Laserfiche WebLink
i <br /> 6066 "N &98 :[ 9 0 '9l 'ur aWIi paniaaad <br /> Inedible Kitchen Grease (IKG) Manifest <br /> Stockton Roto .Rooter Grease & Septic Service <br /> A: e: Time: AM/ Manifest#L- OVL 3 <br /> i <br /> 'BI iness Name: Lo�� ►o!'le..` �J -InS,p�l, ,� <br /> J.' Site Address: Zap Code• <br /> C, stomer Name (print): _j') <br /> Authorized Receiving Facility Name/Address (circle dump site for facility) <br /> City of Lodi4hiteslough SPCZ+' <br /> 12751 N.J hoirnton ltd <br /> Lodi, CA 95242 f, <br /> !' (209) 333` <br /> ij <br /> D e of IKG Receiptj Time of IKG Receipt: J Total IKG Received: <br /> • i <br /> i <br /> Septic Grease <br /> Reiving Facility Rep.Name(1? in sf (�(Signature): <br /> i <br /> �i <br /> All horized Transporter: Vehicle Decal Number: <br /> St� kton Roto Rooter Driver Name(print): <br /> 42 Newton Rd <br /> Sty kton,CA 95205 Driver Signature: <br /> j� <br /> i <br /> j <br /> a <br /> it <br /> ti d 6656 "N WdLS : l UH '9l 'upr <br />