Laserfiche WebLink
[Etti '°NAIO :Z E I 0 Z '0[ '�;a ;W11 paniaO;� <br /> 1 <br /> Inedible Kitchen Grease (IKG) Manifest <br /> Stockton Roto Rooter Grease & Septic Service <br /> Date: l / 3 Time: T��) AM/PM Manifest 9 L- 003 C <br /> Business Name: L � iYl ezkr"q_v'� <br /> i <br /> � 3 <br /> Job-Site Address:—)/7 9.3 rb to-, 2d, Zip Code: <br /> Customer Name(print): j "re- (Signature): <br /> 44&5- 4!�� <br /> 1KG Authorized Receiving Facility Name/Address (circle dump site for facility) <br /> City of Lodi-Whiteslough SPCF <br /> 12751 N.Thornton Rd <br /> Lodi, CA 95242 <br /> (209)333-6749 <br /> Date of lKG Receipt: Time of iKG Receipt: Total 1KG Received- <br /> ----------- <br /> Sep ic <br /> eceived:Septic Grease <br /> Receiving Facility Rep.Name(]Print) �� �J Y1�1-I L ti (Signature) <br /> adh) <br /> Authorized Transporter. Vehicle Decal Number: I <br /> Stockton Roto Rooter Driver Name(print): 9_66S1e_'1)ej <br /> 4228 Newton Rd 1' <br /> Stockton,CA 95205 Driver Signature:lee" <br /> __ y <br /> i <br /> 4W_E;N 4 <br /> VO/VO 39Vd N=ON 0101 9Z6559b60Z TO:VT 6TOZ/0T/ZT <br />