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SAN JOAQOUNTY ENVIRONMENTAL HEALTREPARTMENT
<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 - 4532- SM QUANITY GENERATOR
<br /> Permit ID# PT0022623 for Record ID# PR0537018
<br /> Valid From 1/1/2014 To 12/31/2014
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<br /> PERMITS TO OPERATE are NOT TRANSFERABLE
<br /> and may be SUSPENDED or REVOKED for cause.
<br /> PERMIT(s)Valid only for NGUYEN, QUAN ,t r Eby � , txW
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<br /> THIS FORM MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES
<br /> Regulated Facility: INNOVATION DENTAL Facility ID FA0021254 �#
<br /> x ,7 a Account io AR0038422
<br /> 702 PORTER AVE# F
<br /> issued 11/22/2013
<br /> STOCKTON CA 95207 0yn
<br /> Billing Address: ATTN : NGUYEN, QUAN � �
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<br /> INNOVATION DENTAL t g s 3 �t ,ern
<br /> 702 PORTER AVE STE F ` �
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<br /> STOCKTON CA 95207 x 's
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