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COMPLIANCE INFO
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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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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kr� <br /> SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> h s <br /> s 1868 E. Hazelton Ave. • Stockton,CA 95205-6232 • Phone(209)468-3420 <br /> Y Donna Heran,R.E.H.S.,Director <br /> ENVIRONMENTAL HEALTH <br /> °i'Y. <br /> PERMIT TO OPERATE - 4110-BODY ART PRACTITIONER REGISTRATION <br /> a f r P g ,� . ._ "1, rte, �,:,?' �r <br /> ` ^se's :xx <br /> Permit ID# PT0015166 for Record ID# PRO522429' <br /> tp` <br /> h sF Valid From 7/1/2012 To 6/30/2013 <br /> f Ines q ^ <br /> 5 i n S,ris ? r eylsti < F <br /> i <br /> 3: <br /> p <br /> c r, <br /> dd z f� <br /> to-47. <br /> 4 <br /> x <br /> V,I <br /> c 7. <br /> x` <br /> �3 <br /> ° `zqa, <br /> y <br /> x <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 FORM MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES <br /> Regulated Facility: ANCHORS AWAY(JAMES MORAL) Facility iD FA0015262Account ID AR0026270 <br /> 209 E KETTLEMAN LN <br /> LODI CA 95240 issued 10/16/2012 <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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