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iQutra, Date(MMIDDNY) f'J41-1-S <br /> fay �o Body Art Inspection Report <br /> ;y County of San Joaquin County,Environmental Health Department <br /> Permit Number � <br /> << 1868 E.Hazelton Ave.,Stockton CA 95205 <br /> (209)468-3420 www.sigov.org/ehd <br /> Permit Type 4r <br /> �c4 <br /> Facility Name Address jj City Zip Code CT <br /> Permit/Registration Hold r Name Permit Exp.Date Total Time Inspection Type <br /> Sl�c•n LJ <br /> 6 ' 1.3 :2? " lel. <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> 7 i i <br /> It 1/14' L6t <br /> t3tir <br /> i r <br /> `7renl i /e�sfyL <br /> a VL <br /> lUl�i'Yt - 12, S <br /> /V7 t <br /> t <br /> -r <br /> C' C-)' 711111311ke <br /> LIS <br /> VY- CAA <br /> �i <br /> t;l � <br /> - cr! <br /> f <br /> 6-46 41 <br /> Received b (Print): Received b (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 /> D.—3 of ` <br />