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Inspecdon Repod Date mmxNm - — <br /> County of Son Joaquin County.En*mnenbd Heelh Dqpadrnent <br /> 1868 E Hazefton Ave-Stoddon CA 95205 Permit Number <br /> (M)465-3420 MW-a;iWjqEftW PeffnitType, t <br /> Facility Haan Address CRY zip Code CT <br /> C\es® E <br /> TOWThne InspeclDnTyp <br /> tr° <br /> 11 <br /> Risk fac• a OtS of cross-Wntaminatim <br /> s ° p�. s to another <br /> In In m Tian ," n <br /> A <br /> ` ..�: LV <br /> . <br /> IZ i. Auloclave is iffni� <br /> 0 13 <br /> In 2 9between <br /> t Ik';i <br /> Iz 3. Auloclave loaded a E3 0. <br /> dry <br /> In D 4. Inte jakxs p <br /> TA <br /> maintained <br /> 5. tianxuza/sa11 E3 <br /> 6. Invoioes and log keF Ausad E3 sterilizedC.> <br /> a N10 7. sc ` E3 E3 <br /> et <br /> NIA disposed of W,+ <br /> NIO 8. J <br /> E3 13 <br /> NIA and we <br /> ?pkd to sidn are single <br /> In p 9. No eating,chi or of pigmentsx <br /> E3 13 <br /> Nt <br /> In 40. Hands washed a ect€rr ,Inks,Needy etc approved and used ❑ ❑ <br /> s <br /> in.id{t) 11. Handuvash faalrges n avoided durg all uses ❑ <br /> JE3 <br /> ,q ac,wamt to G Agocedure <br /> i <br /> NIA used.12. Persons�of�ive eq � �j PR <br /> NIA 5 t" a •i s 3. F a t ry <br /> Areasseparatediholiftordeeping <br /> ate..._ ' .# ❑ <br /> aniffials <br /> In 13. i IN' �� in ❑ <br /> procedureweaxfx n ° <br /> In 14. Cuslorners ' 31. Waftellon,surfaces,Including res,,etc.in ❑ <br /> Agood TM trash iernoved Ls�: <br /> Nf <br /> 15. Skin . <br /> E3 0A <br /> In 16. ClarNIO <br /> d records arc&able-Camt bm& r33. IPCP and eniployee training records and ❑ <br /> wiestionnaire A <br /> In 17. Aftercare instuctions given to client E3 ® n 34 ftestroo ,stacked` 01 C3 <br /> WA I <br /> Received b (Print): R (Signature): <br /> allst(Print): s ( ' ): Phone: <br /> This report Is an Official Notice of Vlokition.Corrections must be completed In the time <br /> A reinspection fee maybe charged if violations noted on this report are not corrected by the reinspectlDn date. Refrispection Date(on or abou <br />