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Date(MM/DD/YY) <br /> ,off ro Body Art Inspection Report <br /> $ 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 L <br /> Permit Type �C <br /> 4tikod�°' <br /> Facility Name Address City Zip Code CT <br /> Permit/Registration Holder Name —� Permit Exp.Date Total Time inspection <br /> .� ';,.;. �.,^�i rf ,.,r.7,. 1 r..,�;,`. L €}`? i ,x x '� t'c <br /> - 8 d <br /> . �,,..� ,.,.. _� . ��...;..,�. . =,.3 ..aOB.&E VATIONS�A11UZ4 CTIVP'ACTION&" <br /> .,�z.,E a. ,� ;,,;.,,,� <br /> y 1 <br /> )- y <br /> c +� <br /> �.- all M <br /> M=1GCM1 <br /> l <br /> f <br /> 1- <br /> .3 31 4 <br /> t _ <br /> Received b Print): Received b (Si nature): 69/4'-�,hone: 76 m L4 L4 S'3 <br /> Specialist(Print): Specialist(Signature): / Phone: 07� <br /> This report is an �beochargecl <br /> tice of Violation.Corrections must be completed in the tim sp ' <br /> A reinspection fee m if violations noted on this report are not corrected y the reinspection date. Reinspection Date(on or about) <br /> Pane z of <br />