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EHD Program Facility Records by Street Name
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4500 - Medical Waste Program
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PR0536162
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Last modified
1/10/2023 4:12:13 PM
Creation date
1/10/2023 1:51:21 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4500 - Medical Waste Program
File Section
BILLING/PERMITS
RECORD_ID
PR0536162
PE
4524
FACILITY_ID
FA0009105
FACILITY_NAME
COVENANT CARE LODI LLC
STREET_NUMBER
900
Direction
N
STREET_NAME
CHURCH
STREET_TYPE
ST
City
LODI
Zip
95240
APN
04125035
CURRENT_STATUS
01
SITE_LOCATION
900 N CHURCH ST
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
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SJGOV\cfield
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EHD - Public
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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 E. Main St. • Stockton,CA 95202-3029 • Phone(209)468-3420 <br /> l Donna Heran,R.E.H.S.,Director <br /> ENVIRONMENTAL HEALTH <br /> PERMIT TO OPERATE - 4524-SKILLED NURSING FACILITY <br /> Permit ID#PT0022157 for Record ID# PR0536162 <br /> Valid From 1/1/2012 To 12/31/2012 <br /> PERMITS TO OPERATE are NOT TRANSFERABLE <br /> and may be SUSPENDED or REVOKED for cause. <br /> PERMIT(s)Valid only for: COVENANT CARE LODI LLC <br /> THIS FORM MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES <br /> Regulated Facility: COVENANT CARE LODI LLC ' <br /> Facility ID FA0009105 <br /> 900 N CHURCH ST <br /> Account ID AR0016105 <br /> LODI CA 95240 Issued 11/30/2011 <br /> Billing Address: COVENANT CARE LODI LLC <br /> 900 N CHURCH ST <br /> LODI CA 95240 <br /> 7o2o.rpt <br />
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