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' attl : 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.sigov.orglehd <br />dq�o�a <br />Facility Name Address <br />Permit/Registration Holder Name <br />LL , Q _ i <br />Date (MM/DD/YY) <br />Permit Number loth? <br />Permit Type en C; _I <br />City Zip Code CT <br />.1ecn <br />Permit Exp. Date Total Time Inspection 4 <br />Z- 7ri - i Z —7—n i hA c lfe <br />u <br />Received by (Print): Received by (Signature): Phone: <br />Specialist (Signature): Phone: <br />Specialist (Print) ( 9 <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 />Pa0a3 of <br />WMA ,A1 <br />4-WWAEA <br />Urg <br />i M- 1b I1 <br />1711' <br />r i. <br />1, MIMML <br />A <br />t / M —W <br />■ <br />�. <br />.. •-JW, r. <br />.. _ �. <br />_ <br />rn <br />- <br />• <br />G • <br />I �� <br />�I.NORMA--- <br />My!/ <br />rAff <br />u <br />Received by (Print): Received by (Signature): Phone: <br />Specialist (Signature): Phone: <br />Specialist (Print) ( 9 <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 />Pa0a3 of <br />