HomeMy WebLinkAboutC12-236 WECAD Ambulance License and Permit EAGLE COUNTY
AMBULANCE SERVICE LICENSE
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EAGLE COUNTY
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LICENSURE VALID FROM: July 1, 2012 to June 30, 2013
AMBULANCE SERVICE: Western Eagle County Health Service District
ADDRESS: PO Box 1809 Eagle, CO 81631
PHONE: 970 - 328 -1130 FAX: 970 -328 -1132
WESTERN EAGLE COUNTY HEALTH SERVICE DISTRICT MEDICAL ADVISOR:
Benji Kitagawa, M.D.
The inspection of the above named ambulance service was made on 6/12/12 by
Jennie Wahrer, 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) `
Jennie Wa er, RN
PUBLIC HEALTH DIRECTOR APPROVAL TO ISSUE LICENSE:
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Jen fer L wig, Pu H Director Date
BY AUTHORITYOF THE EAGLE COUNTY BOARD OF COUNTY COMMISSIONERS:
COUNTY OF EAGLE, STATE OF
COLORADO, By and Through Its
VA 44 c., BOARD OF COUNTY COMMISSIONER
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- - to the Board of Peter Runyon
County Commissioners Chairman
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EAGLE COUNTY
AMBULANCE VEHICLE PERMIT
EAGLE COUNTY
PERMIT VALID FROM: July 1, 2012 to June 30, 2013
AMBULANCE SERVICE: Western Eagle County Health Service District
ADDRESS: PO Box 1809 Eagle, CO 81631
PHONE: 970 -328 -1130 FAX: 970 - 328 -1132
VEHICLE YEAR MAKE VIN CO REGISTRATION
#1 (801) 2008 Ford, E450 1FDXE45P78DA77008 359 -REG
#2 (802) 2003 Ford, E450 1FDXE45F63HA19142 933 -HOL
#3 (803) 2003 Ford, E450 1FDXE45F43HA19141 906 -HOL
#4 (804) 2003 Ford, E450 1FDXE45F73HA60864 861 -NBW
#5 (805) 2011 Mercedes, Benz WD3PE7CD4B5533881 844 -XCN
WESTERN EAGLE COUNTY HEALTH SERVICE DISTRICT MEDICAL ADVISOR:
Benii Kitagawa, M.D.
The inspection of the above named ambulances was made on June 12, 2012 by Jennie
Wahrer, RN. This ambulance has met permit requirements for Eagle County as established
in the resolution as approved by the Board of Commissioners May 2007.
INSPECTOR(s): (Signature) i `1 J
Jennie !ahrer, RN
PUBLIC HEALTH DIRECTOR APPROVAL TO ISSUE PERMIT:
J nifer Ludwig, Pub is Health D'I?ector Date
BY AUTHORITYOF THE EAGLE COUNTY BOARD OF COUNTY COMMISSIONERS:
COUNTY OF EAGLE, STATE OF
� COLORADO, By and Through Its
BOARD OF C TY COMMIS NERS
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ATTEST: + 3
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Clerk to the Boar. of Peter Runyon
County Commissioners Chairman
