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HomeMy WebLinkAboutC10-212 Ambulance Service License EC Health Service District EAGLE COUNTY AMBULANCE SERVICE LICENSE .~.~._ EAGLE COUNTY LICENSURE DATE: From: 7/1/2010 To: 6/30/2011 AMBULANCE SERVICE: _ Eagle County Health Service District ADDRESS: _ PO Box 990 Edwards, CO 81632 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 6/10/2010 by _Staci Bruce, RN and Carmella Glover„ 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) k-'^-' (Type Name & Credentials)Staci Bruce, RN 9 ~ (Signature) ~ ~ jM-4.-~ 1 '~"" (Type Name & Credentials)Carmella Glover, RN PUBLIC HEALTH DIRECTOR APPROVAL TO ISSUE LICENSE: Rachel Oys, Public Heath Director Date:~,~ 1 ~~ ~~~~ . ~;~ u-~. ~~-y-- EAGLE COUNTY AMBULANCE VEHICLE PERMIT fA6Lf COUNTY PERMIT DATE: From: 7/1/2010 To: 6/30/2011 AMBULANCE SERVICE: Eag1_e County Health Service District ADDRESS: PO Box 990 Edwards, CO 81632 PHONE: 970-926-5270 FAX: 970-926-5235 VEHICLE YEAR MAKE TYPE VIN CO-REGISTRATION #1 (780) 2003 Ford E-350 1FDWE35F33HB42189 10.0845A #2 (781) 2004 Ford E-350 1FDWE35P15HA12813 10.0844A #3 (782) 2007 Ford E-350 1FDWE35P27DB07679 10.0104A #4 (783) 2007 Ford E-350 1FDWE35P77DB00744 lO.OlOSA #5 (784) 2007 Ford E-350 1FDWE35277DA96425 10.0848A #6 (785) 2003 Ford E-350 1FDWE35F53HA60870 I0.0849A #7 (786) 2005 Ford E-350 1FDWE35P06HA92445 10.0850A #8 (787) 2009 Ford E-350 1FDWE35P19DA71499 10.1701A MEDICAL ADVISOR: Diana Hearne, M.D. (Name/Credentials) The inspection of the above named ambulances was made on 6/10/2010 by Staci Bruce, RN and Carmella Glover, RN .This ambulance service has met permit requirements for Eagle County as established in the resolution as ap oved by the Board of Commissioners May 2007. INSPECTOR(s): (Signature) (Type Name & Credentials) taci Bruce, RN 7 (Signature) ~~~f'~'l~°- ~~ ~°'°- (Type Name & Credentials) Carmella Glover, RN PUBLIC HEALTH ADMINISTRATOR APPROVAL TO ISSUE PERMIT: (Signature) Rachel Oys, Public ealth Director Date: