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F � • <br /> /o'°`'•"•. o Body Art Inspection Report Date(MM/DD/YY) <br /> County of San Joaquin County,Environmental Health Department <br /> m t 1868 E.Hazelton Ave.,Stockton CA 95205 Permit Number <br /> �.: (209)468-3420 www.sigov.org/ehd ,lel <br /> c � <br /> Permit Type VCJ <br /> Facility Name Address City Zip Code CT <br /> �I uik r S��v sem, Ja.�Lj' <br /> Permit/Registration Holder Name Perm p.Date Total Time Inspection Ty4e <br /> rw <br /> rxpv + exa - � .�.� a+pn r. q..ga E "Y a2sw;ti <br /> OBSER1iATIONSAMlYCORRI CTNE' ACT s� fi� r �%Y�!MR.}, Tl,-f as" ; <br /> 0 303 Z -- j n. f-Q sc.t> t <br /> y <br /> 1 U 1V-i\ P(-P CA,ilJc <br /> A(CAI�r\iNJAU s ; xpcp tlel1 <br /> SS b �i m i <br /> J Mi o Ivw LLb±l UA <br /> k� <br /> Received b Print: Received b (Signature): Phone: 2O l `�79 q'I <br /> 1 <br /> Specialist(Print): Y�1 Specialist(Signature): 1 Phone �r /0 <br /> his report is an Official Notice of Violation.Corrections must be completed in the time specified. <br /> reinspection fee may be charged if violations noted on this report are not corrected by the reinspection date. Re�coon Date(on or about) <br /> Page�of <br />