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Environmental Health - Public
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EHD Program Facility Records by Street Name
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FAIRMONT
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975
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4500 - Medical Waste Program
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PR0450003
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Last modified
1/4/2023 1:51:17 PM
Creation date
12/14/2022 8:41:47 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4500 - Medical Waste Program
File Section
BILLING/PERMITS
RECORD_ID
PR0450003
PE
4522
FACILITY_ID
FA0000513
FACILITY_NAME
LODI MEMORIAL HOSPITAL
STREET_NUMBER
975
Direction
S
STREET_NAME
FAIRMONT
STREET_TYPE
AVE
City
LODI
Zip
95240
APN
03107039
CURRENT_STATUS
01
SITE_LOCATION
975 S FAIRMONT AVE
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
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EHD - Public
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- SAN JO *TIN COUNTY PUBLIC HEALTH #VICES <br />304 E. WEBER AVE., THIRD FLOOR • STOCKTON, CA 95202 • PHONE (209) 468-3420 <br />KAREN FURST, M.D., M.P.H., HEALTH OFFICER <br />DONNA RERAN, R.E.H.S., DIRECTOR ENVIRONMENTAL HEALTH DIVISION <br />ENVIRONMENTAL HEALTH <br />PERMIT TO OPERATE - 4522 ACUTE CARE FACILITY <br />Permit ID # PT0000585 for Record ID # PR0450003 <br />Valid From 1/1/00 To 12/31/00 <br />PERMITS TO OPERATE are NOT TRANSFERABLE <br />and may be SUSPENDED or REVOKED for cause. <br />PERMIT(s) Valid only for: LODI MEMORIAL HOSPITAL <br />DBA: <br />THIS FORM MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES <br />Facility ID FA0000513 <br />Regulated Facility: LODI MEMORIAL HOSPITAL Account ID AR0000512 <br />975 S FAIRMONT AVE Issued 3/16/2000 <br />LODI. CA 94240 <br />Billing Address: ATTN : FACILITY MANAGEMENT <br />LODI MEMORIAL HOSPITAL <br />PO BOX 3004 <br />LODI, CA 95241 <br />7020.rpt <br />
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