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regain Detall5 .. <br /> Rewrd ID: MSUS91 Cross ref:�� Fadllty ID: FA0010695 � 'Swnlied into Questys <br /> Program Identifier: site ID: 1.a+n al pmoram nt <br /> Local site ID: <br /> Entered date: 12/3/2007 Entered by: NGIESE Update Bate: 1%]/2015 Update by: IDUNCAN <br /> Designated Employee and Stabs u <br /> Deslgnated employee:INUEL HENDEPS IN <br /> Program/Element coder Pm,nna/Element RWQ®IF MENC CIEANUPRTE <br /> Current status: M.,tallabk <br /> Status cb m,pxI date:1121312W Data program Inactivated: <br /> Last scheduled Inspection:I scheduled lnspectbm <br /> SDE/Dlacount Information: (Wn!) S E/Diatomt date: <br /> Number of units: 0oE number: <br /> K�information <br /> Copy program contact Information from: <br /> Manager name:JSAJASUEY LTD <br /> Mall to:JFACILITY FIIE MAILING ADDRESS <br /> n. <br /> . EnRryepry NatifiOtgn <br /> ppct CI <br /> Name: SURREY LTD <br /> Title: <br /> Dap phone: (209)4)61)91 Extension: <br /> Night phone: Extension: <br /> t2 <br /> Name: <br /> Title: <br /> Day phone: Extension: <br /> Night phone: Extension: <br /> a GeneRi Health Pmg2m Event or CeMRea Prdf�bnal. <br /> Atle an Event <br /> Add a=fled Pmfeg5jog <br /> rmR Delalis <br /> Ra.M ID: F.al.ty It: Related ID: <br /> Permit lnfamation Add a Perini[Comment <br /> Pcrnl[number <br /> Perml[s[a[usl (npne) <br /> Permil type: (none) <br /> Program/Element: (none) <br /> Approved by: (none) <br /> Phase: <br /> PermR is vane Imm: •Disable permit dates <br /> vermin Is vain I- •Does not expire <br /> a a Pemtl[Evert <br /> Odd an Event <br /> Issdaxe , <br /> isieonce sums (n n 7 <br /> Number of rimes printed: <br /> issuance Bate: <br />