Form 79-125 Manifest - Inedible Kitchen Grease Transport - Generator Information - California

Form 79-125 or the "Manifest - Inedible Kitchen Grease Transport - Generator Information" is a form issued by the California Department of Food & Agriculture.

The form was last revised in August 1, 2017 and is available for digital filing. Download an up-to-date Form 79-125 in PDF-format down below or look it up on the California Department of Food & Agriculture Forms website.

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STATE OF CALIFORNIA
DEPARTMENT OF FOOD AND AGRICULTURE
Meat, Poultry and Egg Safety Branch
1220 N Street
Sacramento, CA 95814
Manifest - Inedible Kitchen Grease Transport
(916) 900-5004
Generator Information
79-125 (Est. 08/17)
Complete forms, starting at bottom. Enter Manifest Number from MPES Form 79-124 for the load. Provide generator with copy at
time of grease collection or deliver to generator within 45 days. Attach completed copies to MPES Form 79-124..
AM
Date:
Time:
Manifest Number:
PM
Generator Name:
Generator Address:
Measuring Method Used:
Total IKG Collected:
Used Cooking Oil
Gallons
Type of
IKG:
Pounds
Interceptor/Trap Grease
Container Capacity (If Required):
Percentage Fill (If Required):
IKG Authorized Receiving Facility Name:
Transporter Name:
Generator Representative Name (Print):
Driver Signature:
Generator Representative Signature:
AM
Date:
Time:
Manifest Number:
PM
Generator Name:
Generator Address:
Measuring Method Used:
Total IKG Collected:
Used Cooking Oil
Gallons
Type of
IKG:
Pounds
Interceptor/Trap Grease
Container Capacity (If Required):
Percentage Fill (If Required):
IKG Authorized Receiving Facility Name:
Transporter Name:
Generator Representative Name (Print):
Driver Signature:
Generator Representative Signature:
AM
Date:
Time:
Manifest Number:
PM
Generator Name:
Generator Address:
Measuring Method Used:
Total IKG Collected:
Used Cooking Oil
Gallons
Type of
IKG:
Pounds
Interceptor/Trap Grease
Container Capacity (If Required):
Percentage Fill (If Required):
IKG Authorized Receiving Facility Name:
Transporter Name:
Generator Representative Name (Print):
Driver Signature:
Generator Representative Signature:
STATE OF CALIFORNIA
DEPARTMENT OF FOOD AND AGRICULTURE
Meat, Poultry and Egg Safety Branch
1220 N Street
Sacramento, CA 95814
Manifest - Inedible Kitchen Grease Transport
(916) 900-5004
Generator Information
79-125 (Est. 08/17)
Complete forms, starting at bottom. Enter Manifest Number from MPES Form 79-124 for the load. Provide generator with copy at
time of grease collection or deliver to generator within 45 days. Attach completed copies to MPES Form 79-124..
AM
Date:
Time:
Manifest Number:
PM
Generator Name:
Generator Address:
Measuring Method Used:
Total IKG Collected:
Used Cooking Oil
Gallons
Type of
IKG:
Pounds
Interceptor/Trap Grease
Container Capacity (If Required):
Percentage Fill (If Required):
IKG Authorized Receiving Facility Name:
Transporter Name:
Generator Representative Name (Print):
Driver Signature:
Generator Representative Signature:
AM
Date:
Time:
Manifest Number:
PM
Generator Name:
Generator Address:
Measuring Method Used:
Total IKG Collected:
Used Cooking Oil
Gallons
Type of
IKG:
Pounds
Interceptor/Trap Grease
Container Capacity (If Required):
Percentage Fill (If Required):
IKG Authorized Receiving Facility Name:
Transporter Name:
Generator Representative Name (Print):
Driver Signature:
Generator Representative Signature:
AM
Date:
Time:
Manifest Number:
PM
Generator Name:
Generator Address:
Measuring Method Used:
Total IKG Collected:
Used Cooking Oil
Gallons
Type of
IKG:
Pounds
Interceptor/Trap Grease
Container Capacity (If Required):
Percentage Fill (If Required):
IKG Authorized Receiving Facility Name:
Transporter Name:
Generator Representative Name (Print):
Driver Signature:
Generator Representative Signature:

Download Form 79-125 Manifest - Inedible Kitchen Grease Transport - Generator Information - California

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