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u ...u j <br /> �W "N WdtiE :Z tiI0 '0E 'd;S ;wil pan i aaa� <br /> Inedible Kitchen Grease (IKG) Manifest <br /> Stockton Roto Rooter Grease & Septic Service <br /> • �� <br /> Date:_ �� �� Time:�A'b�(� Manifest#, <br /> a I <br /> _ I <br /> Business Name: /"l e d2l n c r A r 4410s,�'� x <br /> • - I <br /> Job Site Address: 9 `� e � % V`�c,<<'I �' y�, Zip Code• :I <br /> s• to <br /> Custoiner Naw(print): qua <br /> EM!Authorized Receiving vacititty Name/Address (circle dump site for facility) <br /> Citf of Lodi-Whitesloagh SPCA' <br /> 12751 N.Thornton Rd <br /> Lodi,CA 95242 <br /> (209)333-6749 1 <br /> Total <br /> Date of IKG Reneip� Time of IIKG Receipt: fl <br /> Septic- reale <br /> i <br /> Receiving Faeility Rep.Name Orint) <br /> I <br /> AuthorizA Transporter: Vehicle Decal Number: r_-� � <br /> Stockton Roto Rooter Driver Name(print)_ <br /> 4'-Pa Newton Rd � f <br /> Stockton,CA 95205 Driver-S4uatures i <br /> . I <br /> I <br /> P <br /> bi/5e �J�d d3iooJ 0101 9Z6559b60Z 9� �Z biez/0�/6e <br />