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<br />•": o Body Art Inspection Report
<br />r y County of San Joaquin County, Environmental Health Department
<br />1868 E. Hazelton Ave., Stockton CA 95205
<br />(209) 468-3420 www.sigov.oro/ehd
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<br />Facility Name Add ess City Zip Code
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<br />Permit/ egistration Holder Name Permit Exp. Date Total Time
<br />35.
<br />Plan Review
<br />❑
<br />36
<br />Permits Obtained & Available
<br />❑
<br />37.
<br />Impoundment
<br />❑
<br />38.
<br />Hearing Scheduled
<br />❑
<br />39.
<br />Closure *
<br />❑
<br />I Items marked with an asterisk' may also have specific requirements for temporary events I I I
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<br />Date (MM/DD/YY)
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<br />Permit Number
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<br />Permit Type
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<br />inspection Type
<br />411 hS,
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<br />;lp ITIONERIA TIST_NAME ',. ; ., �
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<br />�}_ ' �” "}i� OBSERVATIONS'AND,,CORRECTNE�'ACTIONS.n",, ,+ �.
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<br />Lv $ ' 10aY1
<br />Received by (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)
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