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<br /> SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT
<br /> 600 E. Main St. • Stockton, CA 95202-3029 • Phone (209)468-3420
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<br /> Donna Heran, R.E.H.S., Director }u•r ,` „• x v ', *�,`:
<br /> ENVIRONMENTAL HEALTH �-
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<br /> PERMIT TO OPERATE - 4530-LG QUANITY GENERATOR
<br /> Permit ID#PT0018687 for Record ID # PR0526718
<br /> Valid From 1/10/2010 To 12/31/2010
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<br /> PERMITS TO OPERATE are NOT TRANSFERABLE
<br /> and may be SUSPENDED or REVOKED for cause.
<br /> PERMIT(s)Valid only for DAVITA INCsa. - fi+
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<br /> THIS FORM MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES
<br /> Regulated Facility: DAVITA LODI DIALYSIS CENTER t } �.'.. Facility ID FA0018090
<br /> ,L ` Account ID AR0031818
<br /> 1610 W KETTLEMAN LN #D
<br /> issued 12/2/2009
<br /> LODI CA 95242-3731
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<br /> Billing Address: ATTN : LICENSURE &CERTIFICATION DEPT
<br /> DAVITA LODI DIALYSIS CENTER �. 'k
<br /> 5200 VIRGINIA WAY
<br /> BRENTWOOD TN 37027 z`
<br /> 7027 rpt
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