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i pu rra.,- Date(MM/DD/YY) <br /> Body Art Inspection Report <br /> i County of San Joaquin County,Environmental Health Department <br /> 1868 E.Hazelton Ave.,Stockton CA 95205 Permit Number "),o f <br /> (209)468-3420 www.sigoy.orglehd <br /> Permit Type Q/,Sl <br /> .......... <br /> Facility Name Address city Zip Code CT <br /> � 3-U 1 E-b&-th e wVyt yl LA L4)t� % 615366 -. I a \i r4 a v1 h <br /> Permit/Registration Holder me Permit Exp.Date Total Time Inspection Type <br /> 61--z c-))4-S <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> J <br /> Z304,AA C4 <br /> ti <br /> I'd kalviS1'lsL_ <br /> LJ Received 2og-3V-92 Fe <br /> Received b {Print): (' Received b {Si natur Phone: <br /> Specialist Print): 67-njo Specialist(Signature): Phone:,-�--ferq6d--7120 <br /> This report is an Official Notice of Violation.Corrections must be completed in the time spec] . <br /> F-1 <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 /> P.—ot` r f <br />