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_ _.._.. _ .._ --. <br /> 7 ' <br /> oUtfr, <br /> ar ••-.�o Body Art Inspection Report Date(MM/DD/YY) <br /> fCounty of San Joaquin County,Environmental Health Department S(Lo�9)L <br /> ld <� 1868 E.Hazelton Ave.,Stockton CA 95205 Permit Number <br /> �• (209)468-3420 vsavr.sioov.ora/ehd <br /> Permit Type ��V3 <br /> Facility Name Address City Zip Code CT <br /> lA0>til M04L.�+A�[�t�Cl �n IttM. 3�E. (A La oic� S�. Skog}�r, �t 2oZ Shn, r i r� <br /> Permit/Registration Holder Name Permit Exp.Date Total Time Inspection Typ <br /> fNa1 (�Od� X T+ tons-klA uk�+�/ <br /> S�� 4s�u)� OA <br /> OBSERVATIONS AND CORRECTIVEACTIONS <br /> Received by(Print)S' Received by(Signature): Phone• ��/�' ,�� <br /> Specialist(Print): (�'n 0M»1 Ctcolts Specialist(Signature): k,,,,,;_,� Lj r /Y Phone{o.QVA(pA—Z IA _ <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 /> Page3 of3 <br />