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BILLING_2021
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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1600 - Food Program
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PR0527289
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BILLING_2021
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Entry Properties
Last modified
3/24/2021 3:48:59 PM
Creation date
3/24/2021 3:46:20 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
BILLING
FileName_PostFix
2021
RECORD_ID
PR0527289
PE
1628
FACILITY_ID
FA0009105
FACILITY_NAME
COVENANT CARE LODI LLC
STREET_NUMBER
900
Direction
N
STREET_NAME
CHURCH
STREET_TYPE
ST
City
LODI
Zip
95240
APN
04125035
CURRENT_STATUS
01
SITE_LOCATION
900 N CHURCH ST
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved - Send Email
Scanner
ADMIN
Supplemental fields
EmailAddr
AR0016105 tpetersen@covenantcare.com;ehughes@covenantcare.com
EmailSent
3/24/2021 3:48:42 PM
FilePath
D:\CAPTURE\EHD\OperatingPermits
PermitRecordID
PR0527289
Tags
EHD - Public
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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 E.Hazelton Ave•Stockton,CA 95205-6232•Phone(209)468-3420 <br /> Jasjit Kang,R.E.H.S.,Director <br /> ENVIRONMENTAL HEALTH <br /> PERMIT TO OPERATE - PE 1628 LICENSED HEALTH CARE FACILITY <br /> Permit ID# PT0019088 for Record ID# PR0527289 <br /> Valid From 4/1/2021 To 3/31/2022 <br /> PERMITS TO OPERATE are NOT TRANSFERABLE <br /> and may be SUSPENDED or REVOKED for cause. <br /> PERMIT(s)Valid only for: COVENANT CARE LODI LLC <br /> DBA: COVENANT CARE LODI LLC <br /> THIS FORM MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES <br /> Regulated Facility: COVENANT CARE LODI LLC Facility ID FA0009105 <br /> 900 N CHURCH ST Account ID AR0016105 <br /> LODI, CA 95240 Issued 3/24/2021 <br /> Billing Address: ATTN : <br /> COVENANT CARE LODI LLC <br /> 900 N CHURCH ST <br /> LODI, CA 95240 <br /> 7024.rpt End of report <br />
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