Laserfiche WebLink
HSPIN AdWti ti[OZ 'll 'AON aqui j paAl ;);d <br /> zJ42, 1 1 <br /> Inedible Kitchen Grease (IKG) Manifest <br /> Stockton Roto Rooter Grease & Septic Service twelem (P <br /> Date: Time: l ANI/PM Manifest#L- ;L ;9 <br /> Business Name: <br /> Job Site Address: ck Zip Code.- <br /> Customer <br /> ode:Customer Name (print): Sitruture): <br /> IKG Authorized Receiving Facility Name/Address (circle dump site for facility) <br /> City of Lodi-Whiteslougb SPCF <br /> 12751 N. Thor,ntou Rd <br /> Lodi, CA 952=12 <br /> (209) 333-6749 <br /> ,17 <br /> Date of IKG Receipt-&: ime of JKG Receipt: 1 Total IKG Received: <br /> T— <br /> Septic ? Grease <br /> Receiving Facility Rep.Name.(Print) 9• (5ignature�: <br /> Authorized Transporter: Vehicle Decal Number: -2— ; <br /> r �-�- <br /> Stockton Roto Rooter Driver Name(print): �Z 4'LSC°a <br /> 4228 Newton Rd "F~ <br /> Stockton,CA,95205 Driver Signature:, <br /> 'd Z1H 'ON AdL� tiIOZ l l 'noN <br />