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11H 'ON Wdtil Zl LIH 'S 'd;S ;Wli P;Ci 3;d <br /> Inedible Kitchen Grease (IKG) Manifest <br /> Stockton Roto Rooter Grease & Septic Service <br /> �( o , Q�Date: Time: <br /> BusinessName: <br /> Job Site Address: ` =-7 �� Zip Code: 5,L/d <br /> Customer Name (print) ';�(Signature)• <br /> IKG Authorized Receiving Facility Name/Address (circle dump site for facility) <br /> City of Lodi-Wliiteslough SPCF <br /> 12751 N. Thornton Rd <br /> Lodi, CA 95242 <br /> (209) 333-6749 <br /> Date of IKG Receipts `?- ) Time of IXG Receipt: Total CKG Received:���1 <br /> (Septi Grease <br /> Receivili5 Facility Rep. Name(Print) 0hy dL&T0 V l n_(Signature) <br /> N40jwlm,,� <br /> Authorized Transporter: Vehicle Decal Number: <br /> Stockton Roto Rooter Driver Name(print): <br /> 4228 Newton Rd <br /> Stockton,CA 95205 Driver S9 <br /> 'd 6M 'ON WdN :: [ LIE 'd;S <br />