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Body Art Inspect*Report <br /> Date: <br /> Program San Joaquin County Environmental Health Department Pro <br /> 1868 E.Hazelton Ave.,Stockton,CA 95205 Record: N l=W P� <br /> (209)468-3420 <br /> �4 c <br /> www.siogv.orgProgram <br /> Element: 1-1/.2 <br /> PR Number PRACTITIONER/ARTIST NAME PR Number PRACTITIONER/ARTIST NAME <br /> New PR Carrie Blubaugh <br /> Observations and Corrective Actions: <br /> 6. A facility that uses single use instruments shall maintain record of purchase, log of procedures, names of practitioner and <br /> client, date of procedure, instruments used, and written evidence from the manufacture that the instruments have undergone <br /> sterilization. The record of purchase, evidence of sterilization, type and number of instruments used shall be maintained for a <br /> minimum of 90 days after use. HSC 119315(f) Provide EHD with sterilization certificate. <br /> Notes: <br /> 1. Facility may now begin operation. <br /> 2. Post the permit upon receipt. <br /> 3. Post the Bloodborne Pathogen Certificate. <br /> 4. Pay applicable fees prior to issuing of permit <br /> Reinspecion on/about: A reinspection fee of$162 per hour may be charged. Page 2 of 2 <br /> EH-11/17 <br />