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U`" Body Art Inspectioeport Date: / <br /> �/ iq /iq <br /> a San Joaquin County Environmental Health Department Program <br /> 1868 E.Hazelton Ave.,Stockton,CA 95205 g P�O S (�u Z <br /> \� (209)468-3420 <br /> Record: <br /> Program <br /> ° -1 1 <br /> )Fo e�`' www.siogv.org/ehd <br /> Element: y t (Z.17 <br /> PR Number PRACTITIONER/ARTIST NAME PR Number PRACTITIONER/ARTIST NAME <br /> Briana Gonzales-BBP Expired and Posted,Permit <br /> PRO542097 Updated and Not Posted <br /> Observations and Corrective Actions: <br /> 13. Practitioner shall provide evidence of a completed, EHD approved, OSHA Bloodborne Pathogen Training consistent with <br /> section 119307. —Expired Bloodborne Pathogen Training posted. Renew the bloodborne pathogen training certificate <br /> and sent to the EHD. <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—Include the lot number for the blades use on clients to the client consent form. <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)—All stencils, marking and transfer agents shall be single use. <br /> 34. Certificate of registration and health permit shall be posted in a conspicuous place. HSC 119306 and 119312—Post health <br /> permit in a conspicuous place. <br /> Note: <br /> 1. If you have any question, please contact me at(209)468-3284 or mvue@sjcehd.com <br /> 2. Send a copy of the Bloodborne Pathogen Training Certificate to the EHD. <br /> Correct all violations prior to February 28, 2019. <br /> Reinspecion on/about: A reinspection fee of$152 per hour may be charged. Page 2 of 2 <br /> EH-11/17 <br />