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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 E. Hazelton Ave • Stockton, CA 95205-6232 • Phone (209) 468-3420 <br /> Jasjit Kang, R.E.H.S., Director <br /> ENVIRONMENTAL HEALTH <br /> PERMIT TO OPERATE - PE 4120 - BODY ART FACILITY-SINGLE USE <br /> Permit ID # PT0028401 for Record ID # PR0547362 <br /> Valid From 12/13/2021 To 6/30/2022 <br /> i <br /> PERMIT TO OPERATE - PE 4110 - BODY ART PRACTITIONER REGISTRATION <br /> Permit ID # PT0028402 for Record ID # PR0547363 <br /> Valid From 12/13/2021 To 6/30/2022 <br /> PERMITS TO OPERATE are NOT TRANSFERABLE <br /> and may be SUSPENDED or REVOKED for cause. <br /> PERMIT(s) Valid only for: BARBOSA, SALOMON <br /> DBA: TINY'S INK <br /> THIS FORM MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES <br /> Regulated Facility: TINY'S INK (BARBOSA, SALOMON) Facility ID FA0026918 <br /> 228 W YOSEMITE AVE Account iD AR0051427 <br /> MANTECA CA 95336 Issued 12/22/2021 <br /> Billing Address: ATTN : BARBOSA, SALOMON <br /> TINY'S INK <br /> 1594 ELLIS LN <br /> MANTECA CA 95337 <br /> 7027.rpt End of Report <br />