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m SAN JOAQUIN COTINI ' <br /> FNYTRONMFiNiAL FLF-;ALTti DEYARTR L-N1, Return this farm by <br /> m 304 East Weber Aveauc,3rd Floor,Slocktcn,CA 95202-2708 the 12"'of each month <br /> Ln l�! Telephoxc:(209)466-3420 Fax_(209)464-0136 Rf,-b.ww;v..rjpo%,.orglchd <br /> LCL SEPTAGE CLEANER'S REPORT <br /> COMP111yName: C & C Portable Toilets, Inc. <br /> P.O. BOX 523 — -- Rcrforc for the rn tlr a . <br /> CannVany Address: Riverbank, CA 95367 5igaature: <br /> Zip Cad. <br /> All fi ferlarliew xubmiiltd must tre comriltle rtruratc, rod legible <br /> DATE AAMF OF BUSMESS OR ADDRESS SPHERE W ORl{V,'AS DONE (R) �ssmrxrut <br /> GAa,Lf3ItiS 3Xhh3 OFTR6A"IT2EK(' <br /> rUMP£A FROPER n'OXVNER (G) eauscTaer <br /> PLEASE Ti�el.0 oc s7xrRr j'• ➢lriCCTIoN- STP Ei7 NattlL eru clrti PUMPED FAC[LM <br /> d � <br /> J� LI J qC. t 1 LA-(— till' <br /> Cr <br /> m J ,] Gn-00 <br /> Aj <br /> mss <br /> a _ <br /> o� <br /> NZ +1 cr - _1 fi� i`� (_�L.c�.i _ cin• <br /> ot <br /> - -Q �1 c.-- t <br /> � I[ ls� �c�rJ 12 <br /> 121 a City <br /> L - -' --- <br /> a. —.i_ C:i f Y �' �� __1 :� �' C �i% _4� - — <br /> U <br /> ciw <br /> Ciry <br /> M L'11D 4244 <br /> -4 <br /> CL <br /> w <br />