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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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EHD - Public
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SAN JOAQJ COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 E.Hazelton Ave. * Stockton,CA 95205-6232 •Phone(209) 468-3420 <br /> Donna Heran,R.E.H.S.,Director <br /> ENVIRONMENTAL HEALTH <br /> PERMIT TO OPERATE 4524-SKILLED NURSING FACILITY, <br /> Permit 1D# PT0022157 for Record ID#PR0536162 <br /> Valid From 1/1/2013 To 12/31/2013 <br /> r y£-,...,w:e: • r*`�kfd. '' " '' ''', ,1, 'Y Y-_ e- ja�,K ^"°a?a' rt' '+ "�r- �, <br /> � �.r .,���`rr�fi� � � .�r fax �o,�,'��n+�c ��,�`, `'� •� tr,�r <br /> x <br /> 64, <br /> t tG a rA64 4,max' Xi MA, <br /> 4: <br /> Y, was_ �1` .,I�,f " .. � :.$ '' �� ',� e��>���d�"'� 1.����`4 ���•5.�*�, <br /> a <br /> x T 4 t i l' zn <br /> x <br /> Jh <br /> t <br /> PERMITS TO OPERATE are NOT TRANSFERABLE <br /> and may be SUSPENDED or REVOKED for cause. <br /> f ...m <br /> PERMIT(s)Valid only for: COVENANT CARE LODI LLC # ` <br /> r <br /> THIS FORM MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES <br /> Facility ID FA0009105 <br /> Re mated Facility: COVENANT CARE LOW LLC * . <br /> s #i� Account io AR0016105 <br /> 900 N CHURCH ST K h ,,. �G 11 <br /> Issued /26/2012 <br />� >.,roti -'l.�,�. �„.,.:ie�r, '�; ��; ��� ��•`' � ��a�;rS� e-S�ti',,�r x r'��rv'.v��%�� "'„ <br />
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