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,/oma `'t"moo Body Art Inspection Report Date (MMlDDlYY) 1L�27' IZ <br />J• i County of San Joaquin County, Environmental Health Department <br />j(n 1868 E. Hazelton Ave., Stockton CA 95205 Permit Number <br />4 (209) 468-3420 www.sigov.ora/ehd <br />\ Permit Type <br />-moi, F oil"? <br />Facility Name , t Address %City Zip Code. , CT <br />r.),TmG1 `` �—(Ylc�� �1 ) %I dai I a* nLim'= ISM✓l3M%LAV�— <br />Permit egistration Holder Name Permit Exp. Date Total Time Insp tic ion Type <br />35. Plan Review p <br />36 Permits Obtained & Available <br />37. Impoundment El <br />38. Hearing Scheduled p <br />39. Closure El <br />Items mariA with an asterisk* may also have specific requirements for temporary events <br />': b NY` } t F} t `l' ..._ `" . 5 ` 1 t, : lR z yM1;: il.. . Y',C, i f S NY"fi�' p-'�•''� �f fro 2 Y4 1 #1 . kdc <br />'Seg' f ? %. fi k ,e �.w't S, � Y tg ki r - $' di} '� <br />` 1. ', j"', fXa .. .i5 44 l 1 t k i k,�,,id ':mk'„". <br />4 <br />4 <br />hy Fic, l y t, <br />fi <br />IVY <br />': b NY` } t F} t `l' ..._ `" . 5 ` 1 t, : lR z yM1;: il.. . Y',C, i f S NY"fi�' p-'�•''� �f fro 2 Y4 1 #1 . kdc <br />4 <br />hy Fic, l y t, <br />fi <br />IVY <br />Yn. <br />Received <br />Specialist (Print): facet Specialist Si nature <br />❑This report is an Official Notice of Violation. Corrections must be completed in the . e <br />A reinspection fee may be charged if violations noted on this report are not corrected by <br />Paqe of <br />-TOT -935r7 <br />date. Reinspection Date (on or about) <br />