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Body Art Inspection Report Date(MMIDD/YY) > <br /> County of San Joaquin County,Environmental Health Department <br /> 1868 E.Hazelton Ave.,Stockton CA 95205 Permit Number <br /> (209)468-3420 www.siciov.org/ehd <br /> Permit Type 44t O? <br /> Facility Name Address City Zip Code CT <br /> mr %.- 7 �c wtnn�fr�- Lyc>1 R Flo .Sar, �z�L�, �h <br /> Permit/Registration Holder Name Permit Exp.Date Total Time InspecfYType <br /> OBSERVATIONS AND CORRECTNE'ACTIONS <br /> 1 it 1,I t IV16L <br /> C7i <br /> 3tq cam. <br /> Received b (Print): I, `O ` V Received by(Si nature: f Phone i Z .�3� <br /> Specialist Print): 1 1/ Specialist(Signature): 4� Phone: 60-W <br /> This report is an Official Notice of Violation.Corrections must be completed in the tim sp if <br /> � o/ <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 /> PaOe 41 of <br />