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SAN J OAQ U I N Environmental Health Department <br /> Body Art Inspection Report <br /> Facility Name: Facility Address: Date: <br /> OLD VINE TATTOO(PALMER, JOSH) 521 W KETTLEMAN LN, LODI July 27, 2021 <br /> Preventing Cross Contamination <br /> 26 HSC 119311(h) Barriers used ❑V ❑COS <br /> 27 HSC 119311(a) Products applied to skin are single use/dispensed aseptically ❑V ❑COS <br /> 28 HSC 119315 Storage of inks,pigments,needles,tubes,etc. ❑V ❑COS <br /> 29 HSC 119313, 119311 Jewelry, Inks, Needles etc approved and used correctly ❑V ❑COS <br /> 30 HSC 119309 Cross-contamination avoided during all phases of procedure ❑V ❑COS <br /> Best Business Practices <br /> 31 HSC 119314 Areas separated/no living or sleeping quarters ❑V ❑COS <br /> 32 HSC 119314, 119317 Floors and walls clean and in good repair,adequate light ❑V ❑COS <br /> 33 HSC 119314 Workstation,surfaces,including chairs,armrests,etc.in good repair ❑V ❑COS <br /> 34 HSC 119303, 119312 Permit/registration posted ❑V ❑COS <br /> 35 HSC 119313 Operation and employee training records present ❑V ❑COS <br /> Compliance and Enforcement <br /> 36 HSC 119312 Plan(s)submitted for review V ❑COS <br /> 37 HSC 119312, 119306 Permits obtained and available ❑V ❑COS <br /> 38 HSC 119313 Impoundment ❑V ❑COS <br /> 39 HSC 11932) Hearing scheduled ❑V ❑COS <br /> 40 HSC 11932) Closure V COS <br /> Other Violations <br /> 41 See below Other violations V COs <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> Item# Remarks <br /> Overall Inspection Comments: <br /> OBSERVATIONS <br /> Bloodborne pathogen training source: <br /> Chemical disinfectant used: Wet contact time: <br /> ON SITE PRACTITIONERS <br /> PR0546258--Joshua Palmer BBP EXP 7/26/22 PR0547075--Juancarlo Vela BBP EXP 7/22/22 <br /> PR0537432--Victor Hernandez BBP EXP 7/23/22 <br /> FA0026192 PRO546258 SCO05 07/27/2021 <br /> EHD Rev.6/15/2021 Page 2 of 3 Body ArtOIR <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjgov.org/EHD <br />