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BILLING_2023
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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C
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CORRAL HOLLOW
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2955
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4500 - Medical Waste Program
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PR0546503
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BILLING_2023
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Entry Properties
Last modified
2/7/2023 12:50:57 PM
Creation date
11/29/2022 11:47:49 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4500 - Medical Waste Program
File Section
BILLING
FileName_PostFix
2023
RECORD_ID
PR0546503
PE
4530
FACILITY_ID
FA0026367
FACILITY_NAME
DAVITA GRANT LINE DIALYSIS
STREET_NUMBER
2955
Direction
N
STREET_NAME
CORRAL HOLLOW
STREET_TYPE
RD
City
TRACY
Zip
95376
CURRENT_STATUS
01
SITE_LOCATION
2955 N CORRAL HOLLOW RD STE 101
P_LOCATION
03
QC Status
Approved
Scanner
Accounting
Supplemental fields
EmailAddr
AR0050123 courtney.vela@davita.com;cal_c@davita.com
EmailSent
11/29/2022 11:48:43 AM
FilePath
D:\CAPTURE\EHD\Batch\Operating Permits
ParentPath
Operating Permits
PermitRecordID
PR0546503
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 4530-LG QUANITY GENERATOR <br /> Permit ID# PT0027842 for Record ID# PR0546503 <br /> Valid From 1/1/2023 To 12/31/2023 <br /> PERMITS TO OPERATE are NOT TRANSFERABLE <br /> and may be SUSPENDED or REVOKED for cause. <br /> PERMIT(s)Valid only for: PATTISON DIALYSIS LLC <br /> DBA: DAVITA GRANT LINE DIALYSIS <br /> THIS FORM MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES <br /> Regulated Facility: DAVITA GRANT LINE DIALYSIS Facility ID FA0026367 <br /> 2955 N CORRAL HOLLOW RD# 101 Account ID AR0050123 <br /> TRACY CA 95376 Issued 11/29/2022 <br /> Billing Address: ATTN : MCDOWELL, BRAD <br /> DAVITA GRANT LINE DIALYSIS <br /> 5200 VIRGINIA WAY, L&C DEPT <br /> BRENTWOOD TN 37027 <br /> 7027.rpt End of Report <br />
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