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9HO 'ON Md : 6 9102 '9 -U, r ;W1j pania);u <br /> Inedible Kitchen Grease (IKKG-) IVianifest % � <br /> Stockton Roto Rooter Grease & Septic Service <br /> Date: /V— %�l Time: W Alf #L-d(�/' <br /> Business Name:, <br /> Jolt Site Address: (� /� � err �f ��-/,'Zip Code: � y� <br /> Customer Name (print)-. _ � <br /> g },t,1"(1 <br /> 1KG Authorized Receiving Facility Name/Address (circle dump site for facility) <br /> City of Lodi-Whitesioubh SYCF <br /> 12751 N.Thoruton ltd <br /> Lodi, CA 95242 <br /> (209)333-6749 <br /> Date of XKG Receipt,/0-�VI Time of IKG Receipt: Total IKG Received: <br /> ep c- Grease <br /> Receiving Facility Rep.Name(Print) }r (Signature): <br /> Authorized Transporter: Vehicle Decal Number: y <br /> Stockton Roto Rooter Driver Name(print): p <br /> 4228 Newton Rd <br /> Stockton,CA 95205 Driver Signature: <br /> d H 'ON ME Z 9102 '9 "Pr <br />