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J0 UIN CQ'LFAT`I'YINWRONMENTAL HEALTH DEPARTMENT <br /> 3"-L W. d=Ave.,Third 1%oir_'.Stc)dcton,,C4.95292-27094^*-ne(209)468-3420 <br /> Donna.Heran, <br /> �— <br /> EN <br /> Ol��VIENTAL I ��. <br /> PERMIT Tl OPERATE 4540-COMMON ST(IRACE�-1 . <br /> N Perrrd ID,#PT6011635 for. Record ID# PR051741+5 <br /> Wild f rom 1/1/2006 To 12/3112006:=": - <br /> _ <br /> a4 <br /> •7' <br />} <br /> » <br /> PF 1I ITS TO OPERATE are NOT'TR NSFERABLE <br />#.<.: 4n$-maybe SUSPENDED or REVOKED for cause. <br /> w <br /> PER)kAIT03)'VW11d oolY:for: GREL'W;CHARLES <br /> d$�1: 'WALNUT ST MEDICAL CENTER <br /> t <br />(�4: <br /> THIS FORM MUST RE DISPLAYED CONSPICUOUSLY ON THE PREMISES <br /> Facility ID FA0013445- <br /> Regulated Facility: CALIFORNIA STREET Mi5DIMBLM <br /> m ApCo' t ID' AR00323$2" <br /> 1617;N CAL)FORIVIA St:;. <br /> i STOIf`I ON',CA" 95204 <br /> t&sued 12l1/�005 <br /> r n. <br /> Billing Address: ATTN : GREEN, CHARLES <br /> x CALIFORNIA;STREET MEC?ifi.11�8LD <br /> 1617 N CALIFORNIA ST <br /> STOCKTON CA 95204 K, <br /> x - s <br />