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9099 'ON Wd8S : l tilOZ '9n r UJ I\PA 1 0 I „ <br /> Inedible Kitchen Grease (IKG) Manifest f <br /> Stockton Moto Rooter Grease & Septic Service <br /> Date: �4 / 'f ime: manifest <br /> Business Name: ' • , <br /> Job Site Address: te- '"" Zip Code: <br /> Customer Name(print): 5i a e): <br /> Name/A d (circle dump site for fa ility) <br /> ess <br /> YKG ,Authorized Receiving Facility <br /> City of Lodi-Whiteslough SPCF <br /> 12751.N.Thornton Rd <br /> Lodi, CA 95242 <br /> (209)333-6749 <br /> WTime of IKG Receipt:_ Total IKG Received: <br /> Date of lKG Receipt:��--�-1—y <br /> Sep ' Grease <br /> Receiving Facility Rep.Name(Print) (Signature): <br /> Authorized Transporter: <br /> Stockton Roto Rooter Vehicle Decal Number:. 7� f� <br /> Driver Nawe(print): <br /> _ <br /> 4228 Newton Rd <br /> Stockton,CA 95205 Driver Signature: <br /> I <br /> I <br /> c9/c0 �rJdd zGiOOH OlOZI 9Z6559b6aZ Z0 �T bZOZ/9T/L0 <br />