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/o/.... .° oo Body Art Inspection Report Date(MM/DD/Y`n a- <br /> / ZCounty of San Joaquin County,Environmental Health Department �/ <br /> 'n < 1868 E.Hazelton Ave.,Stockton CA 95205 <br /> Permit Number Sg�P2o53o(/a <br /> �\ (209)468-3420 www.sigov.org/ehd Permit Type ��U3 iao <br /> Facility Name Addre City Zip Code CT <br /> � f i w�tl zu ll�. �I � TjC qS �n p IA 1)Jl <br /> Permit/Registration Holder Name Permit Exp.Date J Total Time Inspection Type <br /> C JI� (2tjnt <br /> F�na� Cc�r�su��q�icv� ��n>Z <br /> OBSERVATIONS AND CORRECT <br /> y t <br /> IVEACTIONS <br /> Received b (Print): l em Received b (Signature):-/////A1ZPhone: <br /> Specialist(Print): (� Z L� Specialist(Si nature: Phone: ,)o 1 —3 <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 /> Page 3 of 3 <br />