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HomeMy WebLinkAboutC08-236EAGLE COUNTY AMBULANCE SERVICE LICENSE ~'1 EAGLE COUNTY LICENSURE DATE: From: 7/1/2008 To: 6/30/2009 AMBULANCE SERVICE: -Western Eagle County Ambulance District ADDRESS: _ PO Box 1809 Eagle, CO 8163 PHONE: 970-328-113 FAX: 970-328-1132 MEDICAL ADVISOR: Benji Kitagawa, D (NamefCredentials) The inspection of the above named ambulance service was made on _6/25/2008 by _Staci Bruce, RN and Linda Maggiore, 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. ~i- 1NSPECTOR(s): (Signature) (Type Name & Credentials) ~ci j~ruce, RN (Signature) 1.NV-(SC,~ ~ t ~~ "`'`j'am/ (Type Name & Credentials) Linda Maggiore, RN Date: ~' t3 'O~ EAGLE COUNTY AMBULANCE VEHICLE PERMIT PERMIT DATE: From: 7/1/2008 To: 6/30/2009 AMBULANCE SERVICE: Western Eagle County Ambulance District ADDRESS: PO Box 1809 Eagle, CO 81631 PHONE: 970-328-1130 FAX: 970-328-1132 VEHICLE YEAR MAKE TYPE VIN CO-REGISTRATION #1 (803) 2003 Ford E450 1FDXE45F43HA19141 960-HOL #2 (802) 2003 Ford E450 1FDXE45F63HA19142 933-HOL #3 (804) 2001 Ford E450 iFDXE45F73HA60864 861-NBW MEDICAL ADVISOR: Benji Kitagawa, M.D. (Name/Credentials) The inspection of the above named ambulances was made on 6/25/2008 by Staci Bruce, RN and Linda Maggiore, 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) StacisBruce, RN (Signature) "~ ~ ~ ~SS~~~ I (Type Name & Credentials) Linda Maggiore, RN PUBLIC I~EALTH ADMINISTRATOR APPROVAL TO ISSUE PERMIT: (Suture) X111 Hlxrlsaker, MPH Date: J ~ ~