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<br /> i. 1868 E.Hazelton Ave. • Stockton, CA 95205-6232 • Phone(209)468-3420
<br /> F' Donna Heran,R.E.H.S.,Director
<br /> ENVIRONMENTAL HEALTH
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<br /> PERMIT TO OPERATE - 4530-LG QUANITY GENERATOR
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<br /> PT0012312 x for Record ID# PR0519180
<br /> Valid From 1/1/2014 To 12/31/2014
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<br /> PERMITS TO OPERATE are NOT TRANSFERABLE
<br /> and may be SUSPENDED or REVOKED for cause.
<br /> u PERMIT(s) Valid only for: TOTAL RENAL CARE INC
<br /> r� DBA DELTA SIERRA DIALYSIS CNTR
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<br /> THIS FORM MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES
<br /> Facility ID FA0010525
<br /> Regulated Facility: DELTA SIERRA DIALYSIS CNTR
<br /> 555 W BENJAMIN HOLT DR#200 AccountiD AR0017525
<br /> Issued 11/22/2013
<br /> STOCKTON CA 95207
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<br /> Billing Address: ATTN : LICENSE DEPARTMENT '
<br /> TOTAL RENAL CARE INC W ' q � # k
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<br /> 1423 PACIFIC AVE
<br /> rx TACOMA WA 98402fi v_ `vt '�
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