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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 3611 - PUBLIC POOL/SPA - PRIMARY <br />Permit ID # PT0001006 for Record ID # PR0360077 <br />Valid From 1/1/2022 To 12131/2022 <br />PERMIT TO OPERATE - PE 3612 - PUBLIC POOL/SPA - ADDITIONAL <br />Permit ID # PT0026176 for Record ID # PR0543525 <br />Valid From 1/1/2022 To 12/31/2022 <br />PERMIT TO OPERATE - PE 3612 - PUBLIC POOLISPA - ADDITIONAL <br />Permit ID # PT0026177 for Record ID # PR0543526 <br />Valid From 1/1/2022 To 12/31/2022 <br />PERMITS TO OPERATE me NOT TRANSFERABLE <br />and may be SUSPENDED or REVOKED for cause. <br />PERMIT(s) Valid only for: ROTHBARD, DR MORT <br />DBA: WEST LANE RACQUET OUTDOOR SPA <br />THIS FORM MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES <br />Regulated Facility: IN SHAPE ATHLETIC CLUB -MANTECA Facility ID FA0001005 <br />1805 E YOSEMITE AVE AcmuntlD AR0001002 <br />MANTECA CA 95336 issued 1/31/2022 <br />Billing Address: ATTN : ACCOUNTS PAYABLE <br />IN SHAPE ATHLETIC CLUB -MANTECA <br />6507 PACIFIC AVE #344 <br />STOCKTON CA 95207 <br />7027.M End of Report <br />