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SAN JOAQUIP60UNTY ENVIRONMENTAL HEALTIIEPARTMENT <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# PT0025250 for Record ID#PR0541182 <br /> Valid From 7/1/2017 To 6/30/2018 <br /> PERMITS TO OPERATE are NOT TRANSFERABLE <br /> and may be SUSPENDED or REVOKED for cause. <br /> PERMIT(s)Valid only for: PEREZ,JORGE U <br /> DBA: BLACK ROSE TATTOO <br /> THIS FORM MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES <br /> Regulated Facility: BLACK ROSE TATTOO (PEREZ,JORGE) Facility ID FA0023583 <br /> 237 E MINER AVE .Account ID AR0043548 <br /> STOCKTON CA 95202 Issued 5/31/2017 <br /> Billing Address: ATTN : PEREZ, JORGE U <br /> BLACK ROSE TATTOO <br /> 237 E MINER AVE <br /> STOCKTON CA 95202 <br /> 7o27.rpt <br />