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N FIVE® <br /> FEB 10 2Uib <br /> Saiaauuin Public Health Services :-•^;RpNMENTAL HEALTHReport for the month a� <br /> w <br /> �4d SP�rhi�, / , <br /> � PO Box 2009(445 K San Joaquin St.) Septic Tank and Cesspool SubtnKteci try- �eof <br /> a 1 <br /> Stockton,California,95209 Cleaners Report <br /> Fa)c4640138 Address {8583 S,�4lir�tT+ 1�/CiSJI <br /> Must be submitted by the 12'*of each month <br /> Date lame of Ptoperty Owner Address where work was performed type waste gal.pirmged disposal site <br /> 0 C S r <br /> C(' 23U a ��s c u <br /> 2 chi 5 g5 n t� u <br /> t -or-61 60 FC q 523 ( 200 <br /> 0 L <br /> � !S c QZ +2 .o vJ 1-C 52 Gt l u <br /> pI ( LS <br /> (01 28 Pre sla SfK- g52i 2 f-es E u <br /> t S1 2Wb �t u <br /> Y s I <br /> 55e- <br /> Do < <br /> TL 0 <br /> Hr J �, <br /> N {` 3ti <br /> 124 <br /> — z <br /> rest 2ZQ <br /> 5Z3 o <br /> i <br /> —t S-ta52D <br /> DfL S s <br /> O <br /> N The foJbvving excerpt from the code of Federal Regulatiom Section 403"Report must be signed by a corporate officer who can legally bled the <br /> N caw <br /> r m direction or su rviskn. <br /> � I certify under p�raity of Saw that this document7Z7777z_-Z'-[� <br /> all attachments prepared y pe <br /> O <br /> A <br /> a� <br /> 44 <br />