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SAN JO*IN COUNTY PUBLIC HEALTH *VICES <br />P 0 Box 388 'V- STocKTox, CA 95201-0388 9 PnoNE (209) 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 IMALUI <br />PERMIT TO OPERATE # 005633 'oy� PR4-S00'z- <br />1, <br />4SZ2 ACUTE CARE FACILITY HEALTH PERMIT <br />Valid frow 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 DOMINIQUES HOSPITAL <br />THIS FORM MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES <br />RERIATT"D FACILITY ,% ST DCS!" INICS HICIC-DPITAL Facility ID! 000998 <br />1777 W YO,:-;EMITE AVE kcoimt IN 000099S <br />MANTECA., CA 9S:336 Peiv-it Issued: 03/29/94---, <br />CCT, <br />ONTA 'T DCBM Iii IQUES ACCT PAY ;BL <br />BILUIN2 AM-K1K,, <br />ST Di_ MINIC".�, HOOPITHAL <br />ATTN: ST DOMINIC'S ACCT PAYABLE <br />17/717 W YOSEMITE AVE <br />MANTECA., CA 95336 <br />