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88titi 'oN Wd8li8 _810ZV 'S IN IU1 I1 paniaaa� <br /> �f <br /> Inedible Kitchen Grease (IKG) Manifest <br /> Grease & Septic Service ' <br /> Stockton Roto Rooter G P <br /> I <br /> Date: Time: AM/PM Manifest it L-602 <br /> Business Name: <br /> Job Site Add,.,,:a) i^. 1 'e � 21, . Com• Zip Code: <br /> Customer Name (print): (Signature): �2� <br /> UKG 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:*Y//3 Time of IKG Receipt: Total 1KG Received: <br /> Septic Grease <br /> Receiving Facility p.Name(Print �� b(Signature): <br /> Authorized Transporter: Vehicle Decal Number:_< SY'. <br /> Stockton Roto Rooter Driver Name(print): <br /> 4228 Newton Rd ;/ <br /> Stockton,CA 95205 Driver Signature: <br /> i <br /> 9I4 <br /> i <br /> 90/b0 39rd d3100d 0101 9Z6559b60Z 6T :80 6TOZ/50/TT <br />