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E 6 1 L '°N WdtiE 6 tiI0 '0E 'daS aWll' pan i aaa� <br /> Inedible I itchen Grease.(IIKG) ManYfest <br /> Stockton Roto Rooter Grease & Septic Service <br /> Date_ `JAAMaloiffesf#Ir Q 'j <br /> Business Name: Z—Ote <br /> ,fob Site Address: Aver Zip Code: -� ® <br /> Customer Name(print): a�✓ Signature) <br /> MG.Authorized Recaiv7uag FiLc ity Name/Address (ch-de dump site for fa <br /> City of Lodi-Whiteslongb•SPCF I <br /> 12751 N.Thornton Rd ,I <br /> ,i <br /> Lodi,CA 95242 <br /> (209)333-6749 ,I <br /> Date of ING Receipt: l` I�Time of MG Receipt: /,, -•�O Total YKG Roceiveds��v v ,i <br /> • .1 <br /> Septitc Grease <br /> ReceMn8 p'acllity Rep.Name(R`rint) <br /> Authorized Transporter: .Vehicle Decal Number: Q <br /> Stockton Roto Rooter Driver Name(print):` �,� e✓ <br /> 4228 Newton Rd <br /> Stockton,CA 95205 Driver ftua <br /> ,i <br /> 'I <br /> :I <br /> PT/60 39dd JIioo�1 OlOd 9Z6559b60Z 96 :"T PTBZ/0c/60 <br />