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�4, °''• . �o Body Art Inspection Report Date (MNUDD/YY) /( I :�'J Z <br />z ? County of San Joaquin County, Environmental Health Department <br />(H$ < Permit Number <br />1868 E. Hazelton Ave., Stockton CA 95205 <br />(209) 468-3420 www.sigov.org/ehd <br />Permit Type <br />�4 <br />Facility Name Address City 9 � Zip Code CT <br />lhal- '4 ��3�7� Y\- <br />Permit/Registration Holder Name Permit Exp. Date Total ime Inspection Type <br />Received b (Print): Received b (Signature): Phone: <br />1 <br />Specialist Print): 6 ;1e, Specialist (Signature): Phone: 90Ct•-e(1T `7 <br />F1This report is an Official Notice of Violation. Corrections must be completed in the tim spe ifi <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-3 of <br />