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<br /> SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT
<br /> 1868 E. Hazelton Ave. • Stockton, CA 95205-6232 • Phone (209) 468-3420
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<br /> Donna Heran,R.E.H.S.,Director
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<br /> tPx � Pcz PERMIT TO OPERATE 4110-BODY ART PRACTITIONER REGISTRATION li
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<br /> Permit ID# PT0023205 for Record ID# PRO537718
<br /> Valid From 4/22/2013 To 6/30/2013
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<br /> PERMITS TO OPERATE are NOT TRANSFERABLE
<br /> and may be SUSPENDED or REVOKED for cause.
<br /> 1 r; PERMIT(s)Valid only for: SHEA,THOMAS F fi
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<br /> THIS FORM MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES
<br /> Regulated Facility:. WRONG SIDE OF THE TRACKS (SHEA,THOM
<br /> Facility ID FA0021737
<br /> 512 N UNION RD Z, yob ' r Ott F Account ID AR0039486
<br /> MANTECA CA 95336 � �f a aX:n' � ; + x,q �+ i� rr wL. Issued 4/22/2013
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<br /> Billing Address: ATTN : SHEA, THOMAS F
<br /> WRONG SIDE OF THE TRACKSSHEAr THOMAS
<br /> 1951 SCARBOROUGH DR APT 10 )
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<br /> LODI CA 95240 ,,,
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<br /> 7020 rptrx
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