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— L690 'IN Nd9 9102 '�l 'add ;LUIJ pania3;� <br /> AIR. AO <br /> fe <br /> Inedible Kitchen Grease ()XG) Manifest <br /> Stockton Roto Rooter Grease & Septic Service <br /> Date: � ����! � dime: ` �� 1V�AV, 1Vranifest 9 L-a/d <br /> -�--� <br /> )Uusiness Name: aG -;tom <br /> Joie Site Address: 75�/ _r(,-A _r 4V .orf.' Zip Code: <br /> Customer Name <br /> 1KG Authorized Recei[ inu Facility Name/Address (circle dump site for facility) <br /> City of Lodi-Whitesiough SPOT <br /> 12751 N.Thornton ltd <br /> Lodi, CA 95242 <br /> (209)333-6749 <br /> Dale of IKG Receipt-2/4/10/ <br /> eceipt /� Time of TKG Receipt- Total YKG Received: <br /> Septic- <br /> Receiving Facility step.Name(Print) Signature): ° <br /> Authorized Transporter: Vehicle Decal Number. <br /> Stockton Roto],looter Driver Name(print): <br /> 422$Newton Rd <br /> Stockton,CA 95205 Driver Signature: <br /> de 6Z8ti '�N NdH :9 91H 'add <br />