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Body Art Inspection Report Date(MM/DD/YY) <br /> r y County of San Joaquin County,Environmental Health Department <br /> < 1868 E.Hazelton Ave.,Stockton CA 95205 Permit Number <br /> (209)468-3420 www.sigov.org/ehd f M <br /> Permit Type I �. <br /> C/Fo a\ <br /> Wif,y Name Address City Zip Code CT <br /> (obuun ca o S. C ® LoA, 9 S-1(40 Ja <br /> Permit/Registration Holder Name Permit Exp.Date Total Time Inspection lT <br /> V-tLJ&A^ <br /> d <br /> 35. Plan Review ❑ <br /> 36 Permits Obtained&Available* ❑ <br /> 37. Impoundment ❑ <br /> 38. Hearing Scheduled ❑ <br /> 39. Closure" ❑ <br /> Items marked with an asterisk`may also have specific requirements for temporary events <br /> G,. IONERIAR iN . , , RE ., r., ...'. t?t2111110051010 ARTiSNA' ," ,: <br /> 617. U, c1tiS�.L <br /> SAM., <br /> it �o <br /> `7 w t-0 S no 0 41 U,P-5 <br /> CA r ' lit��b� r(lv�a n r s <br /> 0j L\jLM(2 it <br /> I <br /> 01 �- u t, Q) v r ° r <br /> i n L 'tY�5 . W t ' n <br /> AAA <br /> l�� 7/LeB 1 l� J S ^ V6 i, V®, <br /> 3 rkukc,- 3+tk&hr=� A-,160V bd 90 AAA <br /> , 1)f1 'S oss%tv, <br /> Received b (Print): Received by(Signature): Phone: <br /> S ecialist Print: �C,i s d Specialist S' nature: Phone(i <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 /> Page 4 of <br />