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COMPLIANCE INFO
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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KETTLEMAN
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1110
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4100 – Safe Body Art
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PR0522429
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COMPLIANCE INFO
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Entry Properties
Last modified
6/13/2023 4:13:40 PM
Creation date
3/21/2023 9:05:08 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4100 – Safe Body Art
File Section
COMPLIANCE INFO
RECORD_ID
PR0522429
PE
4110
FACILITY_ID
FA0015262
FACILITY_NAME
THE FRECKLED ROSE TATTOO (MORAL, JAMES)
STREET_NUMBER
1110
Direction
W
STREET_NAME
KETTLEMAN
STREET_TYPE
LN
City
LODI
Zip
95240
CURRENT_STATUS
02
SITE_LOCATION
1110 W KETTLEMAN LN STE 20B
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\cfield
Tags
EHD - Public
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y E <br /> jg— <br /> r . <br /> <b.x. .� <br /> Uy" - <br /> SAN JOAQULv COUNTY ENVIRONMENTAL HEALTR DEPARTMENT-":,- <br /> 1868 <br /> EPARTMENT 1868 E. Hazelton Ave. • Stockton CA 95205-6232 0 Phone 209 468-3420 <br /> ;2- <br /> �:- n Donna Heran,R.E.H.S.,Director =` <br /> W.1 Vo <br /> ENVIRONMENTAL HEALTH <br /> u � � <br /> k� c 4p PERMIT TO OPERATE 4110 BODY ART PRACTITIONER REGISTRATION r <br /> x <br /> . <br /> Permit ID# PT0015166 for Record ID# PR0522429 ' tf11"- } „ <br /> Valid From 7/1/2013 To 6/30/2014 <br /> 44, <br /> WV <br /> 44 <br /> Yt $ +'a' . <br /> t <br /> g t r V <br /> .Sr< � t +�`R' �,, r��'��. -i k �` �` �`�'rw�`� •� g'�"' -fie a,� } d .: b" <br /> k4R <br /> y _dye <br /> d' moi <br /> Sys t i ka d° <br /> PERMITS TO OPERATE are NOT TRANSFERABLE <br /> and may be SUSPENDED or REVOKED for cause. <br /> PERMIT(s)Valid only for: MORAL,JAMES B <br /> DBA: ANCHORS AWAY (JAMES MORAL) <br /> THIS FORAI MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES <br /> Regulated Facility: ANCHORS AWAY (JAMES MORAL) Facility iD FA0015262 <br /> Account ID AR0026270 <br /> 209 E KETTLEMAN LN issued 6/4/2013 <br /> LODI CA 95240 <br /> Billing Address: ATTN : MORAL, JAMES B <br /> ANCHORS AWAY(JAMES MORAL) <br /> 1794 WHITNEY ST <br /> STOCKTON CA 95210 <br />
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