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--. - . <br /> SAN JOAQUn BOUNTY ENVIRONMENTAL HEALTEPARTMENTs <br /> Mme:y <br /> 1868 E. Hazelton Ave. • Stockton,CA 95205-6232;e Phone(209);4.68-3420 <br /> Donna Heran;)R.E.H.S.,Director <br /> I I � <br /> ENVIRONMENTAL HEAL'T'H <br /> PERMIT TO OPERATE - 4530-LG QUANITY GENERATOR <br /> Permit ID# PT0015339 for Record ID# PR0522691 <br /> Valid From 1/1/2013 To 12/31/2013 <br /> II I, �rl I�1 <br /> 1 <br /> PERMITS TO OPERATE are NOT TRANSFERABLE <br /> and may be SUSPENDED or REVOKED for cause. <br /> PERMIT(s)Valid only for: DAVITA INC <br /> THIS FORM MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES <br /> Regulated Facility: DAVITA MANTECA DIALYSIS CENTER Facility ID FA0013665 <br /> 1156 S MAIN ST <br /> Account ID AR0022822 <br /> MANTECA CA 95336 Issued 11/26/2012 <br /> Billing Address: ATTN : LICENSURE & CERTIFICATION DEPT <br /> DAVITA MANTECA DIALYSIS CENTER <br /> 5200 VIRGINIA WAY <br /> BRENTWOOD TN 37027 <br />