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[HO "N WH81 :01 91H '� 'noN ;Ili pania3;� <br /> Inedible Kitchen Grease (IKG) Manifest <br /> Stockton Roto Rooter Grease & Septic Service <br /> Date: 6 _�� & Time: � A,N[ M Manifest#Lr <br /> Business Name: <br /> Job Site Address: < L Zip C de: <br /> IWO <br /> Customer Name (print)-.X)0,ovy►ab5 a� (Signature): <br /> IKG Authorized Receiving 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 IKG Receipt:,0_4V Time of IKG Receipt; Total IKG Received: <br /> Septic cease <br /> Receiving Facility Rep. Name(Print) (Signature): <br /> Authorized Transporter: Vehicle Decal Number: = <br /> Stockton Roto Rooter Driver Name(print): <br /> 4228 Newton Rd <br /> Stockton,CA 95205 Driver ignatur <br /> 9 'd 98 9 "N WVtiZ : Ol 9l0l 'A ON <br />