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MEDICAL WASTE GENERATOR <br /> FILE COVER SHEET <br /> FACILITY ID#: FA0006752 P/E: 4557 DATE: 02/05/2009 <br /> PROGRAM RECORD#: PR0505389 P/E: DATE: <br /> P/E: DATE: <br /> ADDRESS: 2640 E LAFAYETTE ST CITY: STOCKTON <br /> CILITY NAME (DBA): KING FAMILY HEALTH CENTER <br /> FACILITY PHONE: (209) 948-5410 FACILITY FAX: <br /> FACILITY CONTACT: NANCY PILKINGTON PHONE: <br /> OWNER NAME: A W H C/KING FAMILY HEALTH CEN CITY: STOCKTON <br /> OWNER ADDRESS: 2640 E LAFAYETTE ST PHONE: (209)948-5410 <br /> Water Service: ❑ Large PWS ❑ Small PWS ❑ Domestic Well <br /> Sewer Service: ❑ Public Sewer ❑ OnSite WWTX ❑ OnSite Septic System <br /> Stormwater: ❑ Street Drains ❑ Street Ditches ❑ OnSite Ponds ❑ Other <br /> EH 00 18 rev 05/2007 <br /> rpt#: MWCS New Owner: Create a New Cover Sheet/Change Label of File <br />