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ti909 '°N WdH :E tiI0 'SaWIJ paniaDa� <br /> Inedible Kitchen Grease (IKG) Manifest <br /> Stockton Roto Rooter Grease & Septic Service <br /> Date: Time: AM/PM Manifest#L- .. a 0 . <br /> ' r <br /> Business Name: <br /> Job Site Address: 109 S �,�U Z1 l S�"' �� Zap Code: ��� <br /> Customer Name (print): o e n ne- (Signature): <br /> �c� �s N i <br /> � ��b ): <br /> TTG Authorized Receiving Facility Name/Address (circle dump site for facility) <br /> City of Lodi-Whiteslough SPCF <br /> 12751 N.Thornton Rd <br /> Lodi, CA 95242 <br /> (209)333-6749 . <br /> Date of IKG Receipt: YM/1/7 Time of YKG Receipt: /42 0 7 Total IKG Received: /r <br /> Septic Greas <br /> Receiving Facility (Print) <br /> Rep.Name <br /> p ( ) (Si gnature)- <br /> ,, <br /> Authorized Transporter: vehicle Decal Number: - lQ <br /> Stockton Roto Rooter Driver iVarne(print): � (J - <br /> 4228 Newton Rd <br /> Stockton,CA 95205 Driver Signature: _ <br /> 8T/L0 39Vd i'I31M1 0101 9Z6S99V60Z LZ:VT VTOZ/5T/50 <br />