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6090 "N ME :E l LIE 'S 'upr ;Wj P;C ;);� <br /> Inedible Kitchen Grease 01KG) Mau fest <br /> Stockton Roto Rooter Grease & Septic Service <br /> Date.- , — -7-41�1 Time: �AM/Xg Manifest#L- <br /> Busimess Name: i' 6C C.0 C� �� �` �L`'� G� � , (✓ <br /> ln <br /> Job Site Address: / � �y 1�fi 6/ IZ _exp 5 �� <br /> Customer Name(print) C�I9 cJ tt (Signa tn e <br /> IKG Authorized Receiving Facility Name/Address (circle dump site for fae ity) <br /> City of Lodi-Whiteslough SPCF <br /> 12751 N_Thornton Rd <br /> Lodi, CA 95242 <br /> (209)333-6749 <br /> Date of 11<0 Receipt: Time of 1X<G Receipt: �� is Total XXG Received:_«�� <br /> Septic Grease <br /> Receiving Facility Rep_Name(print)&6e.1kJ 6?,1GPRC, (Signature) <br /> Authorized Transporter: Vehicle Decal Number: Y <br /> Stockton Roto Rooter DriverName(print): <br /> 4228 Newton Rd <br /> Stockton,CA 95205 Driver Signature: <br /> r <br /> 9 'd 16L9 'ON WdE :: Z LIE 'S 'upr <br />