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COMPLIANCE INFO_TARYN WAGNER
EnvironmentalHealth
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4100 – Safe Body Art
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PR0543786
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COMPLIANCE INFO_TARYN WAGNER
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Entry Properties
Last modified
5/23/2024 9:23:53 AM
Creation date
4/1/2021 4:01:55 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4100 – Safe Body Art
File Section
COMPLIANCE INFO
RECORD_ID
PR0543786
PE
4110
FACILITY_ID
FA0024896
FACILITY_NAME
SALON TWO TWENTY (WAGNER, TARYN)
STREET_NUMBER
220
Direction
S
STREET_NAME
CHURCH
STREET_TYPE
ST
City
LODI
Zip
95240
CURRENT_STATUS
02
SITE_LOCATION
220 S CHURCH ST
P_LOCATION
02
QC Status
Approved
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SJGOV\cfield
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EHD - Public
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Body Art Facility Infection Prevention And Control Plan Guideline <br /> 8. Tattoo machine and Clip Cord: <br /> N�h <br /> 9. Reusable instruments, calipers, needle tubes, etc. portable light fixtures or other: <br /> MLA (fV59)9V1 el-Ce ;el-kdkol <br /> ®W Airontina V La <br /> d1YeUkLc)eic_,,, . Aefaceae 14114 <br /> fV 90e 0,Vhd <br /> 10. Permanent Cosmetic Machine: <br /> M01 <br /> A L(D&r -M(Vt)lq K �1 Q-� ff V401'Xe UkO <br /> P;aooia�t i2a U <br /> B. Reusable Instruments or Disposable: Describe the procedures used for decontaminating, <br /> sterilizing, packaging and storing of reusable instruments. Include the procedures for labeling of <br /> sterilized peel-pack. Indicate whether the body art facility uses all pre-sterilized, single-use and <br /> disposable instruments. Describe the record keeping logs and procedure logs maintained on-site <br /> when using 100% pre-sterilized, single-use and disposable instruments (California Health and Safety <br /> Code 119309 and 119315). <br /> 1. Needle tubes: <br /> 9 <br /> to <br /> 2. Calipers: <br /> M� <br /> 3. Other instruments: <br /> 15(14 IR L)V )Q taA42S -f0f Mblb la in , Div ed 1'0;1� <br /> If ri 'i <br /> Nyaff.1 !!A AmikE M05i in -4-eKl 1kqj)bn Ger- 'ca <br /> "V4. jt)M-e5 mo9f w s <br /> tgld in dru &L <br /> d'eC0VV-VjMjYab0Y1 . ivij \,Vi+V\-t& nomloe.'r muzrf loe <br /> a. -e tO OVIe0is Kle . <br /> Page 3 of 11 <br />
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