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,� u�f, Date(MM/DD/YY) 7-4/5'fo �o Body Art Inspection Report <br /> : < County of San Joaquin County,Environmental Health Department <br /> a <br /> 1868 E.Hazelton Ave.,Stockton CA 95205 Permit Number <br /> (209)468-3420 vww.sigov.org/ehd <br /> Permit Type <br /> Facility Name �Atdddr�ess Q ,/��city /A{ /Zip Code CTC ` <br /> �A 1 1T JT"� L.]�� C.(T'V� i /1 Uc `c L L�'��z ce.-Y�'✓L �1� t[rd L-�1� <br /> Perm egistration Hold&Name Permit Exp.Date Total Time Inspection Type <br /> a-- Z L,, <br /> .E _•. OBSERVATIONS AND CORRECT NEi4CT1ON ,`§ . <br /> 3 `'k a L \\ <br /> � 3 / J trZ CJ � ✓ <br /> v a� lj0 <br /> v 1. <br /> Y ✓vt. S � -1-f-c - D- <br /> ( ovt_ LAN <br /> a � _ <br /> Received b Print): , Received b (Signature): Phone <br /> Specialist(Print): o, Specialist(Signature): Phone:-20'�-Y -16 <br /> ❑ This report is an Official Notice of Violation.Corrections must be completed in the'f s cified. <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 /> Pace'of Y <br />