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Body Art Inspection Report Date(MM/DD/YY) <br /> y County of San Joaquin County,Environmental Health Department Permit Number <br /> 1868 E.Hazelton Ave.,Stockton CA 95205 <br /> �. (209)468-3420 www.sigov.org/ehd Permit Type <br /> Facility Name Address City Zip Code CT <br /> 6lc s'>%-7imr61� G±f-20 (2 13h qaQ-r <br /> Permit/Registration Holder Name Permit Exp.Date Total Time Inspections Type <br /> 35. Plan Review p <br /> 36 Permits Obtained&Available ❑ <br /> 37. Impoundment ❑ <br /> 38. Hearing Scheduled ❑ <br /> 39. Closure ❑ <br /> Items marked with an asterisk'may also haves ecific requirements fortemporaa events <br /> REG,# PRACTITIONERIARTIST NAME REG# PRACTITIONERlARTISTNAME <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> S <br /> nn Q0 uX <br /> I,o+- t(1 <br /> �- <br /> Gowt,p to <br /> i l <br /> V <br /> GZ4C (ri <br /> o% <br /> Received b (Print): Received by(Signature): Phone: <br /> Specialist(Print): Specialist(Signature Phone: aO - Y- <br /> ❑ This report is an Official Notice of Violation.Corrections must be completed in the iecified. <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 /> Papez—otof?— <br />