Laserfiche WebLink
5808 '°N NVSB : II S [H '0l 'qad ;W1j paAI ;3;� <br /> .D <br /> Inedible Kitchen Grease (IKG) .Manifest <br /> Stockton Roto Rooter Grease & Septic Service <br /> Date: Time: M/)Pxvi Manifest 9 L- Q Q ( t <br /> r <br /> Business Name:" ` 1/0 C 7 l <br /> Jab Site Address: Zi Code: <br /> Customer Name (print): ign.aturev: r <br /> JKG Authorized Receiving Facility Name/Address (circle dump site for acility) <br /> City of Lodi-Whitesloubh SPCF <br /> 12751 N_Thornton Rd <br /> Lodi, CA 95242 <br /> (209)333-6749 <br /> Date of IKG Receipt: Time ofIXG Receipt: Total IKG Received: <br /> Septic reale <br /> Receiving Facility Rep.Name(Print) � ��� t�r��� (Signature): � <br /> Authorized Transporter- 'Vehicle Decal Number: l c`,_J!L <br /> Stocictoin Roto Rooter Driver Name(print):_ <br /> 4228 Newton Rd <br /> Stockton,CA.95205 Driver Signature: <br /> 6 'd 9L81 'ON Wb88 l l SlOZ 0 [ 'q;d <br />