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4100 – Safe Body Art
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PR0537638
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Entry Properties
Last modified
6/4/2024 1:05:36 PM
Creation date
5/5/2023 10:31:05 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4100 – Safe Body Art
File Section
BILLING
RECORD_ID
PR0537638
PE
4110
FACILITY_ID
FA0021679
FACILITY_NAME
LIVING WATER STUDIOS (PAK, SOPHOLLIE)
STREET_NUMBER
210
Direction
N
STREET_NAME
MAIN
STREET_TYPE
ST
City
MANTECA
Zip
95336
CURRENT_STATUS
01
SITE_LOCATION
210 N MAIN ST
P_LOCATION
04
QC Status
Approved
Scanner
SJGOV\cfield
Tags
EHD - Public
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r <br /> SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 E. Hazelton Ave. • Stockton, CA 95205-6232 • Phone (209) 468-3420 <br /> Donna Heran,R.E.H.S.,Director <br /> ENVIRONMENTAL HEALTH <br /> PERMIT TO OPERATE - 4110-BODY ART PRACTITIONER REGISTRATION <br /> Permit ID# PT0023118 for Record ID# PR0537638 <br /> Valid From 7/1/2012 To 6/30/2013 <br /> t <br /> 1 <br /> f <br /> x <br /> , r <br /> it <br /> y <br /> '} <br /> PERMITS TO OPERATE are NOT TRANSFERABLE <br /> and may be SUSPENDED or REVOKED for cause. <br /> k PERMIT(s)Valid only for: PAK, SOPHOLLIE <br /> r ' <br /> THIS FORM MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES <br /> Regulated Facility: LOYALTY TAT>r0'OS-(PAK,SOPHOLLIE) Facility ID FA002161t <br /> Account lD AR0039$21 , <br /> 707 E MARdirl LN <br /> k ' STQCKTQIV CA,;95Q7issued 212812013- <br /> ' <br /> Billing Address: AT" P1 . -PAK, SOPHOLLIE <br /> LOYALTY TATTOOS (PAK, SOPHOLLIE) z ' <br /> 814 ASTOR DR <br /> STOCKTON CA 95210 ` . <br /> i <br /> . x <br /> r', <br />
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