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titi69 "N Wd�S : � SIOZ '0 [ 'unr ;Wli pania3;� <br /> Inedible Kitchen Grease (IKG) Manifest AL MAMA% <br /> Stockton Roto Rooter Grease & Septic Service AAjrk <br /> Date: Time: <br /> . 5 AM/PNj Manifest#L- Q 13 <br /> 1 <br /> Business Name: ,_ '�i- <br /> Job Site Address: f I--,:�xkWit` r� ,t,, , �4o Zip Code; <br /> Customer Name (print): (Signature): <br /> IKG 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 IKG Receipt: /)�Al Time of lKG Receipt: Total IKG Received: <br /> Septic grease <br /> Receiving paciIity Rep.Name(Print), 1j) 16T?' v4(Signature): <br /> Authorized Transporter: Vehicle Decal Number: ? a <br /> Stockton Roto Rooter Driver Name(print): l <br /> 4228 Newton Rd . <br /> Stockton,CA 95205 Driver Signature: �� _ <br /> S 'd LLtiZ 'ON WdLS : Z SIOZ '0l 'unr <br />