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UIH� <br />Body Art Inspection Report <br />County of San Joaquin County, Environmental Health Department <br />1868 E. Hazelton Ave., Stockton CA 95205 <br />�.. (209) 468-3420 www.sigov.org/ehd <br />Date (MM/DD/YY) <br />Permit Number <br />Permit Type L4 Z� <br />facili Name Address City Zip Code CT <br />�vu, 4 �H� R�i ��� ' <br />Permit/Regi tration Holder Name Permit Exp. Date Total Time Inspection Type <br />��• avt'I.. <br />ftt4l�� <br />�x <br />... !r rw a �A,. <br />OBSEf2VAT10NSAN �08RRECTIVE"ACTIONS.., ,, _ .. <br />fr, S <br />61p S <br />0211AA 1 af <br />(11 <br />,,1 <br />�nA 1110,t` <br />tl <br />s <br />w MAT <br />1& 411 M-1 <br />nin 1' S o <br />' <br />aw <br />t <br />dl <br />wVe� �ni n <br />11 G!U O , N <br />U <br />W1IA, n <br />V <br />L Vh bA <br />!7� � <br />�11 <br />' •, �*'r'' ��� <br />1 �i31 u <br />1 w11OWLIZe, <br />tk.&C, <br />� <br />Moo <br />006's (PtAw5m <br />"1401) <br />UI <br />let <br />�i n1n �-�r►� I <br />Specialist (Print): �Amj•'\ `�--;L041) Specialist (Signature): <br />nni 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. <br />Page 3 of3 <br />Phone: 201 6, 2- `+ -76o t <br />Phone&IJgU-3) / <br />Reinspection Date (on or about) <br />