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COMPLIANCE INFO_2011-2019
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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4500 - Medical Waste Program
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PR0536151
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COMPLIANCE INFO_2011-2019
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Entry Properties
Last modified
2/10/2023 2:54:13 PM
Creation date
7/3/2020 10:19:43 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4500 - Medical Waste Program
File Section
COMPLIANCE INFO
FileName_PostFix
2011-2019
RECORD_ID
PR0536151
PE
4524
FACILITY_ID
FA0018490
FACILITY_NAME
LODI NURSING & REHABILITATION
STREET_NUMBER
1334
Direction
S
STREET_NAME
HAM
STREET_TYPE
LN
City
LODI
Zip
95242
APN
03107032
CURRENT_STATUS
02
SITE_LOCATION
1334 S HAM LN
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\cfield
Supplemental fields
FilePath
\MIGRATIONS\MW\MW_4524_PR0536151_1334 S HAM__2011-2019.tif
Tags
EHD - Public
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ti` ,4s r }`fir} 2, <br /> ` L <br /> SAN JOAQUIPOUNTY ENVIRONMENTAL HEALTH DEPARTMENT � " <br /> ti r <br /> 1868 E.Hazelton Ave. • Stockton, CA 95205-6232 • Phone (2.09) 468-3420 � W <br /> *�r �&`t. '�.. "�...: •., s;h,4,,a4:to <br /> Donna Heran,R.E.H.S.,Director_ t, <br /> �g}� t a� tz , ENVIRONMENTAL HEALTH k � f <br /> 1 +>' <br /> r ; <br /> PERMIT TO OPERATE - 4524-SKILLED NURSING FACILITY <br /> r lt - <br /> Permit ID# PT0022149 for Record ID# PRO536151 <br /> Valid From 1/1/2014 To 12/31/2014 <br /> W`,'+� rk x <br /> z� <br /> t <br /> �C�'t = s a 'Z'i " I rs ', t r '� t 41 "Fi '° <br /> a;- <br /> } '`€ � t � �sayy4, -4 r+y <br /> "q 4` t +'' .F JT. N } t, "'kC'fi `,J!» fj�5 <br /> r. i4 r, <br /> 1 <br /> '' +; f S ", ' ,,` r Bk.,rt s a t ! I �$ f t t;'•r " d� � Hr; t �rsS <br /> t <br /> 9 <br /> 1t3i `�iS' 7 s - v d'. g ,t'''' +' f ' <br /> `4AV,4, y v k Lr, , t`Pa a R <br /> i` a r� ✓gyp o f a " A 1 §" " �„�.., fo r a' x{p, x ,� .. <br /> PERMITS TO OPERATE are NOT TRANSFERABLE <br /> and may be SUSPENDED or REVOKED for cause. <br /> PERMIT(s)Valid only for: DELTA REHAB & CARE CENTER <br /> THIS FORM MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES <br /> Regulated Facility: DELTA REHAB & CARE CENTER Facility ID FA0018490 <br /> Account ID AR0032688 <br /> 1334 S HAM LN <br /> LODI CA 95242 : '` Issuedu 11/22/2013 kx <br /> Billing Address: DELTA REHAB & CARE CENTER F _ i <br /> 1334 S HAM LN <br /> t <br /> LODI CA 95242 s�h <br /> i �'�;`� <br /> r <br /> 'r' .Ap <br />
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