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COMPLIANCE INFO
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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2738
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4100 – Safe Body Art
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PR0541677
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COMPLIANCE INFO
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Entry Properties
Last modified
4/27/2023 11:28:05 AM
Creation date
4/27/2023 10:59:54 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4100 – Safe Body Art
File Section
COMPLIANCE INFO
RECORD_ID
PR0541677
PE
4110
FACILITY_ID
FA0023886
FACILITY_NAME
IN 2 SKIN (PHASAVATH, NATHAN)
STREET_NUMBER
2738
STREET_NAME
PACIFIC
STREET_TYPE
AVE
City
STOCKTON
Zip
95204
CURRENT_STATUS
02
SITE_LOCATION
2738 PACIFIC AVE
P_LOCATION
01
QC Status
Approved
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SJGOV\cfield
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EHD - Public
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SAN JOAQUIOOUNTY ENVIRONMENTAL HEAL*EPARTMENT <br />1868 E. Hazelton Ave., • Stockton, CA 95205-6232 • Phone (209) 468-3420 <br />Linda 11irkatte, R.E.H.S., Director <br />ENVIRONMENTAL HEALTH <br />PERMIT TO OPERATE - 4110 - BODY ART PRACTITIONER REGISTRATION <br />Permit ID # PT0025534 for Record ID # PR0541677 <br />Valid From 2/27/2017 To 6/30/2017 <br />PERMITS TO OPERATE are NOT TRANSFERABLE <br />and may be SUSPENDED or REVOKED for cause. <br />PERMIT(s) Valid only for: PHASAVATH, NATHAN <br />DBA: IN 2 SKIN <br />THIS FORM MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES <br />Regulated Facility: IN 2 SKIN (PHASAVATH, NATHAN) Facility ID FA0023886 <br />2738 PACIFIC AVE Account ID AR0044296 <br />STOCKTON CA 95204 issued 3/3/2017 <br />Billing Address: ATTN : PHASAVATH, NATHAN <br />IN 2 SKIN <br />501 RIVERGATE WAY APT 258 <br />SACRAMENTO CA 95813 <br />7027. rpt <br />
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