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Oti98 "N AVW l 9101 '9 'AP ;W1 j pan i a);� <br /> Inedible Yjtchen Grease (.EKG) ManifestStockton Roto Rooter Grease *o <br /> rSeptic <br /> Date: /6 /Y Tiume. a , '/1 N 1 PM Manifest 4 <br /> Business Name:—&AA O. <br /> �; , '�C <br /> ,Tab Site Address: � �• � t c}5�'� Zip Code* <br /> Customer Name(prin � t. � f (Signature). � <br /> fKG Authorized Receivi ,-,Facility Name/Address (circle dump site for facility) <br /> City of Lodz--Whiteslough SPCF <br /> 12751 N.Thornton Rd <br /> Lodi, CA 95242 <br /> (209)333-6749 <br /> Date of IKG Receipt: / .0 Time of IKG Receipt: �1 s Total IKG Received: <br /> Grease <br /> Receiving Facility Rep. Name(Print) / '� (Sig-nature <br /> Authorized Transporter: Vehicle Decal Number. <br /> Stockton Roto Rooter DriverName(print): �S � <br /> 4228 Newton Rd <br /> Stockton,CA 95245 Driver Signature. <br /> Y <br />