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EnvironmentalHealth
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EHD Program Facility Records by Street Name
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ELEVENTH
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4100 – Safe Body Art
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PR0540594
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BILLING/PERMITS
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Entry Properties
Last modified
11/19/2024 10:19:14 AM
Creation date
5/1/2023 3:58:57 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4100 – Safe Body Art
File Section
BILLING/PERMITS
RECORD_ID
PR0540594
PE
4110
FACILITY_ID
FA0023220
FACILITY_NAME
IN BLOOM TATTOO & PIERCING STUDIO (THAW, KYLE)
STREET_NUMBER
18
Direction
E
STREET_NAME
ELEVENTH
STREET_TYPE
ST
City
TRACY
Zip
95377
CURRENT_STATUS
01
SITE_LOCATION
18 E ELEVENTH ST STE B
P_LOCATION
03
QC Status
Approved
Scanner
SJGOV\cfield
Tags
EHD - Public
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s a. t <br /> C _ ;,a. �E: « '". <br /> SAN"JOA 1OUNTYENVIRON . <br /> Q MENTAL HEALTt ,DEPARTMENT. , <br /> 1868 E.Hazelton Ave. • Stockton, CA 95205-6232 • Phone(( �209 468-3420 " <br /> � l <br /> Linda Turkatte,R.E.H.S.,DirectorTV <br /> ENVIRONMENTAL HEALTH ¢ . <br /> PERMIT TO OPERATE - 4110-BODY ART PRACTITIONER REGISTRATION <br /> Permit ID# PT0024919 for Record ID# PR0540594 <br /> Valid From 11/17/2015 To 6/30/2016 <br /> 1 <br /> s4 , <br /> €t <br /> n ,rre <br /> MR <br /> t" xi <br /> &&jSp. <br /> a ` <br /> , <br /> PERMITS TO OPERATE are NOT TRANSFERABLE <br /> and may be SUSPENDED or REVOKED for cause. <br /> �5 <br /> PERMIT(s)Valid only for: THAW, KYLE <br /> DBA: BLUE MOON TATTOO/PIERCING " r <br /> r; <br /> THIS FORM MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES <br /> Regulated Facility: BLUE MOON TATTOO/PIERCING Facility ID FA0023220 <br /> 2306 EAST ST Account ID AR0042695 « �t. <br /> TRACY CA 95377 Issued 11/23/2015 <br /> Billing Address: x <br /> ATTN : THAW, KYLE <br /> BLUE MOON TATTOO/PIERCING <br /> 90 E GRANT LINE RD#3 <br /> TRACY CA 95376 <br /> - <br /> 7027.rpt . <br /> r w K J s• <br />
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