Laserfiche WebLink
ti909 '°N Wd�Z tiI0 �l '�pW awil pania°;� <br /> pp <br /> Inedible Kitchen Grease KG Mani&st <br /> Stockton Roto Rooter Grease & Septic Service �r � O -2 <br /> Date: Time: `f:/,D AM/PM Manifest#L-X`j S <br /> business Name: <br /> Job Site Address: Zip o <br /> Customer Name(print): (Signature): <br /> XKG Authorized Receiving Facility Name/Address (circle dump site for facility) <br /> City of Lodi-Whitesiough SPCF <br /> 12751 N. Thornton Rd <br /> Loo CA 95242 <br /> (209) 333-6749 <br /> Date of lKG Receipt: Time of� % ' d <br /> p � IKG Receipt: Total>(KG Received: <br /> Sep ' Grease " <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 Signature: <br /> 8T/0T 39tld �Giooa 0101 9Z6559b60Z Lz bT bTOZ/5T/50 <br />