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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH I3EPARTMENT <br /> 600 E.Main St. • Stockton,CA 95202-3029 • Phone(209)468-3420 <br /> Donna Heran,R.E.H.S.,Director <br /> ENVIRONMENTAL HEALTH <br /> PERMIT TO OPERATE - 4524-SKILLED NURSING FACILITY <br /> Permit ID# PT0002061 for Record ID# PR0450029 <br /> Valid From 1/1/2012 To 12/31/2012 <br /> -ndupn.n din iroi�i i�Yi�irr�o� <br /> h <br /> 4. <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 /> Regulated Facility: GOLDEN LIVING CENTER -PORTSIDE Facility ID FA0002069 <br /> 2740 N CALIFORNIA ST Account ID AR0002077 <br /> STOCKTON CA 95204-5529 Issued 11/30/2011 <br /> Billing Address: ATTN : EXECUTIVE DIRECTOR <br /> GOLDEN LIVING CENTER - PORTSIDE <br /> 2740 N CALIFORNIA ST <br /> STOCKTON CA 95204 <br /> 7ozo.mt <br /> _ _ ._�a� _..mss- .•�- _ ,, ,. <br />