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Specialist Print): Specialist (Si nature <br />This report is an Official Notice of Violation. Corrections must be completed in the t" a cified. <br />F1 <br />A reinspection fee may be charged if violations noted on this report are not corrected by the reinspection date. <br />ROra of <br />Reinspection Date (on or about) <br />�o- • .o <br />i <br />Body Art Inspection Report <br />County San Joaquin County, Environmental Health Department <br />Date (MM/DD/YY) <br />y <br />of <br />Permit Number <br />4 zsaa <br />/ <br />°n: < <br />1868 E. Hazelton Ave., Stockton CA 95205 <br />(209) 468-3420 www.sioov.org/ehd <br />Permit Type <br />Facility Name <br />Address City <br />Zip Code CT <br />r.� <br />Permit/Registration <br />Holder Name Permit Exp. Date <br />Total Time Inspectio ype <br />c <br />Specialist Print): Specialist (Si nature <br />This report is an Official Notice of Violation. Corrections must be completed in the t" a cified. <br />F1 <br />A reinspection fee may be charged if violations noted on this report are not corrected by the reinspection date. <br />ROra of <br />Reinspection Date (on or about) <br />