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roe° `"'•, �o Body Art Inspection Report <br />z i County of San Joaquin County, Environmental Health Department <br />1868 E. Hazelton Ave., Stockton CA 95205 <br />(209) 468-3420 www.sigov.oro/ehd <br />Facility Name Address <br />Permit/Registration Holder Name <br />40 <br />Date (MM/DD/YY) <br />Permit Number <br />Permit Type <br />City t Zip Code CT <br />Permit Exp. Date Total Time Inspection Type <br />• o y <br />Received b (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 />Page" of . <br />1 `s?u «;. o€e'ri^; <br />k ,i <br />`11111M <br />35. <br />,.�t.., :.;.? <br />;l Q. <br />. t . , ,�. >, rr�S; s#'"' <br />fi .9 ;, i i '" s�"' <br />S� . � �° " t ; " <br />Plan Review <br />a- a a <br />r <br />i�... TM�2 a <br />"t2'?*�i' <br />`, .F ."S ?, <br />} <br />''' "ca, <br />.e .,Irk, <br />"is?'` -i. £ w,,.. <br />8+,, m•yf i�&`, <br />'e`x^ ��u ase <br />,. i s.: �. 1 x. e,errr�,.'.:i;- <br />a,, i �l e� k@ 'r' i�'1 .. <br />�f y� 4.`: <br />"Ub �f Mail <br />36 <br />Permits Obtained & Available <br />37. <br />Impoundment <br />38. <br />Hearing Scheduled <br />39. <br />Closure <br />Items -d:q•• <br />• o y <br />Received b (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 />Page" of . <br />