Laserfiche WebLink
;1189 '°N AdH: 1 ° tiI0Z V '2nd awil pania)ad <br /> n IneWble Kitchen Grease (IKG) Manifest,„,.,. <br /> Stockton Moto Rooter Grease & Septic Service _ <br /> w Date: Iime: �o Manifest# <br /> L- <br /> BusinessName: <br /> Job Site Address: ADD <br /> � _ ��.� !� �� <fk Zap Code: '1`�5"2-12 <br /> customer Name(print): WW� ,�,� [, (Signature): <br /> r ZKG Authorized Receiving Facility Name/Address(circle dump site for facility) <br /> •City of Lodi-Whiteslough SFCF <br /> I <br /> 12751 N.Thornton Rd <br /> Lodi,CA 95242 <br /> (209)333-6749 <br /> Date of IXG Receipt: 4Z / Time of-EKG Receipt: Total DKG Recetved: d2 U <br /> 4 <br /> s Septic Grease <br /> t <br /> Receiving 1~aciZity Resp.Name(Print) (Signature): <br /> Authorized Transporter: Vebiek Decal Number: / Q <br /> Stockton Roto Rooter DrYver Name(print): ' 5�.1i�.�f' 610 r e-- <br /> 4228 Newton Rd <br /> Stocktou,CA 95205 Driver Signature:v <br /> E <br /> l' <br /> Y <br /> 91/bT 39tid �l iood 010 1 9Z6559b60Z T8 ZT bTOZ/ZT/80 <br />