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�� <br /> la SAN O <br /> JOAQUIOUNTY ENVIRONMENTAL HEALTI3 i�LPARTMENT <br /> 1868 E. Hazelton Ave. • Stockton,CA 95205-6232 • Phone (209) 468-3420 F 3 <br /> Donna Heran,R.E.H.S.,Director ' <br /> ENVIRONMENTAL HEALTH s Kp� <br /> 5 <br /> .�� i+3< <br /> PERMIT TO OPERATE - 4110 -BODY ART PRACTITIONER REGISTRATION y <br /> ,= aK'r + ,r,- .>: :'-"•r` -�.�' .., � �. 7� .� '"; �`v,'a1i ��'"ai �` � "r�."�rs--� `yak"`:*..�'�q ��3��. <br /> Permit ID# PT0023901 for Record ID#PR0538645 ° '� ' <br /> � 4 <br /> Valid From 7/1/2013 To 6/30/2014 <br /> t ;e^X�'kT e+3 +G'sx�.� k �✓,k K "Yt"y" +b+ <br /> gn- <br /> { K71 <br /> t ; . <br /> a'w <br /> �� k <br /> j <br /> f" 'F �� <br /> 55 <br /> A�^>v' <br /> '� <br /> f s,� .�( z�. � � - r, ✓R"3 �� � Y t k-r 'F ~s^ ' 1 i r '� e <br /> vw <br /> n�i r ar iii a Xryc <br /> ; �`�' <br /> �7F ,� } uy a �'��� et �' 9 �i v� � zM t p•aJ <br /> ,�� �� G { , ✓ ,+c x s F=r #�` a 3..g3"6;� '7 $ �t x F �� <br /> }. $ $-ar, y- e � K+K r r� dt N'i v f "' <br /> 3+y .1 av &� }, +, v*° - <br /> ,rr �ya ,a'i. ,Y�, � » � +lz r <br /> F 3 <br /> 4-sr,a'fe-x yA <br /> a ; <br /> v5 t 5 a )x <br /> �'{ <br /> 'i rCdn r1w �, d nr5" <br /> PERMITS TO OPERATE are NOT TRANSFERABLE <br /> and may be SUSPENDED or REVOKED for cause. <br /> PERMIT(s)Valid only for: RIVERA GERARDO r � " <br /> r' rri'd .Ib <br /> THIS FORM MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES <br /> Regulated Facility:, GRAPE CITY(RIVERA,,GERARDO) Facility ID <br /> FA0022192 � <br /> r ; k Account Io AR0040463 <br /> 830 S CENTRAL AVE {, ,, , <br /> r f , y A o 2 Issued 2/4/2014 r <br /> LODI CA 95240 rd y � , <br /> . '1"x.3 a"AY! <br /> r.,x <br /> .. '✓xy a'. ;M 'r,', ,, th',^ r uw r� ? i" rf > ^� t a tr a KE r• <br /> t <br /> 11-11 <br /> BiiiingAddress:' ATTN . RIVERA, GERARDO <br /> GRAPE CITY (RIVERA, GERARDO) <br /> � <br /> 5246 MILLER AVEfx <br /> r -F xtvm <br /> STOCKTON CA 95215 � A) .' <br /> 1�� <br /> J : <br /> 7020.rpt it `�•�o-"Y ! �p "�" {." , '...ws. �'5� 4f -�i„' y 2i ' >'c� ,+tE'rt�r 6 <br />