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SAN JOAQUI007LJNTY'ENVIRONMENTAL HEALAEPARTMENT <br /> 1868 E. Hazelton Ave. • Stockton,CA 95205-6232 • Phone(209)468-3420 <br /> Donna Heran,R.E.H.S.,Director _ <br /> ENVIRONMENTAL HEALTH <br /> PERMIT TO,OPERATE - 4530-LG QUANITY GENERATOR <br /> Permit ID# PT0015339 for Record ID# PR0522691 <br /> Valid From 1/1/2015 To 12/31/2015 <br /> PERMITS TO OPERATE are NOT TRANSFERABLE <br /> and may be SUSPENDED or REVOKED for cause. <br /> PERMIT(s)Valid only for: DVA Healthcare Renal Care, Inc. <br /> THIS FORM MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES <br /> Regulated Facility: DAVITA MANTECA DIALYSIS CENTER Facility ID FA0013665 <br /> Account ID AR0022822 <br /> 3665 <br /> 1156 S MAIN ST issued 11/21/2014 <br /> MANTECA CA 95336 <br /> Billing Address: ATTN : MARY CORDEIRO <br /> DAVITA MANTECA DIALYSIS CENTER <br /> 5200 VIRGINIA WAY <br /> BRENTWOOD TN 37027 <br />