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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 4110 -BODY ART PRACTITIONER REGISTRATION <br />Permit ID # PT0026445 for Record ID # PR0544069 <br />Valid From 7/1/2021 To 6/30/2022 <br />PERMITS TO OPERATE aze NOT TRANSFERABLE <br />and may be SUSPENDED or REVOKED for cause. <br />PERMIT(s) Valid only for: WILSON, DAN <br />DBA: BLUE MOON TATTOO <br />THIS FORM MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES <br />Regulated FacBiry: BLUE MOON TATTOO (WILSON, DAN) Facility ID FA0025068 <br />2306 EAST ST Account ID AR0047098 <br />TRACY, CA 95376 Issued 5/10/2021 <br />Billing Address: <br />ATTN : WILSON, DAN <br />BLUE MOON TATTOO <br />233 ALVARADO WAY <br />TRACY, CA 95376 <br />combinedrpl End of report <br />