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SHVIN AVH :: l S1H 0( ,q;d awil p;Al ;);� <br /> Inedible Kitchen Grease (1KG) Manifest <br /> Stockton Roto Rooter Grease & Septic Service <br /> Date: b I 0 Cv l Pune: tJ A-Ni/ M Nfaani fest#L- <br /> ]Business Name: ca;-\v c-A es-r--, , <br /> Job Site.Address: Zip Code-- <br /> Customer <br /> ode_Customer Name (print): (Sxgxtattzxe): 4f� <br /> 1KG Authorized Receiving Facility Name/Address (circle dump site for facility) <br /> City of Lodi-Whiteslough SPCP <br /> 12751 N. Thornton Rd <br /> Lodi, CA 95242 <br /> (209)333-6749 <br /> Date of[KG Receipt: -ol-IS Time of JKG Receipt: �' Total JK.G Received: r <br /> ,1 <br /> Septic Grease <br /> Receiving Facility Rep.Name(Print) �e metCew� (Si�nat. <br /> Authorized Transporter: 'V'ehicle Decal Number: 77-�f6JT /�f <br /> Stockton Roto Rooter Driver Nam�e(print): �abS6t_)e'ZZ / !Leer�_ <br /> 4228 Newton Rd - - <br /> Stockton,CA 95205 Driver Signature: ` <br /> S 'd 9Lcl 'ON WdB� : ll SlR 0l 'dad <br />