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BILLING_2021
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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M
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MADISON
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1319
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1600 - Food Program
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PR0527308
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BILLING_2021
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Entry Properties
Last modified
1/12/2022 11:43:18 AM
Creation date
1/12/2022 10:54:21 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
BILLING
FileName_PostFix
2021
RECORD_ID
PR0527308
PE
1628
FACILITY_ID
FA0003728
FACILITY_NAME
PLYMOUTH SQUARE
STREET_NUMBER
1319
Direction
N
STREET_NAME
MADISON
STREET_TYPE
ST
City
STOCKTON
Zip
95202
CURRENT_STATUS
01
SITE_LOCATION
1319 N MADISON ST
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved - Send Email
Scanner
Accounting
Supplemental fields
EmailAddr
AR0003307 Willy.demesa@rhf.org;Alicia.Serna@rhf.org
EmailSent
1/12/2022 11:43:16 AM
PermitRecordID
PR0527308
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 />PERMIT TO OPERATE - PE 1628 - LICENSED HEALTH CARE FACILITY <br />Permit ID # PT0019107 for Record ID # PR0527308 <br />Valid From 8/1/2021 To 7/31/2022 <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 />RETIREMENT HOUSING FOUNDATION <br />PLYMOUTH SQUARE <br />Regulated Facility: <br />1319 N MADISON ST <br />STOCKTON, CA 95202 <br />Facility ID <br />Account ID <br />Issued <br />FA0003728 <br />AR0003307 <br />1/11/2022 <br />PLYMOUTH SQUARE <br />PLYMOUTH SQUAREATTN : Billing Address: <br />PSYCHE JOHNSON <br />1319 N. MADISON ST <br />STOCKTON, CA 95202 <br />End of reportcombined.rpt
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