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COMPLIANCE INFO
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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88 (STATE ROUTE 88)
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13500
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4100 – Safe Body Art
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PR0541030
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COMPLIANCE INFO
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Entry Properties
Last modified
11/20/2024 9:23:24 AM
Creation date
7/3/2020 10:13:43 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4100 – Safe Body Art
File Section
COMPLIANCE INFO
RECORD_ID
PR0541030
PE
4120
FACILITY_ID
FA0023514
FACILITY_NAME
THE RAVEN TATTOO & ART GALLERY (FREDERICKSEN, ROBERT)
STREET_NUMBER
13500
STREET_NAME
STATE ROUTE 88
City
LOCKEFORD
Zip
95237
CURRENT_STATUS
02
SITE_LOCATION
13500 HWY 88
QC Status
Approved
Scanner
SJGOV\cfield
Supplemental fields
FilePath
\MIGRATIONS\BA\BA_4120_PR0541030_13500 HWY 88_.tif
Tags
EHD - Public
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SAN JOAQUIMUNTY ENVIRONMENTAL HEALT PARTMENT <br /> 1868 E.Hazelton Ave. • Stockton,CA 95205-6232 • Phone(209)468-3420 <br /> Linda Turkatte,R.E.H.S.,Director <br /> ENVIRONMENTAL HEALTH <br /> PERMIT TO OPERATE - 4110-BODY ART PRACTITIONER REGISTRATION <br /> Permit 1D# PT0025203 for Record ID# PR0541071 <br /> Valid From 7/1/2017 To 6/30/2018 <br /> PERMITS TO OPERATE are NOT TRANSFERABLE <br /> and may be SUSPENDED or REVOKED for cause. <br /> PERMIT(s)Valid only for: FREDRICKSEN, ROBERT <br /> DBA: FORSAKEN TATTOO <br /> THIS FORM MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES <br /> Regulated Facility: FORSAKEN TATTOO (FREDERICKSEN, ROBE Facility ID FA0023514 <br /> 13500 HWY 88 Aunt ID AR0043358 <br /> LOCKEFORD CA 95237 Issued 5/31/2017 <br /> Billing Address: ATTN : FREDERICKSEN, ROBERT <br /> FORSAKEN TATTOO <br /> 5705 LARCOM LN <br /> STOCKTON CA 95210 <br /> 7027.rpt <br />
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