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SAN JOAQUI#OUNTY ENVIRONMENTAL HEALTSEPARTMENT <br /> 1868 E.Hazelton Ave. 0 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 ID# PT0023001 for Record ID# PR0537482 <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: ESCALANTE, DENNIS M <br /> DBA: BLACK ROSE TATTOO <br /> THIS FORM MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES <br /> Regulated Facility: BLACK ROSE TATTOO (ESCALANTE, DENNI! Facility ID FA0021564 <br /> 237 E MINER AVE Account ID AR0039036 <br />` STOCKTON CA 95202 Issued 8/31/2017 <br /> Billing Address: ATTN : ESCALANTE, DENNIS M <br /> BLACK ROSE TATTOO <br />` 237 E MINER AVE <br /> r <br /> STOCKTON CA 95202 <br /> i` <br /> 7oz7.rPt <br />