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9SU 'ON W cS :01 9 [0Z '� 'AWIUJ! paniaaa� <br /> inedible Kitchen Grease (EKG) Manifest <br /> Stockton Rota Rooter Grease & Septic Service L-O <br /> ws <br /> iol <br /> Date: �C' / Time: /'C�" PIM Manifest 9 L- <br /> B-asiness Name: <br /> GY <br /> .Tail Site Address: p <br /> �a�'' Zi Code: <br /> Customer Name (print): �jC' ��� ignatrYre <br /> IKG Authorized Receiving Facility Name/Address (circle dump site for facijity) <br /> City of Lodi-Whiteslough SPCF <br /> 12757 N. Thornton Rd <br /> Lodi, CA 95242 <br /> (209)333-6749 <br /> Date of IKG Receipt:5/11!(/` E- Time of IKG Receipt: Total IKG Received.• <br /> Septic se <br /> Receiving Facilit3 Rep.Name(Print) ( ignature) <br /> : ` <br /> Authorized Transporter: Vehicle Decal Number: <br /> Stockton Roto Rooter Driver Name(print): d S 0�-/ <br /> 4225 Newton Rd ^' <br /> Stockton,CA,9520-5 Driver Signature: <br /> c .d �26� 'IN <br />