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EHD Program Facility Records by Street Name
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1777
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4500 - Medical Waste Program
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PR0450109
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Last modified
12/22/2022 11:45:53 AM
Creation date
12/8/2022 4:00:14 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4500 - Medical Waste Program
File Section
BILLING/PERMITS
RECORD_ID
PR0450109
PE
4522
FACILITY_ID
FA0003978
FACILITY_NAME
KAISER FOUNDATION - MANTECA
STREET_NUMBER
1777
Direction
W
STREET_NAME
YOSEMITE
STREET_TYPE
AVE
City
MANTECA
Zip
95337
APN
20018034
CURRENT_STATUS
01
SITE_LOCATION
1777 W YOSEMITE AVE
P_LOCATION
04
P_DISTRICT
003
QC Status
Approved
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SJGOV\cfield
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EHD - Public
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A SAN JOA j§[N COUNTY PUBLIC I]EALTH*VICFS <br />P 0 Box 388 MWSTOCKTON, CA 95201-0388 0 PHONE )468-3420 <br />ERNEST M. FUJIMOTO, M.D., M.P.H., ACTING HEALTH OFFICER <br />DONNA HERAN, R.E.H.S., DIRECTOR, ENVIRONMENTAL HEALTH DIVISION <br />ENVIRONMENTAL HEALTH <br />PERMIT TO OPERATE # <br />4322 ACUTE CARE FACILITY HEALTH PERMIT <br />Valid from 01/01/9S to 12/31/9S <br />PERMITS TO OPERATE and ANNUAL PERMIT FEE PAYMENTS are NOT TRANSFERABLE <br />and may be SUSPENDED or REVOKED for cause. <br />Those referenced above are Valid ONLY for <br />OWNER NAMEt ST JOSEPHS MEDICAL CENTER CORP <br />DBA" ST DCBM INIQUES HOSPITAL <br />HIS FORM MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES <br />R'ElkUTED FACILITY: ST DOMINICIS HOSPITAL Facility ID: 000998 <br />1777 W YOSEMITE AVE Account ID,- 000099S <br />MAN TECA, CA 953:36 Perruit Issued: 03/22/95 <br />E.-1UNG ADDRUSS! <br />ST DOM INIC'S HOSPITAL <br />ATTN: ST DCT INIC'S ACCT PAYABLE <br />1777 W YOSEMITE AVE <br />MANTECA, CA 953-36 <br />
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