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9160 "N WdD :9 LIOZ l apW awil paniaaa� <br /> inedible Kitchen Grease (IKG) 1VIanifest <br /> Stockton Roto Rooter Grease & Septic Service <br /> Date: �L:-;?/-' Time_ / ,s' AM/& Manifest#L-0.244 <br /> Business Name; <br /> Job Site Address: S`o d / Zap Code: <br /> Customer Name (print): (Signature); <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 IKG Receipt: Ime of IKG Receipt: !V'4 Total IKG Received.• 3 3 S�2- <br /> ceptic <br /> Grease <br /> Receiving Facility Rep. Name(print) (Signature/): <br /> Authorized Transporter: Vehicle Decal Number: <br /> Stockton Roto Rooter Driver Name(print). <br /> 4228 Newton Rd <br /> Stockton,CA 95205 Driver Signature: <br /> S 'd 811L 'ON WdOS :9 L10Z '1 apW <br />