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i <br /> Heti "N PEI 06� lS A 0 N <br /> au�il pania�a� <br /> �- �0 <br /> 1 <br /> Inedible Kitchen Grease (IKG) Manifest <br /> Stockton Roto Rooter Grease & Septic Service <br /> �I <br /> �I <br /> Date: Time: ` -(� M Manifest#j' e! <br /> Business Name: 9- t)d <br /> I <br /> U ( t� LyL. Zi <br /> Job Site Address: p Code: <br /> Customer Name (print): (Signature): <br /> 6I <br /> IKG Authorized Kece' Facility Name/Address (circle dump site for facility) <br /> t <br /> 1 <br /> City of Lodi-Whiteslough SPCF <br /> 12751 N. Thornton Rd <br /> Lodi, CA 95242 <br /> (209)333-6749 <br /> Date of lKG Receipt: Time of 1KG Receipt: Total IKG Received: <br /> Septi Grease <br /> Receiving Facility Pop. Name(Print) �/ JLpf <br /> . (Signature): <br /> Authorized Transporter: Vehicle Decal Number: <br /> I <br /> Stockton Roto Rooter Driver Name(print): <br /> 4228 Newton Rd <br /> Stockton,CA 95205 Driver Signature: <br /> 90;cE0 39-Vd �Id100H 0101 9Z6SS9b60Z 6T :80 ETOZ/50/TT <br />