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BILLING
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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SWAIN
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505
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4100 – Safe Body Art
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PR0537432
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BILLING
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Entry Properties
Last modified
2/13/2025 12:42:51 PM
Creation date
4/12/2023 1:16:15 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4100 – Safe Body Art
File Section
BILLING
RECORD_ID
PR0537432
PE
4110 - BODY ART PRACTITIONER REGISTRATION
FACILITY_ID
FA0023850
FACILITY_NAME
PORT CITY INK (HERNANDEZ,VICTOR)
STREET_NUMBER
505
Direction
W
STREET_NAME
SWAIN
STREET_TYPE
RD
City
STOCKTON
Zip
95207
CURRENT_STATUS
Active, billable
SITE_LOCATION
505 W SWAIN AVE
P_LOCATION
02
QC Status
Approved
Scanner
SJGOV\cfield
Supplemental fields
Site Address
1012 W LODI AVE LODI 95240
Tags
EHD - Public
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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br />1868 E. Hazelton Ave • Stockton, CA 95205-6232 • Phone (209) 468-3420 <br />Jasjit Kang, R.E.H.S., Director <br />ENVIRONMENTAL HEALTH <br />PERNIIT TO OPERATE - PE 4110 - BODY ART PRACTITIONER REGISTRATION <br />Permit ID # PT0022951 for Record ID # PR0537432 <br />Valid From 7/26/2021 To 6/30/2022 <br />PERMITS TO OPERATE are NOT TRANSFERABLE <br />and may be SUSPENDED or REVOKED for cause. <br />PERMIT(s) Valid only for: HERNANDEZ, VICTOR <br />DBA: OLD VINE TATTOOS <br />TRIS FORM MUST BE DISPLAYED CONSPICUOUSLY ON TAE PREMISES <br />Regulated Facility: OLD VINE TATTOO (HERNANDEZ,VICTOR) Facility <br />BillingAddress: <br />ID <br />FA0023850 <br />521 W KETTLEMAN <br />LN <br />AccounuD <br />AR0044201 <br />LODI CA 95240 <br />Issued <br />7/28/2021 <br />ATTN : HERNANDEZ, VICTOR <br />OLD VINE TATTOO <br />405 ESPERAZA WAY <br />STOCKTON CA 95207 <br />7027.rpt End of Report <br />
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