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4 <br /> MEDICAL WASTE GENERATOR <br /> FILE COVER SHEET <br /> ACILITY ID#: FA0003978 P/E: 4522 DATE: 11/09/2004 <br /> PROGRAM RECORD#: PR0450109 P/E: DATE: <br /> P/E: DATE: <br /> ADDRESS: 1777 W YOSEMITE AVE CITY: MANTECA <br /> FACILITY NAME (DBA): KAISER FOUNDATION - MANTECA <br /> FACILITY PHONE: (209) 825-3773 FACILITY FAX: <br /> FACILITY CONTACT: SHEILA YOUNG PHONE: <br /> OWNER NAME: KAISER FOUNDATION HOSPITAL CITY: MANTECA <br /> WNER ADDRESS: 1777 W YOSEMITE AVE PHONE: (209) 825-3773 <br /> Water Service: 191 Large PWS Small PWS Domestic Well <br /> Sewer Service: Public Sewer OnSite WWTX Onsite Septic System <br /> Stormwater: Street Drains Street Ditches OnSite Ponds Other <br /> EH 00 18 rev 05/2007 <br /> rpt#: MWCS New Owner: Create a New Cover Sheet/Change Label of File <br />