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<br /> ' 600 E. Main St. • Stockton, CA 95202-3029 • Phone(209)468-3420
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<br /> s,, Donna Heran, R.E.H.S., Director
<br /> ENVIRONMENTAL HEALTH
<br /> f PERMIT TO OPERATE - 4530-LG QUANITY GENERATOR ;
<br /> Permit ID#PT0015338 for Record ID#PR0522690 �"
<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 INC .y
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<br /> Re ulated Facilit : .- Facility ID FA0010846
<br /> 9 Y DAVITA TRACY DIALYSIS
<br /> 425 W BEVERLY PL#A R k w AccountlD AR0017846 �* �
<br /> TRACY CA 95376 x Issued 12/2/2009 ,�� _
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<br /> Billing Address: A1a5`f J'`F
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<br /> ATTN : LICENSURE& CERTIFICATION DEPT
<br /> DAVITA TRACY DIALYSIS
<br /> 5200 VIRGINIA WAY
<br /> BRENTWOOD TN 37027
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