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EHD Program Facility Records by Street Name
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ELEVENTH
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4100 – Safe Body Art
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PR0539015
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COMPLIANCE INFO
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Entry Properties
Last modified
11/19/2024 10:21:04 AM
Creation date
6/13/2023 1:18:13 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4100 – Safe Body Art
File Section
COMPLIANCE INFO
RECORD_ID
PR0539015
PE
4120
FACILITY_ID
FA0021597
FACILITY_NAME
FOREVER YOURS TATTOO (HULLAR, JOHN J)
STREET_NUMBER
606
Direction
W
STREET_NAME
ELEVENTH
STREET_TYPE
ST
City
TRACY
Zip
95376
APN
23502302
CURRENT_STATUS
02
SITE_LOCATION
606 W 11TH ST
P_LOCATION
03
P_DISTRICT
005
QC Status
Approved
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EHD - Public
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i <br /> tae ajovaT��. kat 0-c-415 <br /> N. Handwashing Sink: List the locations of the handwash sinks and describe the items supplied at <br /> each sink. (California Health and safety Code 119.314 ( )( )) <br /> 0. Aftercare Procedure: Describe the written recommendations and care provided to the client after <br /> a body art procedure. List the type of bandages or wrappings provided after a body art <br /> procedure. (California Health and safety Code 119303 ( ) and 119308 (b)) <br /> em dA roC./JIvr45 c eta.a 64q✓+ lcw a',U w + 41Id1-1 �140 Et- « o! ®v l¢. kri <br /> waxm a., W 4;,;w t AQA 'r-iouvr) 04x, A tl�k4l t <br /> k," , Jtja .8 luke -1b <br /> P. Procedure for an Accidental Spill Describe the clean-up and disinfection procedure taken when <br /> there is ang accidental spill of sharps. {(California Health and safetyCode 119309 (a)(b)(c)) <br /> F't r L 4 J :5021 Y T t.,. {{ <br /> t / to c$:S hs✓ r s^e �r tt <br /> Trash Receptacles and disposal of contaminated trash: List the type of trash receptacles and <br /> their location throughout the body art facility. Describe the procedure for the disposal of <br /> contaminated items,such as gloves. (California Health and safety Code 119311 (a) and 119314 <br /> (d)) <br /> c %Vvi tcas r#-'t,I - A &Ioz . <br /> pt r n, vi r�:15 �r�. tis cacs v,z <br /> �r s� r c /' v <br /> bio " Zaf� O l ma k_ n. .1ucl <br /> egad ailed Spore Test: Describe the procedure conducted when a monthly spore test <br /> has failed. Indicate whether the facility maintains a spore test log on-site. (California Health and <br /> safety Code 119315 (b)(2)(4)) <br /> S. Commercial Ink or PigmentManufacturers: List the manufacturer for the inks or pigments <br /> used at the body art facility. Describe the procedure for dilution of inks. Only sterile water should <br /> be used for dilution of inks or pi ments. (California Health and Safety Code 119311 (b)(c)( )(e)) <br /> T. Permanent Cosmetic Machine Name andManufacturer: Provide the model name and number <br /> for the permanent cosmetic machine sed. (California Health and Safety Code 119311 (i)0)) <br /> k( Y113 <br /> Page 6 of 10 <br />
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