Laserfiche WebLink
San Joaquin County 1868 East Hazelton Avenue <br />Stockton, CA 95205 <br />is Environmental Health De03a Department 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 />Tattooing Body Piercing Mechanical Stud and Clasp Ear Piercing <br />ED Branding Permanent Cosmetics <br />II. REQUIRED REGISTRATION, PERMIT, OR NOTIFICATION FEES: Check all that apply. <br />1�Annual Body Art Practitioner Registration 3®Mechanical Stud and Clasp Ear Piercing Notification <br />2®Annual Body Art Facility Permit <br />III. APPLICANT INFORMATION: t <br />NAME: S\ Phone:�ZO <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 /> <br /> <br /> <br /> \ <br />