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HomeMy WebLinkAboutC08-235EAGLE COUNTY AMBULANCE SERVICE LICENSE ~•~ EAGLE COUNTY LICENSURE DATE: From: 7/1/2008 To: 6/30/2009 AMBULANCE SERVICE: _ Eagle County Health Service District ADDRESS: _ PO Box 990 Edwards, CO 81 PHONE: 970-926-5270 FAX: 970-926-5235 MEDICAL ADVISOR: _ Diana Hearne M.D. (Name/Credentials) The inspection of the above named ambulance service was made on 6/27/2008 by _Staci Bruce, RN and Bethany Van Wyk, RN .This ambulance service has met licensing requirements for Eagle County as established in the resolution as approved by the Board of Commissioners May 2007. - INSPECTOR(S): (Signature) -~" (Type Name & Credentials),Staci Bruce, RN • (Signature) (Type Name & Credentials} ethany Van yk, COMMISSIONERS APPROVAL TO ISSUE LICENSE: Date: ~ l~' ~ 2J EAGLE COUNTY AMBULANCE VEHICLE PERMIT ~~'''~ , EAGLE COUNTY PERMIT DATE: From: 7/1/2008 To: 6/30/2009 AMBULANCE SERVICE: Eagle County Health Service District ADDRESS: PO Box 990 Edwazds, CO 81632 PHONE: 970-926-5270 FAX: 970-926-5235 VEHICLE YEAR MAKE TYPE VIN CO-REGISTRATION #1 (780) 2003 Ford III 1FDWE35F33HB42189 906-JUM #2 (781) 2004 Ford III 1FDWE35P15HA12813 876-LWX #3 (782) 2001 Ford III 1FDWE35F61HA57750 361-CNC #4 (783) 2002 Ford III 1FDWE35F82HA21091 696-FRU #5 (784) 2007 Ford III 1FDWE35P27DA96425 677-PVW #6 (785) 2003 Ford III 1FDWE35F53HA60870 871-ILR #7 (786) 2005 Ford III 1FDWE35P06HA92445 022-NRG MEDICAL ADVISOR: Diana Hearne, M.D. (Name/Credentials) The inspection of the above named ambulances was made on 6/27/2008 by Staci Bruce, RN and Bethany Van Wyk, RN .This ambulance service has met permit requirements for Eagle County as established in the resolution as approved by the Board of Commissioners May 2007. }~ INSPECTOR(s): (Signature) +~'-' (Type Name & Credentials) Staci Bruce, RN (Type Name & PUBLIC HEALTH A MINISTRATOR APPROVAL TO ISSUE PERMIT: ~.._-__- (Si e) Jill H Baker, MPH Date: