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99ti1 "N WdSl :l t [06 'S 'ApA ;Wli pania3ad <br /> Inedible Kitchen Grease (IKG) Manifest <br /> Stockton Roto Rooter Grease & Septic Service <br /> Date: r I Time: l.',Zy AM/(N Manifest#L- <br /> Business Name: Xi4(f ,4d '5—AIZ1 <br /> Job Site Address: Q C Q Zi Coder <br /> Customer Name (print): Cly (Signature <br /> IKG Authorized Receiving Facility Name/Address (circle dump site X 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:_jt �m ime of IKG Receipt:/ ��ZO Total lKG Received: <br /> Septic rea e <br /> Receiving facility Rep. Name(print) �I (Signature): <br /> Authorized Transporter: Vehicle Decal Number: f��- <br /> Stockton Roto Rooter Driver Name(print): fS <br /> 4228 Newton Rd <br /> Stockton,CA 95205 Driver Signature: 004?12� <br /> "61 'd 16SI 'ON LIE 'S '"A <br />