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SAN JOAQU-Al COUNTY ENVIRONMENTAL HEAL'1 W DEPARTMENT <br />1868 E. Hazelton Ave. • Stockton, CA 95205-6232 • Phone (209) 468-3420 <br />Linda Turkatte, RE.H.S., Director <br />ENVIRONMENTAL HEALTH <br />PERMIT TO OPERATE - 4110'- BODY ART PRACTITIONER REGISTRATION <br />Permit ID # PT0024722 for Record ID # PR0540147 <br />Valid From 5/26/2015 To 6/30/2015 <br />PERMITS TO OPERATE are NOT TRANSFERABLE <br />and may be SUSPENDED or REVOKED for cause. <br />PERMIT(s) Valid only for: CORBIN, DANIEL W <br />DBA: BLUE MOON TATTOO (CORBIN, DANIEL) <br />THIS FORM MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES <br />Regulated Facility: BLUE MOON TATTOO (CORBIN, DANIEL) Facility ID FA0022956 <br />2395 .EAST ST Account ID AR0042107 <br />TRACY CA 95376 issued 5/29/2015 <br />Billing Address: ATTN : CORBIN, DANIEL <br />BLUE MOON TATTOO (CORBIN, DANIEL) <br />385 MARSALA CT <br />MANTECA CA 95337 <br />7o2o.rpt <br />