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titi68 '°N MS :� Z—0 ;w1l pania°a� <br /> Inedible Kitchen Grease (IKG) Manifest L400 <br /> Stockton Roto Rooter Grease & Septic Service <br /> Dater r.5 Time: •��- ANE/PNI Manifest 9 L- <br /> Business Name: �- -e' � <br /> ,Yob Site Address: � � �-t✓ ����� `�°��' � � <br /> %� dip Co �.� <br /> Customer Name (print); �7 /� (Signature): <br /> IKG Authorized Receiving Facility Name/Address (circle dump site for facility) <br /> City of Lodi-Whitesiough SPCA' <br /> 12751 N.Thornton Rd <br /> Lodi, CA 9542 <br /> (209)333-6749 <br /> Date of TTCG Receipt: /� / %�Time of TTCG Receipt.-2._- <br /> Total tKG Received:? <br /> _ 1 <br /> Se P 06C Gr <br /> Receiving Facility Rep.Name(Print Sj (Signature): <br /> Authorized Transporter: Vehicle Decal Number: / L f 7 <br /> Stockton Roto Rooter Driver Naine(print): <br /> 4:23 Newton Rd a . <br /> h <br /> Stockton,CA 95205 Driver Signature: -, yU'u' <br /> 2 'd CC�z '°N WdCS Z S [Oz <br />