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I <br /> SAN JOAQU—O—CTY'ENN IRONMENTAL HEAL NIPARTMENT <br /> 1868 E.Hazelton Ave. • Stockton, CA 95205-6232 • Phone(209)468-3420 <br /> Linda Turkatte,R.E.H.S.,Director <br /> ENVIRONMENTAL HEALTH <br /> PERMIT TO OPERATE - 4110 BODY ART PRACTITIONER REGISTRATION <br /> Permit ID# PT0025177 for Record ID#PRO541032 <br /> Valid From 5/20/2016 To 6/30/2017 <br /> PERMITS TO OPERATE are NOT TRANSFERABLE <br /> and may be SUSPENDED or REVOKED for cause. <br /> PERMIT(s)Valid only for: MENCHACA,VINCENT <br /> DBA: GYPSY SOUL TATTOO <br /> THIS FORM MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES <br /> Regulated Facility: GYPSY SOUL TATTOO (MENCHACA, VINCE) Facility ID FA0023494 <br /> 118 W YOSEMITE AVE Account ID AR0043310 <br /> MANTECA, CA 95336 issued 5/24/2016 <br /> Billing Address: ATTN : MENCHACA, VINCENT <br /> GYPSY SOUL TATTOO (MENCHACA, VINCE) <br /> 1424 GONDOLA ST <br /> MANTECA, CA 95336 <br /> 7024.rpt <br />