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titi68 'q WdES :Z S1O� '0l 'unr ;WI j pania);� <br /> Jnedible Kitchen Grease (IKG) Manifest <br /> Stockton Roto Rooter Grease & Septic Service <br /> Date: �71 Time: J� A1VI I M Manifest# <br /> Business Name: ki � �V� <br /> J'ob Site Address: `' <br /> r <br /> a� C.t�• t.�.i 1"L � - r Zip Code- <br /> Customer Name (print): (Signature -: <br /> WG Authorized Receiving Facility Name/Address (circle dump site for facility) <br /> City of Lodi-Whiteslough SPCA' <br /> 12751 N. Thoriaton Rd <br /> Lodi, CA 95242 <br /> (209) 333•-6749 <br /> Date of IKG Receipt: Time of IKG Receipt: Total IXG Received- <br /> --Septic Grease <br /> Receiving Facility Rep.Name(Print (Signature) <br /> Authorized Transporter: Vehicle Decal Number: ��. � <br /> 7 <br /> Stockton Roto hooter Driver Name(print): RxLL,lc <br /> 4228 Newton Rd <br /> Stockton,CA 95205 Driver Signature.---:I <br /> z 'd LLtZ 'ON Wd9S :Z S�0z Ol 'unr <br />