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r SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 E. Hazelton Ave. • Stockton, CA 95205-6232 • Phone (209)468-3420 <br /> ENVIRONMENTAL HEALTH <br /> 4 a <br /> PERMIT TO OPERATE - 4110-BODY ART PRACTITIONER REGISTRATION <br /> Permit ID# PT0022995 for Record ID# PR0537476 <br /> ,." <br /> :. a� � Valid From 7/1/2012 To 6/30/2013 <br /> {'' <br /> q <br /> 4- <br /> Lw �� � A:ui }�r ^•.` ,�L r1 g: ,a + 1Y^%-3^r' '�"y*. �' �. <br /> '4,aY` <br /> 14, <br /> ¢gy,� <br /> 3 <: � "#•• ' ` 4�.#`��""` E '�"g'�'a+ � :L- "�` �� {�t <br /> s <br /> � .� fi <br /> ji aj & 7<rS �k��` fl`,m i 'a > r i,.: R <br /> r` t' a` ,-�i , ` �` ,PS.'+7'i P✓' .� �'" 3 }` 4rif'� <br /> '+^,a ± <br /> r*50 <br /> Vw <br /> s,= <br /> fiP Y ' � k , <br /> PERMITS TO OPERATE are NOT TRANSFERABLE <br /> w and may be SUSPENDED or REVOKED for cause. <br /> PERMIT(s)Valid only for: MARCOS, ADAME <br /> THIS FORM MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES <br /> Regulated Facility: SECRET SIDEWALK TATTOO (MARCOS ADAI Facility ID FA0021558 <br /> t` account ID AR0039030 <br /> 6 W ELEVENTH ST § <br /> TRACY CA 95376 ' �fr g Issued 10/23/2012 <br /> # •,,� i e r s i - <br /> Billing Address: ATTN : ADAME, MARCOS <br /> SECRET SIDEWALK TATTOO (MARCOS ADAME) <br /> 2079 BUENA VISTA DR <br /> MANTECA CA 95337 x <br /> F, y, <br /> v <br /> t I 7 <br /> w. <br /> 5 <br /> t� <br />