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�61L -ON WdtiE :Z til0 '0E,'aag aujil paniaaad <br /> Inedible Kitchen Grease JKG) Manifest <br /> Stockton Roto Rooter Grease & Septic Service <br /> M M fest#x,-6<f <br /> Date_ <br /> 1 <br /> Business Name: L,Lz-,e-s—5 <br /> Job Site Address' <br /> Gn Zip Code: <br /> Custoiner Nano(print): (signature): <br /> a Name/Address drdle dum site for facility) <br /> IKG Authorized Rung�' ( � p <br /> Chy of Lodi Wbiteslough SPCF <br /> 12751 N.Thornton Rd <br /> ,i <br /> Lodi,CA 95242 <br /> (20)333-6749 <br /> M <br /> /� /y Time of IKG Receipt: Total r,R,ecelved• �G J <br /> .Date,of YICG Receipt - '� <br /> . i <br /> Septic' Greas <br /> i <br /> Receiving Facility Rep.Name Qlrin0 <br /> Authorized Transporter: Vehicle Decal Number. <br /> Stockton Roto Rooter Driver NaJeoetp int). <br /> 4228 Newton Rd <br /> Stockton,CA 95205 Driver Signature:_ ? j <br /> 9 <br /> I <br /> i <br /> i <br /> - l <br /> l <br /> 1 <br /> VT/ZT MVd a3ioo1 Oi0a 9Z6559b60Z 96:6T VTOZ/06/60 <br />