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d <br />Body Art Inspection Report <br />�y County of San Joaquin County, Environmental Health Department <br />r" < 1868 E. Hazelton Ave., Stockton CA 95205 <br />(209) 468-3420 www.si-ov.org/ehd <br />Of <br />F <br />Facility Name Address <br />Permit/Registration Holder Name <br />E <br />City Zip Code <br />Permit Exp. Date Total Time <br />n <br />Date (MM/DD/YY) <br />Permit Number <br />Permit Type <br />CT <br />Inspection Type <br />Received b Print : t� <br />® Received b {Si nature): Phone:'7 ` <br />0 .®,.�.( "➢91 .d`1 _. _.__. ••+. _.__...__�. AAA,?. --A moi® <br />U A reinspection fee maybe charged if violations noted on this report are not corrected by the reinspection date. <br />14 <br />D- of <br />14 <br />Reinspection Date (on or about) <br />