Laserfiche WebLink
1206NA Z SIOZ Z lnr awil pania0a� <br /> Y,(Z , Opo 4 0 <br /> Inedible Kitchen Grease (IKG) Manifest <br /> Stockton Roto Rooter Grease R Septic Service <br /> Date: / 15� Time: � �� AM/PM Manifest#L-613 q <br /> BusinessName: <br /> Job Site Address: 5G r r frt 1;1 �/-' Zip Code. �- <br /> Customer Name(print): (Signature):. <br /> II G Authorized Receiving Facility Name/Address (circle dump site for facility) <br /> City of Lodi-Whiteslough SPCF <br /> 12751 N. Thornton Rd <br /> Lodi, CA 95242 <br /> (209)333-6749 <br /> Date of lKG Receipt: Time of JKG Receipt: Total lKG Received: <br /> Receiving Facility Rep.Name(1?Tint) �s (Signature): <br /> Authorized Transporter: Vehicle Decal Number: _ c ;(�i <br /> Stockton Roto Rooter brrver Name{print}: TJ /,f) � . <br /> 4228 Newton Rd <br /> Stockton,CA 95205 Driver Signature: --, <br /> S d 6IL� '°N NdS [ : Z SlOZ Z [ nr <br />