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• .o Body Art Inspection Report Date(MM/DD/YY) <br /> y i County of San Joaquin County,Environmental Health Department <br /> °n: < 4 zsaa <br /> 1868 E.Hazelton Ave.,Stockton CA 95205 Permit Number / <br /> (209)468-3420 www.sioov.org/ehd <br /> Permit Type <br /> Facility Name Address City Zip Code CT <br /> r <br /> Permit/Registration Holder Name Permit Exp.Date Total Time Inspectio ype <br /> r <br /> OBSERVATIONS AND CORRECTIVEACTIDNS <br /> L <br /> OL <br /> _ 1 <br /> 7 <br /> 1n 1 <br /> c r <br /> �- <br /> G <br /> A <br /> V1 r <br /> d <br /> 1 t <br /> L- Q#E�,10 CA <br /> 4 N <br /> Received by(Print) Received b (Signature): Phone: <br /> Specialist Print): Specialist(Sign, ure): Phone: <br /> This report is an Official Notice of Violation.Corrections must be completed in the t" acified. <br /> F1 <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 /> ROra of <br />