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Body Art Inspection Report Date(MM/DD/YY) <br /> a a County of San Joaquin County,Environmental Health Department Permit Number <br /> 1868 E Hazelton Ave.,Stockton CA 95205 <br /> (209)468-3420 www.sigov.oro/ehd <br /> Permit Type <br /> Facility Name Address City Zip Code CT <br /> Permit/Registratlon Holder Name Permit Exp.Date Total Time Inspection Type <br /> :; -' :- 5,16 <br /> ,,....-ek' r,,. a''U, i�.^"x*._Y175CdCYA 1417Y �'� Y,C�RRG\e 1lYG/Q Flo W,41 .,zY <br /> ON WX <br /> in <br /> y <br /> T <br /> a <br /> •` / �� 6. <br /> 1 I <br /> 64 e can <br /> t <br /> L <br /> d <br /> Received by(Print): Received by(Signature): Phone: <br /> Specialist(Print): Specialist(Signature): Phone: <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 /> Paae of <br />