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BILLING_2021
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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T
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TULLY
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17201
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4600 - Public Water System Program
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PR0543080
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BILLING_2021
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Entry Properties
Last modified
6/11/2021 10:45:50 AM
Creation date
6/11/2021 10:42:18 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4600 - Public Water System Program
File Section
BILLING
FileName_PostFix
2021
RECORD_ID
PR0543080
PE
4621
FACILITY_ID
FA0004405
FACILITY_NAME
HAYNES BOARD & CARE HOME
STREET_NUMBER
17201
Direction
N
STREET_NAME
TULLY
STREET_TYPE
RD
City
LODI
Zip
95240
APN
05303037
CURRENT_STATUS
01
SITE_LOCATION
17201 N TULLY RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved - Send Email
Scanner
Accounting
Supplemental fields
EmailAddr
AR0004087 HAYNES@SOFTCOM.NET;
EmailSent
6/11/2021 10:45:49 AM
FilePath
D:\CAPTURE\EHD\Batch\Operating Permits
ParentPath
Operating Permits
PermitRecordID
PR0543080
Tags
EHD - Public
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1868 E.Hazelton Ave. •Stockton, CA 95205-6232 •Phone (209)468-3420 <br />Jasjit Kang, R.E.H.S., Director <br />SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br />ENVIRONMENTAL HEALTH <br />ANNUAL OPERATING FEE PAID - PE 4621 - SMALL COMMUNITY PUBLIC WATER SYSTEM <br />Permit ID # PT0026678 for Record ID # PR0543080 <br />Valid From 7/1/2021 To 6/30/2022 <br />PERMITS TO OPERATE are NOT TRANSFERABLE <br />and may be SUSPENDED or REVOKED for cause. <br /> PERMIT(s) Valid only for: <br />DBA: <br />THIS FORM MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES <br />HAYNES BOARD & CARE HOME <br />HAYNES, RONALD E <br />Regulated Facility: <br />17201 N TULLY RD <br />LODI CA 95240 <br />Facility ID <br />Account ID <br />Issued <br />FA0004405 <br />AR0004087 <br />6/11/2021 <br />HAYNES BOARD & CARE HOME <br />ATTN : RONALD HAYNESBilling Address: <br />HAYNES BOARD & CARE HOME <br />17201 N TULLY RD <br />LODI CA 95240 <br />7027.rpt End of Report
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