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S Q N J O A Q U I N Environmental Health Department <br /> ( Y <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 /> Item #6 - Provided EHD with invoices and sterilization certificates for BLACK CLAW instruments. <br /> CORRECTED. <br /> Item #7 - Provided EHD with proof of sharps disposal record. CORRECTED. <br /> Item #13 - Provided EHD with current BBP certificate exp 7/26/22. CORRECTED. <br /> Item #18 - Consent forms were complete at time of re-inspection. CORRECTED. <br /> Item #32 - Waste containers have liners in them at time of re-inspection. CORRECTED. <br /> Item #33 - The procedure table that has a tare on it will no longer be used. Owner has an extra table <br /> that will be used. CORRECTED. <br /> Item #35 - IPCP has been provided along with training records and is up to date. CORRECTED. <br /> Item #37 - Juancarlo Vela and Victor Hernandez have been registered with EHD and BBP is current. <br /> CORRECTED. <br /> THIS FACILITY IS SUBJECT TO REINSPECTION AT ANY TIME AT EHD'S CURRENT HOURLY RATE <br /> Received by: Date: Inspector: Inspector Phone: <br /> EMAI LEC, Printed Name and Title: PINNE CHAO, EH Specialist (209) 468-3854 <br /> Joshua Palmer <br /> FA0026192 PR0546258 SCO05 07/27/2021 <br /> EHD Rev.6;15/2021 Page 3 of 3 Body Art OIR <br /> 1868 E. Hazelton Avenue I Stockton, California 952051 T 209 468-3420 1 F 209 464-0138 1 www.sjgov.org/EHD <br />