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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 4/1/2022 To 3/31/2023 <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 3/2/2022 <br /> Billing Address: ATTN : MCGARY, DOREEN, EXEC DIRECTOR <br /> COVENANT CARE LODI LLC <br /> 120 VANTIS DR STE 200 <br /> ALISO VIEJO, CA 92656-2677 <br /> combined.rpt End of report <br />