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tiOO "N AVLI :OI 91H 9 'Jad ;V1 pania3;� <br /> Inedible Kitchen Grease (1KG) Manifest <br /> Stockton Roto Rooter Grease & Septic Service <br /> te: Time: AMS Manifest#L- ��G <br /> siness Name: <br /> J Site Address: ��� (Q n _ Zip Code:LJ 2-Zj <br /> stomer Name (print): fyl(Signature).-)Z <br /> G Authorized Receiving Facility Name/Address (circle dump site for facility) <br /> City of Lodi-'CVhiteslough SPCF <br /> 12751 N. Thornton ltd <br /> Lodi, CA 95242 <br /> (209)333-6749 <br /> D te of IKG Receipt:_] 1 QO Time of IKG Receipt: Total 1XG Received: <br /> I <br /> cepoe Grease <br /> R eiving Facility Rep.Name(Print)391rte L 0146e _(Signature),. L` c <br /> Ali horized Transporter: Vehicle Decal Number: <br /> St ;k-ton Roto Rooter Driver Name(print): <br /> 421 Newton Rd <br /> S kton,CA 95205 Driver Signature: <br /> Z 'd ' ltL6 "N AVLZ : OI UH '9 qad <br />