /730 _ 4 S w <br /> F UD , <br /> -ii✓ J.-- <br /> Ile S- <br /> %1 DS- , mill i1 <br /> S,?6 3 ul, lis/ 4 6-LIC) / i 1 <br /> Return by the 12th of each month to: <br /> Date Signature of Applicant Environmental Health Division <br /> 1304E. Weber St., 3rd Floor <br /> Stockton,Ca. 95202 <br />