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mor° lN,o Body Art Inspection Report Date(MM/DD/YY) `L' <br /> County of San Joaquin County,Environmental Health Department /� <br /> y, 1868 E.Hazelton Ave.,Stockton CA 95205 Permit Number5AC064-5 <br /> (209)468-3420 www.siaov.org/ehd� 4/19 <br /> Permit Type <br /> Facility Name Address City Zip Code CT <br /> Q] W\.—Lr, i,:, sz-o S ceAA,,,t- LoL- q sA140 �� n ., , L�N� <br /> Permit/Registration Holder Name Permit Exp.Date Total Time Inspection Type <br /> - <br /> yi <br /> OBSERVAVONS AND CORREMEACT NS , <br /> iLA <br /> , <br /> W 1� n ni <br /> 7Z eV- <br /> 11-ssoq- All <br /> � ✓1 <br /> T <br /> L L 2:14 111 <br /> c <br /> - c <br /> 2 - <br /> Received b (Print): 7 Received b (Signature): Phone: C <br /> Specialist Print: 61 lormoV[G S ecialist(Si natur Phone: <br /> ❑ This report is an Official Notice of Violation.Corrections must be completed in th a spi <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 /> Paae i of 1 <br />