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titi60 "N Wd�S : Z S �0z -0 � -unr awil paniaa;� <br /> Inedible Kitchen Grease (IKG) Manifest LWOO <br /> Stockton Roto Rooter Grease & Septic Service <br /> Date: t-5— Time; ��`�� AM /PM Manifest#L- 013 <br /> cri <br /> 1 } / <br /> Business Name: :y 0/1 c I J c <br /> ,fob Site Address: 7-t-- ry. �� i /� Zip Code: <br /> Customer Name (print): X/ ,� ��� ! (Signature):`- <br /> fKG Authorized Receiving Fa _.�me/Addr-ess4,circle--d-i mp site for facility) <br /> City of Lodi-Whitesiough SPCF <br /> 12751 N. Thornton ltd <br /> Lodi, CA 95242 <br /> (209) 333-6749 <br /> Date of IKG ReceiptTime of IILG Receipt: f Notal IKG Received:,�a <br /> Septic �, reas <br /> -3b aaw <br /> Receiving Facility Rep.Name(Print) (Signature): <br /> Authorized Transporter: Vehicle Decal Number: TZ— '17W,2 <br /> Stockton Roto hooter Driver Name(print): pall <br /> 4228 Newton Rd i <br /> Stockton,CA 9-205 Driver Signature: <br /> o � 'd LLtiz '°N WdLS : Z S�Oz o[ 'unr <br />