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99WI N WdSl :Z L S 'ApA aw!j pania)@� <br /> Inedible Kitchen Grease (IKG) Manifest <br /> Stockton Roto Rooter Grease & Septic Service <br /> Date: _/ % Time: R/PM Manifest#Y,- <br /> Business Name:X,4,./OC,Q <br /> Job Site Address: d �' �' ,�� �E' L Zip Code: �-2 y <br /> Customer Name (print): _(Signature)- <br /> IKG Authorized Receiving Fad ity Name/Addre s (circle dump site for cility) <br /> City of Lodi-Whiteslough SPCF <br /> 12751 N. Thornton Rd <br /> Lodi, CA 95242 <br /> (209)3336749 <br /> Date of IKG Receipt: Time of IKG Receipt: Total IKG Received: 4� <br /> Septic G6reiio <br /> Receiving Facility Rep.Name(Print �� (Signature <br /> Authorized Transporter: Vehicle Decal Number: T/1<- 77 <br /> Stockton Roto Rooter Driver Name(print): fh'i <br /> 4228 Newton Rd <br /> Stockton,CA 95205 Driver Signature; <br /> 01 'd 16SL 'ON WdtiZ z L I OZ 'S � W <br />