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SAN JOAQUI&UNTY ENVIRONMENTAL HEALTOEPARTMENT <br />1868 E. Hazelton Ave. • Stockton, CA 95205-6232 • Phone (209) 468-3420 <br />Linda Turkatte, R.E.H.S., Director <br />ENVIRONMENTAL HEALTH <br />PERMIT TO OPERATE - 4110 - BODY ART PRACTITIONER REGISTRATION <br />Permit ID # PT0025379 for Record ID # PR0541380 <br />Valid From 7/1/2017 To 6/30/2018 <br />PERMITS TO OPERATE are NOT TRANSFERABLE <br />and may be SUSPENDED or REVOKED for cause. <br />PERMIT(s) Valid only for: CHAVEZ, MIRANDA L <br />DBA: BLUE MOON TATTOO <br />THIS FORM MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES <br />Regulated Facility: BLUE MOON TATTOO (CHAVEZ, MIRANDA) Facility ID FA0023710 <br />2306 EAST ST Account ID AR0043863 <br />TRACY CA 95377 Issued 8131/2017 <br />Billing Address: ATTN : CHAVEZ, MIRANDA L <br />BLUE MOON TATTOO <br />812 W CLOVER RD #63 <br />TRACY CA 95376 <br />7027.rpt <br />