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861PIN NM :6` 2 [0l' 'Zl 'aP'A awil paniaaa� <br /> Inedible Kitchen Grease (IKG) Manifest <br /> Stockton Roto Rooter Grease & Septic Service <br /> Aate: �—k 7X_ Time: 0 �(� 4 M Manifest 9 L- o3, 1Co <br /> Business Name: <br /> Job Site Address: t�71 -5 9:: to A� tjAJC- Zip Code: <br /> Customer Name (print): Y1z (Signature): __ <br /> IKG Authorized Receiving Facility Name/Address (circle dump site for facility) <br /> City of Lodi-VVWteslough SPCF <br /> 12751 N. Thornton Rd <br /> Lodi, CA 95242 <br /> (209) 333-6749 <br /> Date of lKG Receipt me of IKG Receipt: 0,`(a Total XKG Received:j <br /> Septic crease <br /> Receiving Facility Rep.Name(Print) (Signature): <br /> Authorized Transporter: 'Vehicle decal Number: l <br /> Stockton Roto Rooter Driver Name(print): � <br /> 4228 Newton Rd <br /> Stockton,CA 95205 Driver Signatur . <br /> Z 'd SL96 'aN AVE :6 91H 71 'IPA <br />