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COMPLIANCE INFO
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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HAM
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4500 - Medical Waste Program
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PR0450055
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COMPLIANCE INFO
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Entry Properties
Last modified
2/9/2023 12:05:38 PM
Creation date
7/3/2020 10:16:29 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4500 - Medical Waste Program
File Section
COMPLIANCE INFO
RECORD_ID
PR0450055
PE
4520
FACILITY_ID
FA0000388
FACILITY_NAME
Lodi Outpatient Surgical Center
STREET_NUMBER
521
Direction
S
STREET_NAME
HAM
STREET_TYPE
LN
City
LODI
Zip
95242
CURRENT_STATUS
02
SITE_LOCATION
521 S HAM LN STE F
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\cfield
Supplemental fields
FilePath
\MIGRATIONS\MW\MW_4520_PR0450055_521 S HAM_.tif
Tags
EHD - Public
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kz qN znWIT W s � ems err T <br /> g, <br /> a a z r rk i s v <br /> 'AN JOAQU OUNTY ENVIRONMENTAL HEALTIRIEPARTMENT <br /> 1868 E. Hazelton Ave. • Stockton, CA 95205-6232 • Phone (209)468-3420 <br /> Donna Heran,R.E.H.S.,Director „ <br /> rti <br /> ENVIRONMENTAL HEALTH <br /> Sts ; PERMIT TO OPERATE - 4520-PRIMARY CARE FACILITY <br /> ��i �; ;! �i'." •` ::" ,,.;.6�.'� t,, �`.: , a,'.s a'r��,.:'p��., r`,. y` s,�+ p� .! �= f x .� t,' <br /> "; Permit ID# PT0000396 for Record ID# PR0450055 <br /> Valid From 1/1/2014 To 12/31/2014 <br /> # <br /> fla�A <br /> 11 <br /> 6,31_QW <br /> W, � } <br /> ?v, <br /> tXXFd 'b P } <br /> r <br /> 6 <br /> yg6e <br /> 41 <br /> ry , <br /> r <br /> n Y y } a <br /> w int 4 i , <br /> IN <br /> Al <br /> PERMITS TO OPERATE are NOT TRANSFERABLE <br /> and may be SUSPENDED or REVOKED for cause. <br /> ' s <br /> PERMIT(s)Valid only for: ARTEL LLC ' '` = " <br /> DBA: LODI OUTPATIENT SURGICAL CENTE <br /> a <br /> THIS FORM MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES <br /> Facility ID FA0000388 <br /> Regulated Facility: LODI OUTPATIENT SURGICAL CENTS Account ID AR0000387 <br /> 521 S HAM LN # F .,�: <br /> LODI CA 95240 issued 11/22/2013 <br /> Billing Address: ATTN : ARTEL LLC ` <br /> LODI OUTPATIENT SURGICAL CENTS " � E <br /> .�"% th <br /> 521 S HAM LANE STE F <br /> LODI CA 95240 <br /> t o <br /> WA <br /> 20%el � # <br />
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