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SAN JOAQU*OUNTY ENVIRONMENTAL REAL EPARTMENT <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 ID# PT0024614 for Record ID# PRO540006 <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: WITT,JESSIE R <br /> DBA: BLACK ROSE TATTOO PARLOR <br /> THIS FORM MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES <br /> Regulated Facility: BLACK ROSE TATTOO PARLOR(JESSIE WIT Facility ID FA0022861 <br /> 237 E MINER AVE Ac—untlD AR0041931 <br /> STOCKTON CA 95202 Issued 8/29/2017 <br /> Billing Address: ATTN : WITT, JESSIE R <br /> BLACK ROSE TATTOO PARLOR - <br /> 154 BLAIN AVE <br /> STOCKTON CA 95204 <br /> 7o27.rpt <br />