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0 0 <br /> °"I c Body Art Inspection Report Date(MMlDD/YY) ?", <br /> y County of San Joaquin County,Environmental Health Department � � <br /> 0064041 <br /> < 1868 E.Hazelton Ave.,Stockton CA 95205 Permit Number <br /> (209)468-3420 www.sioov.org/ehd <br /> c� <br /> /// Permit Type Iq�]__._ <br /> q rFO�a <br /> Facility Name Address City Zip Code CT <br /> `�! �' i t a 1rn q53--> � 1'L <br /> Perm itlRegistration Holder Name f Permit Exp.Date Total Time Inspection Type <br /> OBSERVATIONSANDcdRRECTIVEACTbNS =' y <br /> CV l i <br /> vim. <br /> i <br /> 1 c[ <br /> OVX 1- <br /> 4,94 Ina1 v� <br /> t <br /> o L— <br /> 1WXZAA r&M4 101W lin d' <br /> wa <br /> �'l i l 1t ill t <br /> AMZL im <br /> G -�- <br /> -- <br /> � L <br /> r` P - -r L <br /> ,,�- y, Y <br /> Received b (Print): Received b Si natu A e Pho . <br /> Specialist(Print): A Vt Specialist(Sign Phone: `V 7 3 <br /> ❑ This report is an Official Notice of Violation.Corrections must be completed it the e e <br /> A reinspection fee maybe charged if violations noted on this report are not corrected by the reinspection date. Reinspection Date(on or about) <br /> Paoe,C----)-of 5- <br />