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<br /> r SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT
<br /> 1868 E. Hazelton Ave. • Stockton CA 95205-6232 • Phone(209) 468-3420 t # '
<br /> Donna Heran,R.E.H.S.,Director ipe
<br /> ENVIRONMENTAL HEALTH
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<br /> PERMIT TO OPERATE - 4110-BODY ART PRACTITIONER REGISTRATION
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<br /> Permit ID# PT0023245 for Record ID# PR0537779 '
<br /> Valid From 5/23/2013 To 6/30/2013 M
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<br /> PERMITS TO OPERATE are NOT TRANSFERABLE #
<br /> and may be SUSPENDED or REVOKED for cause atro r �
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<br /> PERMIT(s)Valid only for: MAXIMUS, DAVNCI
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<br /> THIS FORM MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES „e
<br /> �; a Facility ID FA0021784 °
<br /> Regulated Facility: PINS & NEEDLES (MAXIMUS, DAVNCI) ' '
<br /> 64 W ELEVENTH ST# B
<br /> } t ,t�� � h, x �,, Account ID AR0039612
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<br /> TRACY CA 95376 f % � �( '�, "' Issued5/3112013r Y ,
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<br /> Billing Address: ATTN . MAXIMUS, DAVNCI ' �� ytk('AL'� '`s�x
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<br /> PINS & NEEDLES (MAXIMUS,
<br /> 241 E TENTH ST � �
<br /> TRACY CA 95376 �
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