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San Joa tin Pu tic He ENTEM <br /> Health Services _ _ <br /> Q Euvirons, Service Report for the month of �7„t',}jj � <br /> PO Box 2009 (445 N.San Joaquin St.) <br /> Stockton, California,95209 Septic Tank and Cesspool Submitted by: r <br /> Fax:4640138 Cleaners Report ' <br /> month Address: OSd <br /> Y Li <br /> Must esu submitted b the 12`h of each <br /> 0 <br /> U9 Date Name of Property Owner <br /> p Y _-Address where-work.was performed <br /> 1-rt�e'wasts gal.pumped disposal site <br /> (I• <br /> N Y �� V1 it7C �l zU t;U. <br /> f' r <br /> 4. <br /> Rpth Ft-- 6r,5 z-'3 <br /> U ?T2 `t!�-IUB l i <br /> tt tt 4 <br /> ,.� ell ., t�sy}• ,,. <br /> LU <br /> 0 <br /> 0 <br /> zC <br /> U <br /> h <br /> 0. <br /> W <br /> The following excerpt from the code of Federal Regulations.Section 403 °Report must be signed by a corporate officer who can legally bind cornPany'� g y the <br /> i l certify under penalty of law that this document and all attachments were prepared under my direction or supervlslan. <br /> rn <br /> 0 <br /> 0 <br /> Z <br />