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COMPLIANCE INFO
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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4100 – Safe Body Art
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PR0524524
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COMPLIANCE INFO
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Entry Properties
Last modified
8/19/2025 4:10:45 PM
Creation date
7/3/2020 10:15:18 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4100 – Safe Body Art
File Section
COMPLIANCE INFO
RECORD_ID
PR0524524
PE
4120 - BODY ART FACILITY-SINGLE USE
FACILITY_ID
FA0016445
FACILITY_NAME
HARD LUCK TATTOO (NGUYEN, BAO)
STREET_NUMBER
1
Direction
W
STREET_NAME
PINE
STREET_TYPE
ST
City
LODI
Zip
95240
CURRENT_STATUS
Active, billable
QC Status
Approved
Scanner
SJGOV\cfield
Supplemental fields
FilePath
\MIGRATIONS\BA\BA_4120_PR0524524_1 W PINE_.tif
Site Address
1 W PINE ST LODI 95240
Tags
EHD - Public
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rrstand and can perform proper tear-down of workstation <br /> rstand post-exposure procedure and can direct people to the nearest <br /> ency medical facility <br /> 1 understand and can perform proper bandaging of new tattoo <br /> 1 understand and can discuss aftercare for any procedure offered by the shop with <br /> clients <br /> I understand and can perform required record keeping for client services <br /> 1 have been introduced to and can appropriately use new shop technology <br /> I understand and can perform housekeeping tasks and know the location of <br /> supplies_ <br /> I understand that anything that is NOT IN THE ORIGINAL PACKAGING MUST BE <br /> LABELED!! <br /> I understand and can perform required record keeping for housekeeping tasks. <br /> 1 know the location of Emergency eye wash station, First Aid kit,and CPR equipment <br /> (as applicable) <br /> I know the location of shop circuit breaker box <br /> 1 know the location of the shop fire extinguisher(s) :4 <br /> understand and can perform these cross-contamination prevention procedures ?; <br /> By signing this form, I acknowledge that I have presented and explained the above listed topics to <br /> my employees during the annual refresher training. <br /> Signed: . Date: <br /> t0r4� / � 7 <br /> Circle one: Owne an ger <br /> 9£/6T 3Jtid dIHS '8 ADVd IQO- 9Z80L9E-60Z 5b:6T LTOZ/EZ/01 <br />
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