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. _ : 'p- P' .�. - q:' �,i re..S.'k•T r gym, <br />` SAN JOAQUn 'OUNTY ENVII20NMENTAL HEALTHEPARTMENT f y <br /> 1868 E. Hazelton Ave. •Stockton,CA 95205-6232 o Phone(209)46873420 <br /> r� <br /> Donna Heran,R.E.H.S.,Director <br /> k <br /> ENVIRONMENTAL HEALTH <br /> PERMIT TO OPERATE - 4110- BODY ART PRACTITIONER REGISTRATION <br /> Permit ID# PT0023407 for Record ID# PR0538002 <br /> Valid From 7/1/2013 To 6/30/2014 <br /> f <br /> zy <br /> l <br /> - - <br /> PERMITS TO OPERATE are NOT TRANSFERABLE <br /> t. <br /> ` and may be SUSPENDED or REVOKED for cause. <br /> PERMIT(s)Valid only for: HARDCASTLE, JEFF L <br /> a DBA: HI TIMES <br /> THIS FORM MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES <br /> i" Facility ID FA0021939 <br /> Regulated Facility: HI-TIMES (HARDCASTLE,JEFF) <br /> Account ID AR0639983 <br /> 3310 N TRACY BLVD# E <br /> TRACY CA 95376 Issued 9/27/2013 <br /> Billing Address: ATTN : HARDCASTLE, JEFF <br /> HI-TIMES (HARDCASTLE, JEFF) <br /> 822 SAINT ANDREW ST <br /> LATHROP CA 95330 = , <br />