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Am <br /> Body Art InspectioseportDate:San Joaquin County Environmental Health Department Program <br /> ` 1868 E.Hazelton Ave.,Stockton,GA 95205 Record: uu ROS—1 I 1 11 <br /> (209)468-3420 <br /> P Program <br /> www.sjogv.org/ehd <br /> 912-0 tFaRia` <br /> Element: <br /> PR Number PRACTITIONER/ARTIST NAME PR Number PRACTITIONER/ARTIST NAME <br /> PRO541299 Tina Phon-BBP Posted <br /> Observations and Corrective Actions: <br /> 18. The facilities client consent form and medical questionnaire must include all of the information listed in Form B, and are <br /> available for inspection. HSC 119303-On the medical questionnaire, make sure to change herpes to herpes infection at <br /> the procedure site.Always have a copy of the client identification. <br /> 27. Products applied to skin prior to tattooing or application of permanent cosmetics, including, but not limited to, stencils, <br /> marking and transfer agents, shall be single use and discarded into a waste container at the end of the procedure. HSC <br /> 119311(a)—Stencils/marking should be single use.Discard blades into the sharp container after usage. <br /> 28. Sterilized instrument packs, equipment and jewelry shall be stored in a labeled container or cabinet that is protected from <br /> dust or moisture. Sterile instrument packs shall be evaluated before use; instrument packs shall be discarded or reprocessed if <br /> condition is compromised. HSC 119315—Inks must be stored in a container to prevent dust and moisture from <br /> contaminating them. <br /> Unless otherwise noted, correct all violations prior to January 30, 2019. <br /> Reinspecion on/about: A reinspection fee of$152 per hour may be charged. Page 2 of 2 <br /> EH-11/17 <br />