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SAN JOAQUII#OUNTY ENVIRONMENTAL HEALTOEPARTMENT <br />1868 E. Hazelton Ave. 9 Stockton, CA 95205-6232 • Phone (209) .468-3420 <br />Linda T11rkatte, R.E.H.S., Director <br />ENVIRONMENTAL HEALTH <br />PERMIT TO OPERATE - 4110 - BODY ART PRACTITIONER REGISTRATION <br />Permit 1D# PT0026881 for Record ID # PR0544374 <br />Valid From 7/1/2019 To 6130/2020 <br />PERMITS TO OPERATE are NOT TRANSFERABLE <br />and may be SUSPENDED or REVOKED for caiise. =i <br />PERMIT(s) Valid only for: LEACH, JACQUELINE <br />DBA: BLUE MOON TATTOO & PIERCING <br />THIS FORM MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES <br />Regulated Facility: BLUE MOON TATTOO & PIERCING (LEACH, J Facility ID FA0025224 <br />2306 EAST ST Account ID AR0047467 <br />TRACY CA 95376 issued 5/1/2019 <br />Billing Address: ATTN : LEACH, JACQUELINE <br />BLUE MOON TATTOO & PIERCING <br />760 QUAKER RIDGE CT <br />LATHROP CA 95330 <br />7o27.rpt <br />