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• pul Body Art Inspection p Report Date(MM/DD/YY) <br /> ,;o;,,•~ •••.�o <br /> County of San Joaquin County,Environmental Health Department <br /> N <� 1868 E.Hazelton Ave.,Stockton CA 95205 Permit Number <br /> (209)468-3420 www.siaov.org/ehd <br /> Permit Type <br /> Facility Naryie Address City Zip Code T <br /> 11.i�1yn ,i�rn >U �kur�lip Q II 1 5317 L 0"M),n <br /> Permit/Registration Holder Name Permit Exp. ate Total Time Inspection Type <br /> �On �1 11�h�� QotAT lALI <br /> �K a�� <br /> �r <br /> 1` -4'� r.�t•,ice <br /> �'... v ' OBSERVATIONS AD,CORI�EC AC701 S - 4 ,�. ` r <br /> WIN - ,.V " iS 0 i' �u,�c, W- s r s <br /> (WSV � AW1 is (?W&V)i <br /> `? 1�a31u 1�•� wns (jAl j �- u 11 i� rd kuj sures <br /> ul4w' 3 w f <br /> 1 G3 <br /> ttit, 1Lr_w5 u 1A,f S <br /> n 1 Gt c 4 i n ., <br /> 315 — 6 iL '20 m1414r 1 ) VAm <br /> fIl—tinfok <br /> -I 'fU r n SI <br /> JI ) '1 fJ <br /> U':� il/U bet-In 4\j <br /> b C s <br /> Received b Print: Re ived b (Si hone!Z9►1 ,'{ 'j <br /> Specialist(Print): to S ecialist(S�nature: Phon a0 4Q 6-3)1 0 <br /> This report is an Official Notice of Violation.Corrections must be completed in the time specified. <br /> (�J 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 /> Page 3 of -9 <br />