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M '°N WdU :S .9lH '9 'u'n'r�;W1 j 'Pani ;);d <br /> Inedible Kitchen Grease (IKG) Manifest � <br /> Stockton. Roto Rooter Grease & Septic Service <br /> Date: 5�- f,z�l Time: A-M L Manifest#L- <br /> Business Name: r <br /> .lob Site Address: 7i Code: <br /> Customer Name (print): {SiatY+xxe - <br /> LKG Authorized Receiving Facility Name/Address (circle dump site for facility) <br /> City of Lodi-Wbitesloagh SPCA' <br /> 127511V.Thornton Rd <br /> Loci, CA 95242 <br /> (209)333-6749 <br /> Date of IKG Receipt2l" S4 4 Time of IKG Receipt: Total IKG Received. <br /> eptic Grease <br /> f:. <br /> Receiving Facility Rep_Name(Print) (Signature): �� ✓�_.'ti ��, <br /> Authorized Transporter: Vehicle Decal Number. 2Z !k� <br /> T <br /> Stockton Roto Rooter <br /> Driver Name(print): LCC-Il e' <br /> 4228 Newton Rd <br /> Stockton,CA 95205 Driver Signature:_. ...._ <br /> I <br /> d C9ZS 'ON AflZ :S 9lOZ 8; 'unr <br />