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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br />1868 E. Hazelton Ave • Stockton, CA 95205-6232 • Phone (209) 468-3420 <br />Jaspt Kang, R.E.H.S., Director <br />ENVIRONMENTAL HEALTH <br />PERMIT TO OPERATE - PE 4120 -BODY ART FACILITY -SINGLE USE <br />Permit ID # PT0025508 for Record ID # PR0541621 <br />Valid From 7/1/2021 To 6/30/2022 <br />PERMIT TO OPERATE - PE 4110 - BODY ART PRACTITIONER REGISTRATION <br />Permit ID # PT0025509 for Record ID # PR0541622 <br />Valid From 711/2021 To 6/30/2022 <br />PERMITS TO OPERATE aze NOT TRANSFERABLE <br />and may SUSPENDED or REVOKED for cause. <br />PERMIT(s) Valid only for: GREEN-FRESE, ERICA <br />DBA: VERSAILLES SALON <br />THIS FORM MUST BE DISPLAYED CONSPICUOUS <br />LY ON TRE PREMISES <br />Regulated Facility: <br />VERSAILLES SALON (GREEN-FRESE, ERICA) Facility ID FA0023856 <br />1010 CENTRAL AVE Account ID AR0044221 <br />TRACY, CA 95376 Issued 5/10/2021 <br />Billing Address: <br />ATTN : GREEN-FRESE, ERICA <br />VERSAILLES SALON (GREEN-FRESE, ERICA) <br />2108 DEBORAH ST <br />TRACY, CA 95376 <br />combinedrpt End of report <br />