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Body Art Inspect Report Date: I'02 8 <br /> { San Joaquin County Environmental Health Department Program <br /> 1868 E.Hazelton Ave.,Stockton,CA 95205 Record: <br /> i! (209)468-3420 Program <br /> wvvw.sioay.orp/ehd Element: <br /> PR Number PRACTITIONERIARTIST NAME PR Number PRACTITIONER/ARTIST NAME <br /> PR0538150 Jamie"Lucky"McGovern-Permit+BBP posted <br /> Observations and Corrective Actions: <br /> 6. A facility that uses single use instruments shall maintain record of purchase, log of procedures, names of practitioner and <br /> client, date of procedure, instruments used, and written evidence from the manufacture that the instruments have undergone <br /> sterilization. The record of purchase, evidence of sterilization, type and number of instruments used shall be maintained for a <br /> minimum of 90 days after use. HSC 119315(f) <br /> 19. At the completion of the procedure, the practitioner shall provide postprocedure instructions that include all elements listed in <br /> Form B. HSC 119308(b) <br /> Items listed above will be checked during the routine inspection. <br /> Notes: <br /> 1.) Facility has ordered machine bags and plan to receive them tomorrow. <br /> 2.) Facility paid $212 during this inspection for a facility permit. <br /> 3.) Facility has been cleared to open. <br /> Reinspecion on/about: A reinspection fee of$130 per hour may be charged. Page 2 of 2 <br /> EH-03/2015 <br />