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0 , . <br />o aU! " : �o Body Art Inspection Report <br />y County of San Joaquin County, Environmental Health Department <br />u t 1868 E. Hazelton Ave., Stockton CA 95205 <br />(209) 468-3420 www.siaov.ora/ehd <br />Facility Name Address <br />WQ <br />t&,r AN31, a`1 <br />Permit/Registration Holder Name <br />Date (MM/DDNY) I 3 <br />Permit Number <br />Permit Type V <br />City Zip Code CT <br />4C)C60 q�1pm Sa') j0(4,141n <br />Permit Exp. Date Total Time Inspection Type <br />,re, <br />�— A reinspection fee may be charged if violations noted on this report are not corrected by the reinspection date. <br />Page, of 3 <br />Reinspection Date (on or about) <br />