Laserfiche WebLink
i <br /> X920 "N AdE :S 9l0Z 8 'unr mull P;AI ;D;� <br /> Inedible Kitchen Grease (IKG) Manifest � <br /> Stockton Roto Rooter Grease & Septic Service <br /> Date: �/ 'l`ime: ......� . � �' AM Mani€est 4 L•- 0 ' <br /> Business Nance: J��. S <br /> Job Site Address: zo/U l)T `l -rr1y w'� Zip Code: <br /> Customer Nance(pa-�i3at}`�,�`�� �7�-`� (Signature): <br /> IXG Authorized Receivzug-Facility Name/Address (circle dump site for facility) <br /> ; <br /> City of Lodi-Whitesiough SPCF <br /> 1.27x1. N- Thornton.fid <br /> Lodz, CA 95242 <br /> (209)333•-6749 <br /> Date of IXG Receipt;07/4 Time of IKG Receipt: 1•otal IKG Received: <br /> se tip )Grease <br /> Receiving Facility Rep.Name(Print) (Sibnatu - <br /> Authorized Transporter: Vehicle Decal Number: <br /> Stockton Roto Rooter Driver Name rint - 2;szll��.ed�-- rf5o; <br /> 228 Newton Rd <br /> Stoekton,CA 95205 Driver Sibnature:_ <br /> I <br /> ' I <br /> d L9Z9 'ON 'unf <br />