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y, <br /> SAN JOAQU�, UNTY ENVIRONMENTAL HEALT 'PARTMENT <br /> r , <br /> 1868 E. Hazelton Ave. • Stockton, CA 95205-6232 • Phone (209)468-3420 <br /> ' Donna Heran,R.E.H.S.,Director <br /> ENVIRONMENTAL HEALTH a� f§j ¢I 7 ' <br />€ PERMIT TO OPERATE - 4524-SKILLED NURSING FACILITY <br /> Permit ID# PT0002061 for Record ID# PR0450029 <br />�, s4 Valid From 1/1/2013 To 12/31/2013 <br /> -2 - - <br /> ky���4 <br /> I <br /> q - <br /> t s ' <br /> f <br /> C it <br /> t � <br /> Y <br /> k <br /> PERMITS TO OPERATE are NOT TRANSFERABLE <br /> and may be SUSPENDED or REVOKED for cause. <br /> M E 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: `j MW LIVING CENTER-PORTSIDE <br /> 2140 N CALIFORNIA ST Account lD AR0002077 <br /> STOCKTQN:•CA -95204-5529 <br /> Issued 11/26/2p12 <br /> Billing Address: ATTN : EXECUTIVE DIRECTOR =` <br /> GOLDEN LIVING CENTER- PORTSIDE <br /> 2740 RCALIFORNIA ST <br /> STQKTON CA 95204 <br />