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77 <br /> ..,k <br /> 77 <br /> �, <br /> ; - <br /> „ - <br /> :+d <br /> SAN JOA LT OUNTY ENVIRONMENTAL HEALTPARTMENT h <br /> Q �r <br /> 1868 E. Hazelton Ave. 9 Stockton, CA 95205-6232 Phone(209) 468-3420 <br /> r x Donna Heran,R.E.H.S.,Director <br /> -A IENVIRONMENTAL HEALTH; ' , <br /> PERMIT TO OPERATE 4520-PRIMARY CARE FACILITY <br /> Permit ID# PT0016588 for Record ID# PRO524322 <br /> Valid From 1/1/2015 To 12/31/2015 <br /> iX <br /> �¢ _; r <br /> * r <br /> A � dd yy <br /> ' Y rW- <br /> Y <br /> ,�"�:.,�7-�. } 4 ✓t ,. r 3�'. ;a< heck .,"s 7; <br /> e� 'x x <br /> aa t :' � ax1 r a <br /> k.` kT' ix s 7. 1011 <br /> A�'lq <br /> � <br /> PubW� <br /> -" <br /> f' AK�= r ✓ - F. fi <br /> d a '�: f i 3 to r ,S L s .� 3 <br /> 'dy f P s <br /> 3.�1,�d"'`� /�,. � Y..� tFr.,t�s.r, � .. ..f 7�Y'`�o !,u� t r. ty;+.• � t �'� ���K��.' �� � �#� ' ,.;-. <br /> PERMITS TO OPERATE are NOT TRANSFERABLE <br /> and may be SUSPENDED or REVOKED for cause. <br /> PERMIT(s)Valid only for THE PERMANENTE MEDICAL GROUP 4 <br /> 1 � <br /> THIS FORM MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES <br /> Facility ID FA0016313 <br /> Regulated Facility: KAISER PERMANENTS •'' <br /> Account ID AR0028558 <br /> 2185 W GRANT LINE RD <br /> a 1 Issued 11/21/2014 <br /> u, <br /> TRACY CA 95377 Y i <br /> µ <br /> Er <br /> Billing Address: ATTN . EVSr -,r � <br /> KAISER PERMANENTS <br /> 1777 W YOSEMITE AVE <br /> x' MANTECA CA 95337 , �a <br /> x���;R � ��.* 6'-0S•.v i ..n�:` ` � �' k'4T��i�l.�� � iz�kEf�l$a.:� V L 7�" rte � } Y S• � <br /> _:fir `"`�;_..w� ° 4x4sU�a�.'. c« �k �k ;,.,;: eas✓attany«,sta�,.1t1��.���9,r. �s�n,�,_.�iti_.,�ca�..,..i:€.n;k`_:e=a,,���.'`., � <br />