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0 <br /> i p U t ryt <br /> Body Art Inspection Report Date(MM/DD/YY) <br /> i= y County of San Joaquin County,Environmental Health Department <br /> c a Permit Number <br /> m < 1868 E.Hazelton Ave.,Stockton CA 95205 <br /> (209)468-3420 www.sioov.orglehd <br /> y Permit Typel � <br /> c.N.i...... <br /> Facility Name Address city Zip Code CT <br /> Permit/Registration Holder Name Permit Exp.Date Total Time Inspection Type <br /> OBSERVATIONS AND CORRECTWEACTiONS.k% ,®s" a,� .w ° •- <br /> Z <br /> 410 y z' <br /> 1 <br /> ` <br /> \LCA <br /> t � <br /> l te' <br /> - - <br /> c� �• Z <br /> 11 <br /> 1 <br /> ✓1 'Y !� <br /> a <br /> G M G <br /> i <br /> rA <br /> 1 <br /> CA 2�4 dr-i Z101 <br /> f <br /> ClYz L.1 CS <br /> n _CA <br /> ty-6-LAbLr. <br /> Received b (Print): Received b (Signature): Phone: <br /> Specialist Print): At f2y-)OAb, Specialist(Signature): Phone: '?,6'i.1 <br /> This report is an Official Notice of Violation.Corrections must be completed in the time specifi <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 /> Paa�of <br />