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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 E.Hazelton Ave•Stockton,CA 95205-6232•Phone(209)468-3420 <br /> Jasjit Kang,R.E.H.S.,Director <br /> ENVIRONMENTAL HEALTH <br /> PERMIT TO OPERATE - PE 1628 LICENSED HEALTH CARE FACILITY <br /> Permit ID# PT0019088 for Record ID # PR0527289 <br /> Valid From 4/1/2023 To 3/31/2024 <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 /> DBA: COVENANT CARE LODI LLC <br /> THIS FORM MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES <br /> Regulated Facility: COVENANT CARE LODI LLC Facility ID FA0009105 <br /> 900 N CHURCH ST Account ID AR0016105 <br /> LODI, CA 95240 Issued 3/21/2023 <br /> Billing Address: ATTN : MICHAEL SMITH EXEC DIRECTOR <br /> COVENANT CARE LODI LLC <br /> 900 N CHURCH ST <br /> LODI, CA 95240 <br /> 7024.rpt End of report <br />