Laserfiche WebLink
Dare'. 524201610:55.12At SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT Repo""' <br />Run W Pagel <br />Facility Information as of 5/24/2016 <br />Re se.ctw Fuer. Fec.iiy i0 FA0003761 <br />Make changesicomectlons In RED Ink. <br />INFORMATION CHANGE (date) (Dja3J (lv <br />OWNERSHIP CHANGE (date) (eIL/IIT o <br />OWNER FILE INFORMATION Number of facilities for this owner: 1 SSN I Fed Tax ID `il, -53x3309 <br />Owner ID 0W0018545 'q I - II 910203 New Owner ID : <br />Owner Name DIGNITY HEALTH FORMERLY CATHOLIC H POc'c C1tLt Ot7e rO i\nq Gam YLnN L Lr <br />Owner DBA ST. JOSEPH'S MEDICAL CTR. <br />Owner Address 1800 N CALIFORNIA ST =ubo a W e <br />STOCKTON, CA 95204 i24rCho CL>rdov c�(A R SLO-10 <br />Home Phone 209-956-3400 <br />WorklBusiness Phone 209-943-2000 <br />Mailing Address P.O. BOX 213008 <br />STOCKTON, CA 95213-9008 <br />Care of DIGNITY HEALTH FORMERLY CATHOLIC H Port G-tVA OQ2r0. 1�LLC- <br />FACILITY FILE INFORMATION <br />Facility ID / CERS ID FA0003761 10181391 <br />Facility Name ST JOSEPHS HOSPITAL <br />Location 1800 N CALIFORNIA ST <br />STOCKTON, CA 95204 <br />Phone 209-943-2000 x <br />Mailing Address P.O. BOX 213008 <br />STOCKTON, CA 2139008 <br />Cam of DONALD WILEY <br />Location Code 01 -STOCKTON <br />BOS District 002 - MILLER, KATHERINE <br />APN 12718044 <br />EMERGENCY NOTIFICATION CONTACT INFORMATION <br />Contact Name <br />Title <br />Day Phone <br />Night Phone <br />ACCOUNTS RECEIVABLE FILE INFORMATION <br />Account ID AR0003340 <br />Mail Invoices to Account <br />Account Name CATHY GRAHAM <br />Account Balance as of 5/24/2016: $0 00 <br />PM,E.mwie DOa Pi <br />Fax <br />EMad: C P d i' <br />R..d 10 Emp.yae ID v. Name <br />New Account ID: . <br />Mail Invoices to. Owner I Facility I Account <br />(caca one) <br />iCacis Oriel <br />T..io is AtlnelYVdva <br />Statue Na.Ovmare Deela <br />1626 - RESTAURANT/BAR 101 + SEATS <br />PRO160504 <br />EE0009488 - JEFFREY WONG <br />Active <br />N <br />A I D <br />D <br />1921 - HMBP-Reqular-Primary Location <br />PRO519820 <br />EE0000006 - HAZA SAEED <br />ACINe <br />N <br />A 1 <br />A I D <br />2217 •APPLIANCE RECYCLER <br />PR0538119 <br />EE0000005 - FATINAH ZAREEF <br />Active <br />Y <br />N <br />N <br />A I D <br />2224-HAZ MAT BUSINESS PLAN AUTHORIZATION <br />PRO512004 <br />EE0000000- HAZ MAT SJC DES <br />mil <br />2225 - CalARP PROGRAM <br />PRO514656 <br />EE0000000 - HAZ MAT SJC OES <br />Inactive <br />N <br />A I D <br />I D <br />2227- GEN 5<25 TONS PERMIT <br />PRO514003 <br />EE0000005 - FATINAH ZAREEF <br />Active <br />Y <br />N <br />A <br />2301 - UST STATE SURCHARGE FEE <br />PRO515549 <br />EE0000008 - LETITIA BRIGGS <br />ka lve <br />Y <br />N <br />A I D <br />2361 - UST FACILITY <br />PRO231036 <br />EE0000005 - FATINAH ZAREEF <br />Active <br />I D <br />2399. UNIFIED PROGRAM FAC STATE SURCHARGE F <br />PRO507445 <br />EE00D0008 - LETITIA BRIGGS <br />InectlytN <br />A <br />D <br />2832 - AST FAC 10 K - y=100 K GAL CUMULATIVE <br />PRO528692 <br />EE0000005 - FATINAH ZAREEF <br />Active <br />N <br />A I <br />I D <br />2951 - UGT-CAP <br />PROD10381 <br />EEODD0684 - MICHAEL INFURNA <br />Inactive <br />N <br />A <br />I D <br />4522 - ACUTE CARE FACILITY <br />PR0450006 <br />EEOD02622 - BENJAMIN ESCOTTO <br />Active <br />Y <br />N <br />A <br />D <br />4557 - MED WASTE LIMITED HAULER <br />PRO522306 <br />EE0003973 - ROBERT MCCLELLON <br />Inactivf <br />Y <br />N <br />N <br />A I <br />D <br />ERSC - ELECTRONIC REPORTING STATE SURCHARG <br />PR0532652 <br />EED005838 - ADRIENNE ELLSAESSER <br />InaCINr <br />Active <br />Y <br />N <br />,A-�,�,� <br />(A may) 0 <br />4630. NTNC WATER SYSTEM <br />WA0461082 <br />