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v <br /> ,ot°`'•"°�o 0 <br /> Body Art Inspection Report Date(MM/DD/YY) <br /> County of San Joaquin County,Environmental Health Department <br /> 1868 E.Hazelton Ave.,Stockton CA 95205 Permit Number <br /> (209)468-3420 www.sioov.oro/ehd <br /> Permit Type <br /> Facility N e Address City Zip Code CT <br /> to MU„ s� qll , r Sc,,,fomj in. <br /> PermittRegistration Holder Name Permit Exp. ate Total Time Inspection Type <br /> 35. Plan Review ❑ <br /> 36 Permits Obtained&Available* ❑ <br /> 37. Impoundment p <br /> 38. Hearing Scheduled ❑ <br /> 39. Closure” ❑ <br /> Items marked with an asterisk`may also have specific requirements for temporary events <br /> u, t v <br /> h at; r CHs <br /> 4-4 <br /> 11g3b - mac, i s ave lx -aha..Absl s - S lticcin pUlio <br /> - <br /> f Sewn i t�l m/ l� - t n <br /> i r <br /> r, <br /> wa VC r, i c f' A41 <br /> �v rs PCP o r <br /> �i ' S ' ' (161 <br /> v ,Ui <br /> u 0D A+e. <br /> S V fil 0J1 1 al QLj <br /> Received b Print: Receive Si natur hone:2®U, . `Jti-[0'214 14 <br /> S ecialist(Print): i A G S Specialist(Signature): Phone: v l <br /> This report is an Official Notice of Violation.Corrections must be completed in the time specified. <br /> A reinspection fee may be charged if violations noted on this report are not corrected by the reinspection date. Reinspection Date(on or about) <br /> Pages-of 3 <br />