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mr <br /> F <br /> Body Art Inspection Report Date(MM/DD/YY) <br /> i 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 Ql a` <br /> Permit Type <br /> <<FO <br /> Facility Name Address City Zip Code CT <br /> LaVi �L. 1Agq M.� vdt. �Eal, �53'1L S�nTpK WA <br /> Permit/Registration Holder Name Permit E)e.Date Total Time Inspection Type <br /> on=SEMEN=1111111=I <br /> �- �bM1�,1N►; �'�It3 zt1;��a1 <br /> RENEE=0=11 11 <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 /> � YN <br /> RE RAGTIIIOpER1ARTIS�, �. . .. E. REt� ' :0 NT.(T ONERIARTIST ; <br /> r pt. �►n - hf%t%Uff,AWftr% Oft <br /> RrrIO'Now OT > <br /> 1b <br /> '7- <br /> 1-n — TV\, m4®W l a M ;,re. � C M, 11 JY--'- <br /> 43&- 'SS!a f u'f SSU F m to a <br /> -TtWL kAxte- ;Cf n-4% +4 <br /> , F <br /> r as} tl►� rLr X111 'r 1� u <br /> Un V J;�'t' 1A% c� cess °• S &\1 <br /> cc era i °os� • chi , u S k.rm <br /> ', S — tlg3tu c -r6 b ®-0 <br /> (� 1 -qo 1144 + M a s <br /> ° OL U (\t) Wrdlf o.e SL9LAP. 2 Mh4 1A <br /> d}"e1 S NtLim jrno6lauA <br /> Received by(Print): P 17 Received by(Signature): Phone: <br /> Specialist(Print): Specialist(Signature): Phone: <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 a of <br />