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� 10 (,,po 0 LI 'IN 06ti :8 L '6l 'unr aWI j paniaaa� <br /> F <br /> Inedible Kitcheii Grease (IKG) Manifest <br /> Stockton Roto Rooter Grease & Septic Service <br /> Date: 'I'i�oae:�1 ( - PM Manifest#L- O),�5 <br /> $usiness Name: <br /> Job Site Address: e J Zip Code: �� <br /> Customer Name (print): (Signatulre)- �~ <br /> IKG Authorized Receiving Facility Name/Address (circle du)<np 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(KG Receipt:5—�- l7rime of XKG Receipt: Total XKG Received: <br /> Septic Grease <br /> Receiving Facility Rep. Name(Priv v`J-- 6-A (Signature <br /> Authorized Transporter: 'Vehicle Decal Number: <br /> Stockton Roto Rooter Driver Name(print): 2)Q o� <br /> 4228 Newton Rd <br /> Stockton,CA 95205 Driver. �re � <br /> Z 'd 116L "N Wd95 : 8 LIOZ 6 [ wr <br />