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BodyArt Ins eco Report i 2p <br /> PDate: <br /> San Joaquin County Environmental Health Department Program <br /> { 1868 E.Hazelton Ave.,Stockton,CA 95205 Record: <br /> (209)468-3420 Program <br /> �,FORia`''• www.siogv.org/ehd Element: <br /> PR Number PRACTITIONER/ARTIST NAME PR Number PRACTITIONER/ARTIST NAME <br /> Briana Gonzales-BBP available,permit to be mailed <br /> Observations and Corrective Actions: <br /> 11. The procedure area shall be equipped with a sink with hot and cold running water, containerized liquid soap, and single use <br /> paper towels dispensed from a wall-mounted, touchless dispenser that is readily accessible to practitioner. Bathrooms must also <br /> meet these same requirements(hot water, paper towels). HSC 119314(b) <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 <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 /> Correct all violations listed above by August 21 , 2017 <br /> Notes: <br /> 1.) Upon receipt, post permit on site. <br /> 2.) Post bloodborne pathogen certificate. <br /> 3.) Facility has been approved 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 />