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SAN JOAQUPti CO Y ENVIRONMENTAL HEALTH DEATMENT <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 ID# PT0022157 for Record ID#PRO536162 <br /> Valid From 1/1/2015 To 12/31/2015 <br /> PERMITS TO OPERATE are NOT TRANSFERABLE <br /> i <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 /> Facility ID FA0009106 <br /> Regulated Facility: COVENANT CARE LODI LLC Account ID ARD016105 <br /> 900 N CHURCH ST <br /> LODI CA 95240 Issued 11/21/2014 <br /> Billing Address: ATTN : COVENANT CARE LODI LLC DBA ARBOR NURSING CENTER <br /> COVENANT CARE LODI LLC <br /> 900 N CHURCH ST <br /> LODI CA 95240 <br /> 7020.rpt <br />