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COMPLIANCE INFO
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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ELEVENTH
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4100 – Safe Body Art
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PR0541160
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COMPLIANCE INFO
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Entry Properties
Last modified
11/19/2024 10:19:27 AM
Creation date
6/13/2023 11:18:05 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4100 – Safe Body Art
File Section
COMPLIANCE INFO
RECORD_ID
PR0541160
PE
4110
FACILITY_ID
FA0023570
FACILITY_NAME
FOREVER YOURS TATTOO (WALKER, KENNY)
STREET_NUMBER
606
Direction
W
STREET_NAME
ELEVENTH
STREET_TYPE
ST
City
TRACY
Zip
95376
CURRENT_STATUS
02
SITE_LOCATION
606 W ELEVENTH ST
P_LOCATION
03
QC Status
Approved
Scanner
SJGOV\cfield
Tags
EHD - Public
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San Joaquin County1868 East Hazelton Avenue <br />*Environmental Health De artmeni� Stockton46 -3220 <br />p Tel: (209)) 468-3420 <br />Fax: (209) 464-0138 <br />BODY ART FACILITY AND PRACTITIONER REGISTRATION/ <br />MECHANICAL STUD AND CLASP EAR PIERCING NOTIFICATION <br />I. PROCEDURES TO BE PERFORMED: Check all that apply (see back for definitions) <br />12ITattooing IDBody Piercing MMechanical Stud and Clasp Ear Piercing <br />Branding MPermanent Cosmetics <br />II. REQUIRED REGISTRATION, PERMIT, OR NOTIFICATION FEES: Check all that apply. <br />1MAnnual Body Art Practitioner Registration 3MMechanical Stud and Clasp Ear Piercing Notification <br />2MAnnual Body Art Facility Permit <br />III. APPLICA T INFORMATION: `/, <br />NAME: K e nn\) ,V `" �K.� r - <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br />
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