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4100 – Safe Body Art
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PR0541390
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Last modified
10/4/2023 12:47:34 PM
Creation date
5/5/2023 10:50:28 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4100 – Safe Body Art
File Section
BILLING/PERMITS
RECORD_ID
PR0541390
PE
4110
FACILITY_ID
FA0023716
FACILITY_NAME
LIVING WATER STUDIOS (ROMAN, MACKENZIE)
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
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EHD - Public
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SAN JOAQLOCOUNTY ENVIRONMENTAL HEAL DEPARTMENT <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#PT0025385 for Record ID#PR0541390 <br /> Valid From 10/31/2016 To 6/30/2017 <br /> , I <br /> iJ <br /> I <br /> PERMITS TO OPERATE are NOT TRANSFERABLE <br /> and may be SUSPENDED or REVOKED for cause. <br /> PERMIT(s)Valid only for: ROMAN, MACKENZIE <br /> DBA: LIVING'WATER STUDIOS <br /> THIS FORM MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES <br /> Regulated Facility: LIVING WATER STUDIOS (ROMAN, MACKENZIE) Facility ID FA0023716 <br /> 210 N MAIN ST Account ID AR0043876 <br /> MANTECA, CA 95336 Issued 11/1/2016 <br /> Billing Address: ATTN : ROMAN, MACKENZIE <br /> LIVING WATER STUDIOS ' <br /> 210 N MAIN ST <br /> MANTECA, CA 95336 <br /> I <br /> 7o2a.rpt { <br /> a _ <br /> � j <br />
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