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REG # PRA CTITIONERIARTI.ST NAME REG -# PRAUMONERIMMT.NAME <br />t <br />F <br />yrz-.c f. <br />Received by (Print): Received by (Sicinature): ✓ , rr Phone:r �(Ga ! 0,;-,7--0 <br />F1This report is an Official Notice of Violation. Corrections must be completed in the1tiffe <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 />Paco -A of —7— <br />• <br />o�gpr~ ;o <br />y <br />Body Art Inspection Report <br />County of San Joaquin County, Environmental Health <br />Department .E <br />Date (MM/DD/YY) <br />�-1.Q <br />II <br />Permit Number��--�– <br />1868 E: Hazelton Ave., Stockton CA 95205 <br />(209) 468-3420 www:siciov.org/ehd <br />Permit Type 41 <br />Facility Name <br />Address <br />City <br />Zip Code <br />CT <br />.✓ <br />Iry ,);>, 4';J` <br />Permit/Registration <br />Holder Name <br />Permit Exp. date <br />Total Time <br />InspectionTMe <br />REG # PRA CTITIONERIARTI.ST NAME REG -# PRAUMONERIMMT.NAME <br />t <br />F <br />yrz-.c f. <br />Received by (Print): Received by (Sicinature): ✓ , rr Phone:r �(Ga ! 0,;-,7--0 <br />F1This report is an Official Notice of Violation. Corrections must be completed in the1tiffe <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 />Paco -A of —7— <br />