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1 <br />,oQ° •" c° Body Art Inspection Report <br />i County of San Joaquin County, Environmental Health Department <br />1868 E. Hazelton Ave., Stockton CA 95205 <br />(209) 468 3420 wwwsiaov.or /q ehd <br />4<<FO <br />Date (MM/DDNY) <br />Permit Plumber SR. 103 <br />Permit Type 1 <br />Received b (Print): Keceiveo d 5i nature : rnone: <br />Specialist (Print): 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 />Page _ of _ <br />