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1189 '°N ME l tiI0 Zl 'end awij paniaaa8 , <br /> / 7 <br /> Inedible Kitchen Grease (IKG) Manifest <br /> Stockton Roto Rooter Grease & Septic Service <br /> Date: ime: U Manifest#,L-ill \ <br /> 7 �� <br /> Business Name: t'l , .S A , <br /> �r <br /> Job Site.Address: �1 � � ( Zip Code: <br /> Customer Namp riot` (Signature . .. <br /> (P 1� <br /> ZKG Authorized Receiving Facility Name/Address (circle dump 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 JKG Rmeipt:7—/d Time of IKG Receipt: 5 Total IKG R.ecei`'ed <br /> eptic' Grease <br /> Receiving Facility Rep.Name(Priv r <br /> Authorized Transporter: -Vehicle Decal Namber: <br /> Stockton Roto Rooter Driver Name(print): ' GLU V SCS r� <br /> 4228 Newton Rd <br /> Stockton,CA 95205 Driver Signature: <br /> ' f <br /> 9T/0T 39dd �Gioo�1 OiOH 9Z6559b60Z TE:ZT PTOZ/ZT/80 <br />