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0,-1�lIvDate(MM/DD/YY) t7 1v <br /> �o Body Art Inspection Report <br /> y County of San Joaquin County,Environmental Health Department <br /> 1868 E.Hazelton Ave..Stockton CA 95205 Permit Number <br /> (209)468-3420 www.sigov.org/ehd <br /> ` Permit Type <br /> q</.F per? <br /> Facility Name Address City Zip Code CT <br /> a utas. `K '361 L1l i,j,riJ9 1%)(L44 � .S -i�-_I�' ) Gl .L�f %e.- i -liu—i iIn <br /> Permit[Registration Holder Name Permit Exp.Date Total Time Inspection Type <br /> 4C 41CUL3 <br /> `. W, <br /> OBSERVATIONS'ANrrD CORRECTNE'i4CT(ONB <br /> n <br /> j <br /> 1 <br /> Y <br /> 1 �Y <br /> love, C <br /> i <br /> C O. <br /> J <br /> L lir <br /> �. E S <br /> ty <br /> : i <br /> c ( rye r <br /> 1 � c " 153 A ' U q -2 <br /> '1 j 11 t 1��.� <br /> LArr <br /> Itba 66 4101-3 <br /> Received by(Print): Received by(Signature): Phone: <br /> Specialist(Print): Specialist(Signature): Phone: <br /> F1This report is an Official Notice of Violation.Corrections must be completed in the time specified. <br /> d. <br /> reinspection fee may be charged if violations noted on this report are not corrected by the reinspection date. Reinspection Date(on or about) <br /> Paae 3 of <br />