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�� stn•,�o Body Art Inspection Report Date(MNUDD/YY) "1 <br /> r $ County of San Joaquin County,Environmental Health Department <br /> a Permit Number <br /> m. < 1868 E.Hazelton Ave.,Stockton CA 95205 --- <br /> (209)468-3420 www.sigov.oro/ehd Gl <br /> Permit Type <br /> a�s F Cc) ? <br /> Facility Name Address City Zip Code CT <br /> L,7 <br /> Permit/Registration Holder Name ermit Exp.Date Total Time inspe�donn�Tyge <br /> 6 /,3lr S <br /> ,,, "kU '" <br /> X.�..:, #.i"� <br /> �,, a?"}?t n �� � �' 4 f p1 s <br /> . .},.:,�,,.m a4i3SFtV�1Tlt)NS'AN�GpRREG7IVE'AGT10Nb` � r 4... F „a.. <br /> Gi <br /> t 1 <br /> L f <br /> ti <br /> A— <br /> a <br /> l <br /> 41e <br /> r <br /> m _ e -eamjoi <br /> c- <br /> 1 <br /> 4ccAJ-7.; S <br /> Alga <br /> t <br /> Received b (Print): Received b (Signature): Phone: <br /> i <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 /> Paaeo of <br />