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,%WCalifornia Environmental Reporting System(CERS) Business Owner <br /> Operator <br /> Facility/Site <br /> CERS <br /> Satellite Dialysis University Park 104ID <br /> 10458379 <br /> 590 E Harding Way <br /> Stockton,CA 95204 <br /> Submittal Status <br /> Submitted on 9/23/2013 by Tern Grenz of Satellite Healthcare(Sacramento,CA) <br /> ubm I was Accepted Processed on 1/10/2014 by NG,WILL for San Joaquin County Environmental Health <br /> omments b regulator:Please enter a valid EPA ID number and resubmit --- <br /> dentification <br /> atellite Healthcare Beginning Date Ending Date <br /> Aerator Phone Business Phone Business Fax 9/23/2013 9/22/2014 <br /> 916)437-5800 (916)437-5800 (916)920-1648 Dun&Bradstreet SIC Code Primary NAILS 1 <br /> Facility/Site Mailing Address Primary Emergency Contact <br /> 590E March In. 1 -Ferri Grenz <br /> (Stockton,Ca 95204 iue <br /> IIIL ethnical supervisor <br /> uslness Phone 24 Hour <br /> Phone Pager Number <br /> 209)473-6890 (209)200-9144 <br /> Owner Secondary Emergency Contact <br /> Satellite Healthcare Don Balcom <br /> x(560)404-6500 Title <br /> 1300 Santana Row#3001Technical Manager <br /> an Jose,Ca 95128 FL smess Phone 24-Hour Phone Pager Number <br /> '(209)338-8716 (209)338-8716 <br /> Billing Contact nvironmental Contact <br /> Satellite Healthcare Ferri Grenz <br /> 650)404-6500 209)200-9144 grenzt@satellitehealth.com <br /> 00 Santana Row#300 90 E.March In. <br /> an Jose,Ca 95128 tockton,Ca 95204 <br /> Name of Signer Signer Title Document Preparer <br /> Terri Grenz Technical Supervisor Terri Grenz <br /> Additional Information <br /> Locally-collected Fields <br /> I <br /> orae or all of the following fields may be required by your local regulator(s). <br /> roperty Owner Assessor Parcel Number(APN) <br /> atellite Healthcare <br /> hone Number of Employees <br /> 650)404-6500 35 <br /> Wailing Address Facility ID <br /> 00 Santana Row#300 <br /> an lose,Ca 95128 <br /> Printed on 2/18/2014 10:00 AM <br />