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ti909 "N WdH :E til0l 'Sl 'SPA aU)I j paniaaa� <br /> Inedible Kitchen Grease (IKG) Manifest <br /> Stockton Roto Rooter Grease & Septic Service t o-OC�a <br /> Date: Time: 4'��G� TPM Manifest#L• <br /> Business Name: 1 by 1` ��i YI U �•e.S /���5 its r <br /> Job Site Address.,- _ _/fj- kf C,k Zip Code: <br /> Customer Name (print): ' (Signature): <br /> XKG Authorized'Receiving Facibty Name/Address (circle dump Ile for facility) <br /> City of Lodi-Whiteslough SPCF <br /> 12751 N. Thornton Rd <br /> Lodi, C.A.95242 <br /> (209) 333-6749 <br /> Date of ZKG Receipt: Time of 1KG Receipt: �a Total TKG Received: , / <br /> Septic cease <br /> Receiving Facility Rep.Name Oignature): . <br /> Authorized Transporter: Vehicle Decal Nuaaber: <br /> Stockton Roto Rooter Driver Name(print) <br /> 4228 Newton Rd <br /> Stockton,CA 95205 Driver Signature: <br /> 8T/LT 39vd �DiOON 0101 9Z6559b6OF LZ:bT PTeZ/5T/5e <br />