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96L6 "N WdtiS z SIOl 'til '100 aWlj pania3;� <br /> Inedible Kitchen Grease (IKG) Manifest LWOWO 61C <br /> Stockton Roto Rooter Grease & Septic Service <br /> p�S <br /> Date: Time: AM% M Manifest#L- 01 <br /> BusixLess Name: � <br /> Job Site Address: 707 S �-occ� �c,, t� Zi Code: <br /> Customer Name(print): ' ""lam`i (Si pature): <br /> IKG Authorized.Receiving Facility Name/Address (circle damp site for facility) <br /> City of Lodi-'CVhiteslough SPCF <br /> 12751 N. Thornton Rd <br /> Lodz, CA 95242 <br /> (209)333-6749 <br /> Date of iKG Receipt: /� Time of I KG Receipt: Total IKG Received: ! a O <br /> Septic Grease <br /> Receiving Facility Rep.Name(Print) la 12[&n) �NGP (Si=gnature): <br /> Authorized Transporter: Vehicle Decal Number: <br /> Stockton Roto Rooter Driver Name(print): �t���t_l_P_�/ <br /> 4228 Newton Rd <br /> Stockton,CA 95205 Driver Signature: <br /> 9 Wd9s : Z SIH <br />