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9099 'ON MS : [ tiI0 '9l 'Ind IWI J pa Al ;);a <br /> r <br /> Inedible Kitchen Grease (IKG) Manifest ; <br /> Stockton Roto Rooter Grease & Septic Service <br /> Dater '�ime: , A1V1� <br /> r ,�Cf / c/ Manifest#I,- � <br /> P �Business Name: - <br /> Job Site Address: � (1d 9k-z &L zip Code: <br /> Customer Name(print): (Signature): <br /> IKG Authorized Receiving Facility Name/Address (circle site for facility) <br /> City of Lodi-W iteslough SPCF I <br /> 12751 N.Thornton Rd <br /> Lodi,CA 95242 <br /> (209)333-6749 <br /> r p <br /> pate of IKG Receipt,�l� Time of IKG Receipt: 1�I Total IKG Received:-3P�— <br /> , � <br /> - I <br /> I <br /> Se Grease <br /> Receiving Facility Rep.Name(Print)S�L1 A� 1"'k ignna✓tJurree): i <br /> Authorized Transporter: Vehicle Decal Number: /rK <br /> Stockton Roto Rooter Driver Name(print): <br /> 4228 Newton Rd <br /> Stockton,CA,95205 Driver Signature: <br /> i <br /> i. <br /> I <br /> E0/Z0 39dd a3iooa Oio�l 9Z6559b6OZ ZO:ET 7T0;7,/9T/L0 <br />