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COMPLIANCE INFO
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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C
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CALIFORNIA
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2740
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4500 - Medical Waste Program
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PR0450029
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COMPLIANCE INFO
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Entry Properties
Last modified
2/9/2023 12:44:03 PM
Creation date
7/3/2020 10:19:17 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4500 - Medical Waste Program
File Section
COMPLIANCE INFO
RECORD_ID
PR0450029
PE
4524
FACILITY_ID
FA0002069
FACILITY_NAME
GOLDEN LIVING CENTER - PORTSIDE
STREET_NUMBER
2740
Direction
N
STREET_NAME
CALIFORNIA
STREET_TYPE
ST
City
STOCKTON
Zip
952045529
APN
12536016
CURRENT_STATUS
02
SITE_LOCATION
2740 N CALIFORNIA ST
P_LOCATION
01
P_DISTRICT
002
QC Status
Approved
Scanner
SJGOV\cfield
Supplemental fields
FilePath
\MIGRATIONS\MW\MW_4524_PR0450029_2740 N CALIFORNIA_.tif
Tags
EHD - Public
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r esr.�b ra a' at a A r <br /> a ;z p ♦ <br /> 4 SAN JOAQUI*OUNTV E2N IA0NMENTAL HEALT <br /> ' 1868 E.Hazelton Ave. • Stockton,CA 95205-6232 • Phone(209)468-3420 <br /> Donna Heran,R.E.H.S.,Director <br /> ENVIRONMENTAL HEALTH <br /> } <br /> A 4 PERMIT TO OPERATE - 4524-SKILLED NURSING FACILITY <br /> . , <br /> Pt" <br /> w <br /> .c <br /> 4 1 j Permit ID# PT0002061 for Record ID# PR0450029 ; , <br /> Valid From 1/1/2013 To 12/31/2013 r <br /> ,t <br /> * * * DUPLICATE * * * <br /> l <br /> s t' " za73 t rs A L/ <br /> iiy•1�xx.�lk '( � "x4t j' I� gr <br /> 1 <br /> A x <br /> 'q }i� <br /> n Yrkry4 <br /> a <br /> H' v,kid ; �' '1 <br /> r { 1 <br /> PERMITS TO OPERATE are NOT TRANSFERABLE <br /> and may be SUSPENDED or REVOKED for cause. <br /> PERMIT(s)Valid only for: GOLDEN ENTERPRISES <br /> DBA: GOLDEN LIVING CENTER <br /> THIS FORM MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES <br /> Facility ID FA0002069 <br /> Regulated Facility: GOLDEN LIVING CENTER- PORTSIDE <br /> Account ID AR0002077 <br /> 2740 N CALIFORNIA ST <br /> Issued 8/21/2013 M <br /> STOCKTON CA 95204-5529 <br /> Y <br /> Billing Address: ATTN : EXECUTIVE DIRECTOR <br /> GOLDEN LIVING CENTER - PORTSIDE �� <'�� <br /> 2740 N CALIFORNIA ST r <br /> STOCKTON CA 95204 <br /> v"' <br /> _ <br /> ": Fait <br /> _7 <br /> �$ <br /> k <br /> 2 <br />
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