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Body Art Inspection Report Date(MM/DD/YY) <br /> County of San Joaquin County,Environmental Health Department <br /> < 1868 E.Hazelton Ave.,Stockton CA 95205 Permit Number <br /> (209)468-3420 www.siaov.oro/ehd Lf 1.2— <br /> Permit Type <br /> Facility Name Address Citynneek Zip Code CT <br /> ps-1mc.y%C✓1,4 La4a 6a P <br /> � A��� SLA, l� 23 1 %ki, A„,e.. SIr���,�-ra•, �s�U 7 <br /> Permit/Registration Holder Name Permit Exp.Date Total Time _Inspection Type L j <br /> �IG1, a E't1.ittl't <br /> OBSERVATIONS AND CORRECTIVE ACTIONS u <br /> LA <br /> a- - k <br /> s <br /> \'VP <br /> i vV.s r <br /> �i <br /> rte- <br /> E ; L -r O <br /> L o <br /> A-i- ids a <br /> r <br /> Y\GL ?SCP <br /> r fVA J J _ <br /> /- -7 CAL v Yn v� <br /> L <br /> 3 r v� <br /> 1 O <br /> �- <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 if violations noted on this report are not corrected by the reinspection date. Reinspection Date(on or about) <br /> Paae 4 of <br />