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COMPLIANCE INFO
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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BENJAMIN HOLT
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555
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4500 - Medical Waste Program
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PR0519180
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COMPLIANCE INFO
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Entry Properties
Last modified
2/9/2023 4:03:29 PM
Creation date
7/3/2020 10:20:59 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4500 - Medical Waste Program
File Section
COMPLIANCE INFO
RECORD_ID
PR0519180
PE
4530
FACILITY_ID
FA0010525
FACILITY_NAME
DELTA SIERRA DIALYSIS CNTR
STREET_NUMBER
555
Direction
W
STREET_NAME
BENJAMIN HOLT
STREET_TYPE
DR
City
STOCKTON
Zip
95207
APN
08126029
CURRENT_STATUS
02
SITE_LOCATION
555 W BENJAMIN HOLT DR STE 200
P_LOCATION
01
P_DISTRICT
002
QC Status
Approved
Scanner
SJGOV\cfield
Supplemental fields
FilePath
\MIGRATIONS\MW\MW_4530_PR0519180_555 W BENJAMIN HOLT_.tif
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EHD - Public
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SAN JOAQUIN OUNTY ENVIRONMENTAL HEALT �PA12T1VIENT <br /> ' r a <br /> 1868 E. Hazelton Ave. • Stockton,CA 95205-6232 • Phone(209)468-3420 <br /> 'r Donna Heran,R.E.H.S.,Director <br /> t� ENVIRONMENTAL HEALTH <br /> Ii <br /> PERMIT TO OPERATE - 4530-LG QUANITY GENERATOR <br /> as <br />"X , Permit ID# PT0012312 for Record ID# PR0519180 . <br /> Valid From 1/1/2015 To 12/31/2015 <br /> 1 v r " 4 <br /> ?49 -"W;' <br /> W trx+' i� <br /> 3 a '"� Ijr {` ; <br /> H ' �4 _ <br /> t4 <br /> Va <br /> r A <br /> g, yy; t <br /> f <br /> rY x v <br /> C S � 'Si " _._ )' "` .Y �✓ <br /> ,j <br /> �r / <br /> PERMITS TO OPERATE are NOT TRANSFERABLE <br /> and may be SUSPENDED or REVOKED for cause. <br /> PERMIT(s)Valid only for: TOTAL RENAL CARE INC . <br /> h tr DBA: DELTA SIERRA DIALYSIS CNTR <br /> 'sE� <br /> THIS FORM MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES <br /> Regulated Facility: DELTA SIERRA DIALYSIS CNTR '.' 4 Facility ID FA0010525 <br /> J Account ID AR0017525 <br /> 555 W BENJAMIN HOLT DR 200 ' <br /> M b Issued 11/21/2014 <br /> STOCKTON CA 95207 j?4 r t <br /> Billing Address: ATTN : LICENSE DEPARTMENT <br /> � fir. ,'�a <br /> t TOTAL RENAL CARE INC _ y � �" T��F� <br /> 1423 PACIFIC AVE x, t <br /> TACOMA WA 98402 ' �471 <br /> VJK <br /> t ezaWo <br /> .y¢y Ia1 t ( ' <br /> �,��l..t,.ffi S*A...�+' ,G.. <br /> f ... td.r&Y,Y <br />
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