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s.4}x.,3Z <br /> 5'77, <br /> SAN JOA UIN COUNTY ENVIRONMENTAL HEALTH EPARTMENT <br /> 1868 E. Hazelton Ave. • Stockton, CA 95205-6232 • Phone (209)468-3420 z q <br /> Donna Heran,R.E.H.S.,Director <br /> ENVIRONMENTAL HEALTH , <br /> �+�i� y'R���z '�,.-+. a'`S'� 'x�� t��x M:. � '�r �r'?�q • <br /> PERMIT TO OPERATE - 4110-BODY ART PRACTITIONER REGISTRATION � z `� <br /> �.. r w y -,y 'K "+,''a•SibY'€.7�x'`.. reezt ;R,,,a,;d %s a:,+.„~ r <br /> ._� Permit ID# PT0022589 for Record ID#PRO536973 <br /> Valid From 7/1/2012 To 6/30/2013 <br /> T <br /> UN, x <br /> ' a �. u rn t <br /> v .5 <br /> In I <br /> r �,� S F ; f _ *X,� �' � -aeit� 44*'4+ . ) f}• �,: <br /> �+i.p._ a s�.Fq° ` x tT�! <br /> ,e Rw 46411 <br /> WR +two" „ '9zc <br /> + <br /> At <br /> # .4 &N, "I <br /> � <br /> 7 � }.s ^� � -s;�s� "'�,� -.+as 5y t; �r ��'� ,� xx rv� ro•� } <br /> F'#rir P N 4•t , FdrSr�Lt:x,:14:ri.' q< f <br /> 7�� <br /> -" 1, <br /> rg k' x t 7 4. £'• r� e AWADI..w,y <br /> ar' 'gI'•,,"'-T_' <br /> °k;. il <br /> t +. # xR res j 1+ ° i:g Y 33al t <br /> � � <br /> a pw as Z 'xsI zt�t <br /> Wgg i'3 ^' ➢ .1 �l�. ;}lpy tY <br /> Yl' _�i"`sss ° xb 'sf'y' Y fi '�4 j �+ �¢ >rN .r 5 w sr ti s L ' <br /> ar F,sg� s. 'y, <br /> Y 4't`^ 4'4T' <br /> $ r a <br /> PERMITS TO OPERATE are NOT TRANSFERABLE ;. „ . <br /> and may be SUSPENDED or REVOKED for cause. <br /> ,s <br /> PERMIT(s) Valid only for: ZUNIGA JOSE M �� � P <br /> r� DBA: BLACK ROSE TATTOO 4 k” =fi�ggh <br /> p >c, q� ,r•,-,_ _ „ - =-�` _.w*n'K«.��r ;� ti, �hC .3`.r�°r0. ,+re t�„',v#al L + .'� vu. t � ��.R�a <br /> THIS FORM MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES <br /> Regulated Facility: ~+T = Facility ID <br /> s v BLACK ROSE TATTOO-ZUNIGA, JOSE <br /> Y FA0021229 <br /> Account ID AR0038342 <br /> 237 E MINER AVE r Issued 10/16/2012 . <br /> STOCKTON CA 95206 � � , <br /> r' K•,Y!'s4 f ry f <br /> � <br /> Billing Address: ATTN . ZUNIGA, JOSE M <br /> BLACK ROSE TATTOO-ZUNIGA, JOSEk � <br /> 237 E MINER AVE + <br /> STOCKTON CA 95202 <br />