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SHOW AVd� : ll � [H '0l 'qad aWlj paAl ;)a� <br /> Inedible Kitchen Grease (1 G) Manifest <br /> Stockton Roto Rooter Grease & Septic Service r <br /> bate: �-Ql 1� <br /> Time: ,R AM 1VJ Maniffest# <br /> business Name: ri-Zl'ok r7j-,o7f to. a vc S f <br /> Job Site Address: G� - l Zip Code; f�D�19 <br /> Customer Name (print)- (Signature):_ <br /> iKG Authorized Receiving Facility Name/Address (circle clump 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 1KG Receipt: 605'Time of TKG Receipt: Total l'KG Received: q,6-"D <br /> Set c ��Gr eas+e <br /> P <br /> Receiving Facility Rep.Name(Print) �Q� �� ��( ►` mature): <br /> Authorized Transporter: V"ehiclejDecal Number: 7- -W6 j <br /> Stockton Roto Rooter DriverName(print):.. &Se rq)"Z Idae- <br /> 4225 Newton Rd <br /> Stockton,CA 95205 Driver Signature:__ <br /> - L 'd 9L�1 'ON Wd8� l l S10� Ol 'qac <br />