Laserfiche WebLink
6090 '°N WdH :: [ LIH —S 'upr IWI J pan i aDad <br /> r(Y43") <br /> Inedible Kitchen Grease ( KG) Manifest <br /> Stockton Roto Rooter Grease& Septic Servicew � <br /> 300 <br /> Date: 1 -2 — 2—(—f, Time. h M Manifest# <br /> BusinessName: - <br /> Job Site Address:- / O � �D � .S��ocJ ( Zip de: <br /> Customer Name(print): 0 (Signature) <br /> IRG Authorized Receiviug 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 1KG Receipt:-Li--21-4ime of WG Receipt: r `lQ Total XKG Received: <br /> Septic Gr <br /> Receiving Facility Rep.Name(Prin Signature V0 <br /> Authorized Transporter: Veld Decal Number- <br /> Stock-ton <br /> umberStockton Roto Rooter Driver Name(print): (�.p Ca l'd V `M,t �-S 4 f <br /> 4228 Newton Rd <br /> Stockton,CA 95205 Driver Signature: Cti <br /> 0 'd 1E9 '°N Wd6E : Z [ LIE 'S upr <br />