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COMPLIANCE INFO
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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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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u a R say77� <br /> 77 <br /> s421, <br /> » ? <br /> SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 E. Main St. • Stockton, CA 95202-3029 • Phone(209)468-3420 <br /> �t P <br /> Donna Heran, R.E.H.S., Director _a _ ,� 4„ <br /> . ENVIRONMENTAL HEALTH ¢ t <br /> PERMIT TO OPERATE - 4520-PRIMARY CARE FACILITY ' <br /> Permit ID#PT0000396 for Record ID# PR0450055„> <br /> Valid From 1/1/2011 To 12/31/2011 >' ��4”, <br /> ......' <br /> d+A ' r � a � <br /> s Y x lot <br /> 4. <br /> a <br /> t <br /> P %3 _.' t: <br /> yLe10- <br /> x§ fii 4 "s <br /> -31 <br /> sa ? <br /> Tf <br /> # ro, � a a. <br /> s S s e "a z61 <br /> adz F <br /> .c ,r r �k �. <br /> �€ r t <br /> s a <br /> -A- <br /> -e tr " <br /> kyr"a �t � o <br /> r r t a <br /> rsy? ! <br /> 4, <br /> �d <br /> u {s ✓ J <br /> isd� .� s 1 ?f ie xx atg r z snr e <br /> Wr 4 <br /> 1 <br /> � �; f � x r ma tit a <br /> 7F ¢ � r�.Jt � � � <br /> t <br /> °¢ t j� <br /> P-. <br /> '� `3 .31„ <br /> PERMITS TO OPERATE are NOT TRANSFERABLE <br /> and may be SUSPENDED or REVOKED for cause. <br /> PERMIT(s)Valid only for: ARTEL LLC <br /> d DBA. LODI OUTPATIENT SURGICAL CENTE <br /> V. <br /> THIS FORM MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES 40 <br /> r <br /> Facility ID FA0000388 t <br /> Regulated Facility: LODI OUTPATIENT SURGICAL CENTE k <br /> 521 S HAM LN# F Account ID AR0000387 <br /> Issued 12/10/2010 . <br /> LODI CA 95240 <br /> Billing Address: ATTN : ARTEL LLC "_ , <br /> TA"''W A%�r ' <br /> LODI OUTPATIENT SURGICAL CENT � a <br /> 521 S HAM LANE STE F <br /> ra <br /> LODI CA 95240 A, � <br /> MR:, :9 <br /> � z <br />
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