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SAN JOW COUNTY PUBLIC HEALTH VICES <br /> P O Box 388 TT STocKToN, CA 95201-0388 • PHo 09) 468-3420 <br /> ERNEST M. FUJIMOTO, M.D., M.P.H., ACTING HEALTH OFFICER <br /> DONNA RERAN, R.E.H.S., DIRECTOR, ENVIRONMENTAL HEALTH DIVISION <br /> ENVIRONMENTAL HEALTH <br /> IT TO OPERATE * 001191 <br /> 4524 SKILLEDNURSING FACILITY ATF# PERMIT <br />{ Valid from 01/01/95 to 12/31/95 <br /> i <br /> a <br /> PERMITS TO OPERATE and ANNUAL PERMIT FEE PAYMENTS are NOT TRANSFERABLE <br /> andmay he SUSPENDED or REVOKED for cause. <br /> Those referenced above are Valid ONLY for <br /> OWNER NAME : CADRE WEST - MANTECA <br /> THIS FORM MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES <br /> FtE6U.'IED FACILITY: CARE WEST - MANTECA Facility ID.- 001190 <br /> 410 EA'=TWOOD AVE Account IU: 0001188 <br /> MANTECA, CA 95336 Permit Issued: <br /> BILLING A MOS: <br /> CARE WEST - MANTECA <br /> 410 EA' TWOOD AVE <br /> MANTECA, CA 95336 <br />