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/o °''•�'.'�o Body Art Inspection Report Date (MMIDDNY) <br />r.' y County of San Joaquin County, Environmental Health Department <br />1868 E. Hazelton Ave., Stockton CA 95205 Permit Number <br />(209) 468-3420 www.slgov.oro/ehd <br />Permit Type <br />raciiity Name Address city Zip Code CT <br />SSC :t;- s . �-�V • 'S j �� `7 �f�t✓� t. <br />Permit/Registration Holder Name Permit Exp. Date Total Time Inspection Type <br />n <br />Received b (Print): Received b (Signature): _ Phone: <br />Specialist Print): Al JaLjr,Specialist (Signature Phone °( 6f6X-JA- <br />F1 <br />_r j" <br />F <br />F1This report is an Official Notice of Violation. Corrections must be completed in the ti ecif <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 />Pacer of <br />1 <br />A �T' <br />t n r Nil <br />0 1:► <br />MZWS <br />W <br />I * %A' <br />I <br />Vii: <br />l <br />�u <br />f <br />VA <br />Received b (Print): Received b (Signature): _ Phone: <br />Specialist Print): Al JaLjr,Specialist (Signature Phone °( 6f6X-JA- <br />F1 <br />_r j" <br />F <br />F1This report is an Official Notice of Violation. Corrections must be completed in the ti ecif <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 />Pacer of <br />