Laserfiche WebLink
i 9080 '°N WdLS :ti L10 8 'qad aWIj paniaaa� <br /> Inedible Kitchen Grease (IKG) Manifest <br /> Stockton Roto Rooter Grease & Septic Service <br /> Date: ( ^/ Time: Z 1 � 'lam' Ma>u.ifest#L- <br /> Business Nam ` • ell, <br /> C <br /> Job Site Address: 0 2 C:;, 6! I Zap Code: 7 c� <br /> Customer Name Optvxt): (Signature):/-,4" 'f <br /> 1KG Authorized Receiving Facility Name/Address (circle dump site for facility) <br /> City of Lodi-Wbuiteslough SPCF <br /> 12751.N. Thornton Rd <br /> Lodi, CA 95242 <br /> (209)333-6749 <br /> Date of lKG ReceiptO� 31` 7 Time of IKG Receipt: `7 Total IKG Received: 600 <br /> Septic Grease <br /> Receiving Facility Rep.Name(Print) 3ignature): <br /> Authorized Transporter: Vehicle Decal Number: <br /> Stockton Roto Rooter Driver Name(print): •��kc�s�YL <br /> 4228 Newton Rd <br /> Stockton,CA 95205 Driver Signature: <br /> RECEI V I=I) <br /> FEB 0 9 2017 <br /> MWRONMEWAL f. + Ty <br /> P'ErWtT/sERyrE3 <br /> 6 'd MCI WdtiO : S L106 '8 qad <br />