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HWON NMI EIOZ 'S 'noN awil paniaOa� �I <br /> Inedible Kitchen Grease (IKG) Manifest <br /> Stockton Roto Rooter Grease & Septic Service <br /> Date: Time: �/ ' v(,/ �/PM Manifest#L-,O&,4 I <br /> I <br /> I <br /> - I <br /> Business Name: r�S r JGL <br /> Job Site Address: .e.r Zip Code: C/ <br /> I <br /> Aw <br /> c <br /> Customer Name (print): ignature) <br /> IKG Authorized Receiving Facility Name/Address (circle dump site for facility) <br /> City of Lodi-VMiteslough SPCF <br /> 12751. N.Thornton Rd <br /> Lodi, CA 95242 <br /> (209)333.6749 <br /> Date of 1KG Receipt: U / Time of IKG Receipt: Total IKG Received: v`' <br /> Septic Grease <br /> Receiving Facility Rep.Name(print) (Signature): �JV <br /> Authorized Transporter: Vehicle Decal Number: <br /> Stockton Roto Rooter Driver Name(print): <br /> 4228 Newton Rd <br /> Stockton,CA 95205 Driver Signature: <br /> 90/90 39dd d3100�J 0101 936559V603 6T:80 6T03/50/TT <br />