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o I Body Art Inspection Report Date(MM/DD/YY) I✓ <br /> y County of San Joaquin County,Environmental Health Department c <br /> 1868 E.Hazelton Ave.,Stockton CA 95205 Permit Number _ <br /> (209)468-3420 www.sigov.org/ehd <br /> Permit Type <br /> Facility Name Address City Zip Code CT <br /> s E .1 C- "Td lt"11V1CM� - LDtJ t Gt �(J �cx.l� VLLA.r��.n1 r <br /> Permit/Registration Holdef Name Permit Exp.Date Total Time Inspection Type �— <br /> 35. Plan Review 1136 Permits Obtained&Available777❑ <br /> 37. Impoundment ❑ <br /> 38. Hearing Scheduled ❑ <br /> 39. Closure` ❑ <br /> Items marked with an asterisk'may also have speck requirements for temporary events <br /> 444"v'" «"' pt�i4Cti Rb ERIARTt$ It MME=` ,r a � s r .`''IZ�Ca)����.r{`k� FRACTRIONF�RU�iRTIST NAME,. z.,:'"" ' ,., �.` i'-4 <br /> wt r.. sir <br /> €,a �, w , t <br /> 11 <br /> N XW ORRECTivE`AcTION ��x.. .a � � <br /> 2 �t' �V1 �� 1 Vs. <br /> -S Ile <br /> L - <br /> - <br /> Or Av �\J ' <br /> l Lr-- o:v\- <br /> Received b (Print): Received by(Signature): Phone: <br /> Specialist(Print): Specialist(Signature): Phone: <br /> F] 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 /> Pace—4 of <br />