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09SZ '°N WdSO : ll Ll[H '6 'noN @ it pani ;3;d <br /> . <br /> 3q I <br /> Inedible Kitchen Grease (IKG) Manifest <br /> Stockton Roto Rooter Grease & Septic Service <br /> Date: Time: "MM Manifest# L- <br /> o � <br /> Bus4ness Name: ALL �2E <br /> ,1obj Site Address: V,, nW Zip Code: <br /> Customer Name (prinP (Signature): / <br /> IKG Authorized Receiving Facility Name/Address (circle dump site for facility) <br /> j City of Lodi-Whiteslough SPCF <br /> 12751:N. Thornton Rd <br /> Lodi, CA. 95242 <br /> (209) 333-6749 <br /> Date of IKG Receipt: r42e of IKG Receipt: Total IKG Received: 00 <br /> 1 <br /> ept'c Grease <br /> i <br /> r <br /> Receiving Facility Rep.Name(Pr► Signature): <br /> AuthorizedNumber- <br /> Stockton <br /> �^ <br /> Transporter: Vehicle Decal Number: <br /> Stockton Roto Rooter Driver Name(print): ot vt _j 0A <br /> 4228 Newton Rd <br /> Stockton,CA 95205 Driver Signature: <br /> r <br /> I <br /> i <br /> Zl 'd 9S 16 'ON oSl l l LlH '6 AO <br />