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ouiN, 3 �3�1 <br /> 0 0o Body Art Inspection Report Date(MM/DD/YY) <br /> i County of San Joaquin County,Environmental Health Department os-51 no <br /> 1868 E.Hazelton Ave,,Stockton CA 95205 Permit Number 1 On�� <br /> (209)468-3420 www.sigov.orq/ehd 1 i 11 <br /> •e <br /> Permit Type "1 1 <br /> Facility Name Address City Zip Code CT <br /> Ti rU9-CII.sS;c.T^630 LA.;i-3 E rn'Nr Ave. 0, Toct!win <br /> Permit/Registration Holder Name Permit Exp.Date Total Time Inspection Type <br /> V GV19r Lult" Izou�)'nL <br /> OBSERVATIONS ANY ORRECTNEACTIONS 4 <br /> l - t1�31 'tom calk C-A Cf46 <br /> uv►`I Oki 17t.4 c. fl- �t <br /> ori 1 )U G <br /> 11114,0116-5--+aof S <br /> S t' r(1 S d'` i ics <br /> 1 13_ , t <br /> I I�31�t 11 31'7 , u rc aj4oi' ' <br /> S UJB n ' <br /> titr <br /> c�l 'n ufu Wea, <br /> i �eil <br /> DU114,64411e, 1 <br /> L.,C)n P s 4AA f0l' 5- <br /> } ss <br /> 1 <br /> Received b Print: IAl r r Received b (Signature): Phone: 2 c3 <br /> Specialist(Print): colib Specialist(Signature): - Phone: 0i <br /> ❑ This report is an Official Notice of Violation.Corrections must be completed in the time specified. <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 /> Page 3 of 3 <br />