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Body Art Inspection Report Date(MM/DD/YY) "0�?—U <br /> County of San Joaquin County,Environmental Health Department Permit Number Sr'lJ1�'7 <br /> 1868 E.Hazelton Ave.,Stockton CA 95205 <br /> (209)468-3420 www.siaov.oro/ehd <br /> dq r` a <br /> Permit Type <br /> Facility Name Address City Zip Code CT <br /> ,p sera <br /> PermdRegistration Holder Name Permit Exp.Date Total Time Inspection Type <br /> le f) li fi <br /> e " <br /> ., _ ,p_ ', �„'�1.a+ <br /> ' _ �;,'06SERVATION�ANQ-CO AGT�ONS� <;a <br /> nvA <br /> i /Z a I <br /> tkct-w,3 C L-�LD CfCb) <br /> ryt 1, 1k -lam <br /> L L CVNJ 1- m+- <br /> lZnr <br /> ' ) Z _ C3 c ( t <br /> ti or <br /> 1•t i t <br /> ff <br /> 43 4i — aCZ <br /> ZAL <br /> v- cj ( iY <br /> 1 It > t t <br /> 33fi� t/ <br /> C j ( J� ) 4 <br /> ope kt IK- . <br /> Received bSnature Phone:Received b Prnt:^ <br /> Specialist Print: , Specialist(Signature): Phone: S07 <br /> ❑ This report is an Official Notice of Violation.Corrections must be completed in the ti e s e fled. <br /> A reinspection fee maybe charged if violations noted on this report are not gcorrected by the reinspection date. Reinspection Date(on or about) <br /> IPaoe 1 of <br />