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9HO "N &9Z :Z 9102 -9 'uPr ;wlli P;A ' ;O;� <br /> Inedible Kitchen Grease (YRG) Manifest <br /> Stockton Roto Rooter Grease & Septic Service <br /> c� "L!,, <br /> M 1Vxanifest#][�W- 7 <br /> Rate: Time! <br /> r <br /> Business Name: <br /> Job Site Address: & Z- ix zod,' Zip Code: n2 <br /> Customer Name (print): t (Sx nature): <br /> 1KG Authorized Receiving Facility Name/.Address (circle dump site for facility) <br /> City of Lodi-Whiteslougab $PCF <br /> 1.2751 N.Thornton ltd <br /> Lodi, CA 95242 <br /> (209)333-6749 <br /> Date of lKG Receipt-f^ _/ ��xme of MG Receipt-_ Total XKG Recei-Ved: <br /> Septic 7 Grease <br /> Receiving Facility Rep_Name(print) <br /> �J <br /> Authorized Transporter" Vehicle Decal Number:— — <br /> Stockton Roto Rooter Driver Name(print): ✓�'' <br /> 4225 Newton Rd �{r <br /> Stockton,CA 9205 Driver Signature: "r <br /> 2b�7 S <br /> �� 'd �fl� 'ON Ude 9M '9 'upr <br />