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COMPLIANCE INFO
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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E
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88 (STATE ROUTE 88)
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13500
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4100 – Safe Body Art
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PR0537651
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COMPLIANCE INFO
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Entry Properties
Last modified
11/20/2024 9:23:08 AM
Creation date
5/18/2023 10:58:24 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4100 – Safe Body Art
File Section
COMPLIANCE INFO
RECORD_ID
PR0537651
PE
4110
FACILITY_ID
FA0023492
FACILITY_NAME
FORSAKEN TATTOO (HENSON, ANTHONY)
STREET_NUMBER
13500
STREET_NAME
STATE ROUTE 88
City
LOCKEFORD
Zip
95237
CURRENT_STATUS
02
SITE_LOCATION
13500 HWY 88
QC Status
Approved
Scanner
SJGOV\cfield
Tags
EHD - Public
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���,4,��,�,'��tR.# ,• rri ; ^'� u �,.�'. � � � ; s���k ira��jP4: A"t"i4 Y.��.5�.`"�. <br /> ' SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> srt , 1868 E.Hazelton Ave. • Stockton,CA 95205-6232 • Phone(209) 468-3420 <br /> Donna Heran,R.E.H.S.,Director <br /> x ENVIRONMENTAL HEALTH <br /> PERMIT TO OPERATE - 4110-BODY ART PRACTITIONER REGISTRATION t 'max <br /> r <br /> Permit ID# PT0023134 for Record ID#PRO <br /> 537651 ' <br /> 5 Valid From 7/1/2012 To 6/30/2013 <br /> PERMIT TO OPERATE - 4121 -BODY ART FACILITY-STERILIZATION <br /> Permit ID# PT0023135 for Record ID# PR0537652 <br /> Valid From 7/1/2012 To 6/30/2013 <br /> 14. <br /> , <br /> PERMITS TO OPERATE are NOT TRANSFERABLE <br /> and may be SUSPENDED or REVOKED for cause. <br /> PERMIT(s)Valid only for: HENSON, ANTHONY G <br /> THIS FORM MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES <br /> Regulated Facility: FORSAKEN TATTOO Facility ID FA0021687 <br /> Account ID AR0039345 <br /> 13463 HWY 88Issued 3/19/2013 <br /> LOCKEFORD CA 95237 <br /> Billing Address: ATTN : HENSON, ANTHONY G <br /> FORSAKEN TATTOO <br /> 14441 PROSPECT PL <br /> LOCKEFORD CA 95237 <br />
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