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PERMITS TO OPERATE are NOT TRANSFERABLE <br />and may be SUSPENDED or REVOKED for cause. <br />3>- PERMIT(s) Valid only for: VILLA, HUGO <br />DBA: BLACK ROSE TATTOO PARLOR (HUGO VILLA) <br />THIS FORM MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES <br />'NJOAiQUU& LINTY ENVIRONMENTAL HEA LT EP"TMENT <br />Regulated Facility: <br />BLACK ROSE TATTOO PARLOR (HUGO VILLA <br />� Account ID R0038890 <br />A <br />" <br />1$68 E. Hazelton Ave. • Stockton, CA 95205-6232 • Phone (209) 468-3420 <br />1 Issued 5/23/2014 <br />STOCKTON CA 95202 <br />d k <br />Donna Heran, R.E.H.S., Director <br />.0,a <br />jiBilling Address: <br />ENVIRONMENTAL HEALTH <br />'P RIMPERMIT <br />TO OPERATE - 4121- BODY ART FACILITY -STERILIZATION <br />Yk Fd <br />237 E MINER AVE w <br />Permit ID # PT0022910 for Record ID # PR0537393 <br />Valid From 7/1/2014 To 6/30/2015 <br />PERMIT TO OPERATE - 4110 -BODY ART PRACTITIONER REGISTRATION <br />Permit ID # PT0022911 for Record ID # PR0537394 <br />Valid From 7/1/2014 To 6/30/2015 j <br />I. <br />PERMITS TO OPERATE are NOT TRANSFERABLE <br />and may be SUSPENDED or REVOKED for cause. <br />3>- PERMIT(s) Valid only for: VILLA, HUGO <br />DBA: BLACK ROSE TATTOO PARLOR (HUGO VILLA) <br />THIS FORM MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES <br />r <br />Facility ID 00 95 <br />Regulated Facility: <br />BLACK ROSE TATTOO PARLOR (HUGO VILLA <br />� Account ID R0038890 <br />A <br />J <br />237 E MINER AVE <br />1 Issued 5/23/2014 <br />STOCKTON CA 95202 <br />jiBilling Address: <br />ATTN : VILLA, HUGO <br />BLACK ROSE TATTOO PARLOR (HUGO VILLA) <br />237 E MINER AVE w <br />STOCKTON CA 95202 <br />