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body Art Facility Infection Prevention And Control Plan Guideline <br /> 'Pon en�nrsmet c`hine mach�ine Name and <br /> used <br /> (California <br /> ta Health and Provide ttio mooei name and number <br /> l t formf me r ran" Code 1 t93t t (Owl <br /> U, ll the facAltY*$ n ltSttytiid(Tn p ure <br /> 5°Ni4 on sand sterilization a eas(CaliforsHah anng d Code t MI}$ rnao <br /> dKord <br /> maintain a copy of this completed document in your files Submit one copy to the Local Enforcement <br /> agency <br /> hereby certify that all body art practitioners performing body art at this facility and employees <br /> ( � a indrviduals involved with decontamination and sterilization procedures have been trained with <br /> the procedures and information contained in this document 7o the best of my knowredge and <br /> Delief, the statements made herein are correct and true. <br /> / Date <br /> SQnatufe <br /> Tine <br /> rl j <br />