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MI "N 06ti :2 LIE '6I 'unr awii paniau;� <br /> o q 3S A rvx <br /> Inedible Kitchen Grease JKG) Manifest <br /> Stockton Roto Rooter Grease & Septic Service <br /> Date: Lf Time: APNI Manifest#L- <br /> Business Name: <br /> Job Site Address: LV/ Tip Code: 252 iL,5 <br /> Customer Name (print): ignature): v�C <br /> IKG 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 1KG Receipt:Q(]� me of IKG Receipt: 11r Total IKG Received:�� <br /> (;setic Grease <br /> 19 <br /> Receiving Facility Rep_Name(Print) g V fumi Lomank—c— _( i tune): <br /> T� 7 <br /> Authorized Transporter: Vehicle Decal Number: q <br /> � 1r-ScJ L'� <br /> Stockton Roto Rooter Driver Name(print): � CGI j. <br /> 4228 Newton Rd <br /> Stockton,CA 95205 Driver Signature: <br /> L d I I6L 'ON W S1 clot '6I 'unr <br />