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COMPLIANCE INFO
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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CENTRAL
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1010
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4100 – Safe Body Art
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PR0541621
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COMPLIANCE INFO
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Entry Properties
Last modified
6/10/2025 10:17:48 AM
Creation date
4/12/2023 3:50:04 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4100 – Safe Body Art
File Section
COMPLIANCE INFO
RECORD_ID
PR0541621
PE
4120 - BODY ART FACILITY-SINGLE USE
FACILITY_ID
FA0023856
FACILITY_NAME
VERSAILLES SALON (GREEN-FRESE, ERICA)
STREET_NUMBER
1010
STREET_NAME
CENTRAL
STREET_TYPE
AVE
City
TRACY
Zip
95376
CURRENT_STATUS
Active, billable
QC Status
Approved
Scanner
SJGOV\cfield
Supplemental fields
Site Address
1010 CENTRAL AVE TRACY 95376
Tags
EHD - Public
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EMEMAgMil <br />Ethylene Oxide Sterilization Certificate <br />Customer: <br />Madluvv <br />it fE :Address <br />7624 E Kramer St Mesa,AZ 85207 USA <br />F,i& TeL : <br />1 (480) 459-1555 <br />X1WHJq Date: <br />2021-01-21-2021-01-2 <br />iiEi'14p s No. of Certificate: <br />XMGTO/D-GR-2101221 <br />Xffi t-�- Sterilization Lot NO : <br />UB02201227 MB02201226 MB02201225 MB02201228 <br />fm <br />Product name Lot No. Quantity Cartons Comment <br />Madluw Disposable microblading pen MB02201227 2500 5 <br />balck handle #9 <br />Madluw Disposable microblading pen MB02201226 6000 10 <br />balck handle #12 <br />Madluw Disposable microblading pen MB02201226 3500 7 <br />balck handle #14U <br />Madluvv Disposable microblading pen MB02201228 3000 6 <br />balck handle #18U <br />A it Total: 28 V Cartons <br />• i1 T J: 3MT^IT%Z:AXMt0t 4M-/rM <br />Biological Indicator: 3MTM 1264-S <br />MB02201227 <br />Olt s M8022012202201225 1aMIA Lot NO: MMB02201226802201225 <br />Temperature:370C t 2°C <br />MB02201228 <br />eIRMf No. Placed: VXtliA No, Retrieved: 20 QXiWYA Noon Test: 20 <br />BI AIMMA RESULT <br />M41j-fi Hours � Isat c <br />Quantity 24H 48H No.of Growths of <br />TestOrganism <br />ViMJt Test Organism 120 0 0 0 <br />X$IW PositiveControls 12 2 2 2 <br />1.t"M N�OY415 Biological Indicator Test Disposition: a4 Pass: TA4Fail: ❑ <br />2. Chemical Indicator Test Disposition: p Pass: �Aili Fail: ❑ <br />3, XIWWP15� Sterilization Parameters Decision: a Pass: 1 u * Fail: ❑ <br />*R Comments: N/A <br />Rs7i$ijUKASfHDanakik-PT `jfAVicjkiljEfl jQBVM ISO 13485:2003, 1809001 :20081 2MW711 ry1,1E,,.,, <br />Our company has passed the ce 'I tdseyed by BV of Europe Union of IS( ?901 11 ?901, 2008. <br />CerificateNo.: IT2739761 CN <br />Tet By: o�, yz pp oved by: yoj3i't <br />d <br />Add: Room 3010, Yunjinghui Buiidin O, -571, Yuncheng East Road, Baiyun District, Guangzhou China <br />r�ffl rrj-NW r1kifirO n—RIK iiAMyM559-571'&,5 1*1i$010 <br />Te1:86-20.86553738 E-mail: Judy@semipermanentmakeuppigments.com charmingtattoo.com <br />
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