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<br /> SAN JOAQUIri COUNTY ENVIRONMENTAL HEALT EPARTMENT
<br /> a ^d5n� � 1868 E. Hazelton Ave. • Stockton,CA 95205-6232 • Phone(209) 468-3420
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<br /> Donna Heran,R.E.H.S.,Director
<br /> ENVIRONMENTAL HEALTH
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<br /> PERMIT TO OPERATE - 4522-ACUTE CARE FACILITY
<br /> Permit ID# PT0005633 for Record ID# PR0450109
<br /> Valid From 1/1/2013 To 12/31/2013
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<br /> PERMITS TO OPERATE are NOT TRANSFERABLE
<br /> and may be SUSPENDED or REVOKED for cause.
<br /> " r PERMIT(s)Valid only for: KAISER FOUNDATION HOSPITAL
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<br /> THIS FORM MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES
<br /> Regulated Facility: KAISER FOUNDATION - MANTECA Facility ID FA0003978
<br /> Account ID AR0003603
<br /> 1777 W YOSEMITE AVE 44 :.
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<br /> MANTECA CA 95337 � Yt IT,
<br /> � '` issued 11/2612012
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<br /> Billing Address: ATTN : ATTN: LEONARD POKLAY-EVS f tea;
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<br /> KAISER FOUNDATION - MANTECA W
<br /> 1 r 1777 W YOSEMITE AVE
<br /> _MANTECA CA 95337
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