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Body Art Inspection Report Date(MM/DD/YY) 3 <br /> o� <br /> y County of San Joaquin County,Environmental Health Department <br /> < <br /> Permit Number <br /> 1868 E.Hazelton Ave.,Stockton CA 95205 <br /> (209)468-3420 wvwv.sioov.oro/ehd <br /> Permit Type <br /> Facility Name Address City Zip Code CT <br /> 4AyjaSa]Oh l®h7L, 0Pc, at; yc q.. 9S-zo9 SU�Joa�Ul� <br /> Permit/Registration Holder Name Permit Exp.Date Total Time Inspection Type <br /> V, <br /> 35. Plan Review ❑ <br /> 36 Permits Obtained&Available* ❑ <br /> 37. Impoundment ❑ <br /> 38. Hearing Scheduled ❑ <br /> 39. Closure" ❑ <br /> Items marked with an asteriskmay also havespecific requirements for temporary events <br /> ,kk '�4:� id'.:'����r .,SN...x.� "t�b,.,?i. <br /> rm <br /> ' <br /> .P.RAGTITIONERIARTISTNAM zap. �„ ,,E ,.�.--; .x. 4 ...,i REG#., �. ��PRACTITIONEWARTISTsNAME.. °x <br /> PdLbSl1 '1 'T _ _ ee AQP <br /> t z,w x ,a *s ;" : <br /> xNIS ., # � ,a, ti08SERVATIONS'AN®`GORREGTIVEACTIONS....�..?a'. .,...,, t k , �5 , , , <br /> .. �. �M, ,,.. z.a�.< .. �A,...,t=: <br /> s <br /> 113 S — s s <br /> ek c Ctki i tU J <br /> ' j ' (1fY etA 'fS <br /> �i uUA <br /> 1 ' 1 ti <br /> 1 <br /> t a , o <br /> 1 <br /> A inl . 1 to i' <br /> es u 5 u w, 5 <br /> iso b 0 <br /> M; C h <br /> L C4 1 . <br /> 1�31�1 - v 41CCA Jore, w PAjOCP u <br /> Luci n ' <br /> t'3. <br /> Received by(Print): t P.� Received by(Signature): Phone: <br /> Specialist(Print): Specialist(Signature): Phone: <br /> This report is an Official Notice of Violation.Corrections must be completed in the time specified. <br /> A reinspection fee maybe charged if violations noted on this report are not corrected by the reinspection date. Reinspection Date(on or about) <br /> Pag ®of 3 <br />