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Body Art Inspection Report Date(MNUDD/YY) 'l / <br /> z County of San Joaquin County,Environmental Health Department <br /> < 1868 E.Hazelton Ave.,Stockton CA 95205 Permit Plumber <br /> (209)468-3420 www.sigov.oro/ehd <br /> Permit Type / <br /> Facility Name Address city Zip Code CT <br /> L,6-),ii, 4SX14 a in S nf, t i <br /> Permitthegistration Hot ee r Name Permit Exp.Date Total Time Inspection TyPY <br /> 35. Plan Review p <br /> 36 Permits Obtained&Available' <br /> 37. Impoundment p <br /> 38. Hearing Scheduled <br /> 39. Closure <br /> Items marked with an asterisk'may also have specific requirements for temporary events <br /> ..� +c„ ,o-..: v Nor _ .. �?� s. ti, .,`' fa°Ef7 s� ..�ayhx sas" °"',;rv"" ..h':?�, 'a, .' ';`,-_,-. <br /> a. ,.x r r '` ` 7� «3 '� <br /> REG � � pR CT 14 R/ARTI�s I dARP ,<.... .z° IZEG PRAGTIfIONERI_R Ti C�. <br /> .,, <br /> _.�..ic <br /> :a �a <br /> 'r ��.�`�- <br /> 1223 IM'MCA 4Vc (- <br /> s <br /> LC <br /> a_ <br /> ill <br /> Al <br /> F s <br /> Ls( B <br /> Received by(Print): Received by(Signature): Phone: <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 ifviolations noted on this report are not corrected by the reinspection date. Reinspection Date(on or about) <br /> Page f <br />