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oU7' <br />• .,o �o Body Art Inspection Report <br />y County of San Joaquin County, Environmental Health Department <br />1868 E. Hazelton Ave., Stockton CA 95205 <br />(209) 468-3420 www.sjgov.orQ1ehd <br />Date (MWDDNY) <br />E"CLl <br />Permit Number <br />i°l 777 <br />Permit Type <br />--/ 1 -it- j <br />Facility Name Address City Zip Code CT <br />r> e -%Lpr 1 P %r r iWA =iy L c .ifi �Trtu �i 371 S� n .) i <br />PermittRegistration Holder Name 14 Permit Exp. Date Total Time Inspection Type <br />t . . A---- i :3v.. 6 1 i� fru_ <br />35. Plan Review ❑ <br />36 Permits Obtained & Available * ❑ <br />37. Impoundment ❑ <br />38. Hearing Scheduled ❑ <br />39. Closure' ❑ <br />larked with an asterisk' may also have specific requirements for temporary events <br />►; I - ► ► <br />%_ � a L �/ � /�, • Its <br />I /, ► i� , / <br />f <br />'/IIS IR � ♦ 1 I/ i _ � �� L <br />i <br />fi . ► 'r <br />Received by (Print)' Received by (Signature): Phone: <br />Specialist (Print): Specialist (Signature): Phone: <br />FThis 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 o2 of <br />