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SAN JOAQ*kDUNTY ENVIRONMENTAL HEAL*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# PT0023136 for Record ID# PR0537653 <br /> Valid From 7/1/2015 To 6/30/2016 <br /> PERMITS TO OPERATE are NOT TRANSFERABLE <br /> and may be SUSPENDED or REVOKED for cause. <br /> PERMIT(s)Valid only for: QUEZADA,JESSE <br /> THIS FORM MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES <br /> Regulated Facility: BLACK ROSE TATTOO (QUEZADA,JESSE) Facility ID FA0021688 <br /> 237 E MINER AVE Account ID AR0039346 <br /> STOCKTON CA 95202--232 Issued 5/28/2015 <br /> Billing Address: ATTN : QUEZADA, JESSE <br /> BLACK ROSE TATTOO (QUEZADA, JESSE) <br /> 334 E 21 ST ST <br /> TRACY CA 95376 <br /> 7027.rpt <br />