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E ,IE <br /> MAY U 1,4 2016 <br /> w � r 2 <br /> ®fin $1_ 9ZR AIM <br /> -- ENVIRONMENTAL HEALTH rr <br /> wuAa�tii c SePbr Tm*a EN VICES �bf C Jam. <br /> PO Box 2"t tb.San ruin SO <br /> i 85209 Cleaners Report <br /> stockton,Cauf m a, Address± t0 t �tty, <br /> S <br /> ust be submitted{2y the 12`"of each month <br /> o tebare r Address* work was pesfam►ed type wasEe gat.pumped disposal site <br /> o pale flame of property <br /> r te? r2s -Z-CC) <br /> CO Y - S ' t res <br /> t' S1 L >ul p c <br /> -V&Iao �Cwy <br /> N 1C <br /> — <br /> (Una—_ 21cp �t©reACswcfs24 resA? toC)o s i cr <br /> } k <br /> ` Z C <br /> Cj 1-, 1 ori <br /> 4 k <br /> U - <br /> r- <br /> o <br /> _ o <br /> P4 <br /> v" <br /> Qsy <br /> the code of f=ederal Reguiatf m Section 403-Report rmm be signed by a corporate ofI`w who can{egaffy bind the <br /> a <br /> The fob a rPt frvasa � <br /> I certify underof taw that this int and all a.achmerds were pmpwed under my d'kecton or supervis an. <br /> O > <br />