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LIE9 "N &60 : 9 til0l '0 [ 'ung awil p;A 1 ;0 <br /> E <br /> Inedible Kitchen Grease (YKG) Manifest j <br /> Stockton Roto Rooter Grease & Septic Semice <br /> _ E <br /> Date: �7' Time: ,Q6 AM/ M Manifest# <br /> Business Name: L 1"7 0 Ccs <br /> Job Site Address:_ cT�_ �� (��,�� La1 L-O (' Zi Code: ^ � <br /> Customer Name(print): F--N N'5�0 ��1 u (Signature): <br /> i <br /> LKG Authorized Receiving Facility Name/Address (circle dump site for facility) i <br /> i <br /> City of Lodi-Whitesiough SPCF <br /> 12751 N. Thornton Rd i <br /> Lodi, CA 95242 <br /> (209)333-6749 <br /> Date of IKG Receipt: Time of IKG Receipt: Total]KG Received,. <br /> Septic rens <br /> Receiving Facility Rep.Name Y C4_ aL <br /> Authorized Transporter: Vehicle Decal Number: f6!L <br /> Stockton.Roto Rooter Driver Name(print): 12-z) eo jcn// 6%)'t <br /> 4228 Newton Rd <br /> Stockton,CA 95205 Driver Signature: <br /> E <br /> i <br /> E <br /> E <br /> 0T/60 �Jdd �GiOO�] 0101 9Z6559b6OZ 90:LT 17TOZ/OT/90 <br />