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C' <br /> c Body Art Inspection Report Date(MWDDNY) S -!-3 <br /> County of San Joaquin County,Environmental Health Department <br /> 1868 E.Hazelton Ave.,Stockton CA 95205 Permit Number -5AQ2a-X.�j <br /> (209)468-3420 www.siaov.org/ehd <br /> Permit Type `//���- <br /> C{4•�/,p p R�� <br /> Facility Name Address city Ziipp Code CT <br /> Q�s'!i PrP YL &'M1 L 9107 J (i-,/l Y?. 6,3:2 "�y C-..)---/® <br /> Permit/Registration Holder Name Permit Exp.Date Total Time Inspection Type C/ <br /> zi-x. ,-b k C <br /> o8sMATIOIJSANWCORRECTNEACT)ONS•' ` . <br /> e _ <br /> `S s C-) —W 7 A- S <br /> nM4 , L tr <br /> Y <br /> � � G <br /> ve Liz <br /> \ - <br /> IF <br /> 1 <br /> \ J <br /> fy r loom,IF �IjY <br /> 1 l <br /> lvr� - - <br /> w�- <br /> \'v-,-z, 1F J <br /> Received b (Print): ptf- Received by(Signature): Phone: <br /> Specialist(Print): Specialist(Signature): Phone: <br /> F1This 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 /> Pao,-?, Of 41 <br />