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0 0 -7 <br /> Body Art Inspection Report Date(MhNDD/YY) la-1 —1 <br /> County of San Joaquin County,Environmental Health Department Permit Number 5.6.w <br /> y. 4 1868 E.Hazelton Ave.,Stockton CA 95205 <br /> (209)468-3420 www.sigov.org/ehd 41 <br /> Permit Type <br /> Facility Name Address city Zip Code CT <br /> ?eiwageyt-� aM -Skm 4ayr-p- 69-31 Ayr q6-3,o-7 <br /> Perm it/Registration Holder Name Permit Exp.Date Total Time inspection Type <br /> -10\PAC� ' 4AWO <br /> TIM`, <br /> OBSERVATIONS AND CORRE CT ACT ON82' <br /> AY, 1:7 <br /> hCA A/-I--- <br /> rly-L- cin i-l-ay <br /> Received by(Print): Received by(Signature): Phone: <br /> Specialist(Print): t7 Specialist(Signature): Phone:Arj-Y.61—❑ 76 73 <br /> This report is an Official Notice of Violation.Corrections must be completed in the ti sp ed. z ),oL,1 <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 /> Pane 4101' 4j <br />