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6901 'IN AVOE : l [ ti[H '9l 'd;S awi j 'paniaa;� <br /> 022j� <br /> 20 �1')f <br /> 1 <br /> Inedible Kitchen Grease (1KG) Manifest <br /> Stockton Roto Rooter Grease & Septic Service <br /> Date•_ 'Einoie: i � VVTM Manifest <br /> Business Name: 4a Y111f if <br /> .lob Site Address:, l C��f �(° ,GJI Zip Code: <br /> Customer Name(print): 34,1'x- (Si9=ftm)• <br /> IKC Auth* ized Receiving FaciW Name/Address(circle dump$ite for fiaOW) <br /> City of Lodi,Whiteslough SPCF <br /> 12751 N.Thornton Rd <br /> Lodi,CA 95242 <br /> (209)333-6749 <br /> ilz—& /f Total1KG R ed: <br /> Date of IXG ReceiptTime of nCG Receipt:_, <br /> Septic Grease <br /> ReceMug Facitity Rep.Name <br /> Authorized Transporter. Vehicle Decal Number:,_.ML�9y /� <br /> Stockton Roto Rooter Driver Name(print): <br /> 4228 Newton Rd <br /> Stockton,CA 93205 Driver Share: <br /> 90/bd �Jdd �Oiooa 0101 9Z655976OZ 66:0T 17TOZ/9T/6O <br />