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SAN JO COUNTY COUNTY PUBLIC HEALTHdbRVICES <br />P 0 Box 388 'W STocKToN, CA 95201-0388 e PnoNgn2O9) 468-3420 <br />ERNEST M. FUJIMOTO, M.D., M.P.H., ACTING HEALTH OFFICER <br />DONNA RERAN, R.E.H.S., DIRECTOR, ENVIRONMENTAL HEALTH DIVISION <br />ENVIRONMENTAL HEALTH <br />PERMIT TO OPERATE #00S633 f o c PR4S010'S <br />4522 ACUTE CARE FACILITY HEALTH PERMIT <br />Valid from 01/01/96 to 12/31/96 <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 NAME; ST JOSEPHS MEDICAL CENTER CORP <br />DBA; ST DOMINIQUE'-:; HOSPITAL <br />THIS FORM MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES <br />REGVLATED FACILITY! '3-T [-1OM.1NPC"-7.' HOSPITAL Facility 10-1. 000998 <br />J777 W YOSEMITE AVE Account ID: 000099S <br />MANTECA, CA 9S336 Perrijit issued! 03/07/9C, <br />BILLIN6 ADDRESS; <br />ST DOMINICIS HOSPITAL <br />ATTN: ST DOM INIC'S ACCT PAYABLE <br />1777 W YOSEMITE AVE <br />MANTECA, CA 95:336 <br />