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��tn•,�o Body Art Inspection Report <br />r County of San Joaquin County, Environmental Health Department <br />m. < 1868 E. Hazelton Ave., Stockton CA 95205 <br />(209) 468-3420 www.sigov.oro/ehd <br />a�s F cc) ? . <br />Date (MM/DD/YY) —1 <br />Permit Number ` > <br />Permit Type G611 <br />Facility Name Address City Zip Code CT <br />c <br />Permit/Registration Holder Name Permit Exp. Date Total Time inspectctiio�n�Tyge <br />46 <br />Phone: <br />Specialist (Print): V 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 />Paaeo of <br />,l AF�i M <br />V <br />SIL <br />i <br />y <br />I C4 <br />MIMIC <br />W1 'L �' �'.i( <br />J. <br />.' <br />riLr� A A <br />GA A <br />i <br />r <br />411 <br />r <br />•OTAI <br />1 <br />JW r' t <br />r�►rr f+� /JI <br />.. <br />Phone: <br />Specialist (Print): V 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 />Paaeo of <br />