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S. Commercial Ink or Pigment Manufacturers: List the manufacturer(s) for the inks or <br />pigments used at the facility. Describe the procedure for dilution of inks. Only sterile water <br />should be used for dilution of inks or pigments (California Health and Safety Code 119311 <br />(b)(c)(d)(e)). <br />"Face Inks" by: Lasting Impressions 473 S. Dean Street, Englewood, New Jersey 07631 <br />Sterile Water, aka "Rewetting Solution", is used to dilute pigment. <br />T. Permanent Cosmetic Machine Name and Manufacturer: Provide the model Warne and <br />number for the permanent cosmetic machine(s) used (California Health and Safety Code <br />119311 (i)(j)). (Various machines and models used for clients and models — see each machine <br />for serial and/or model number) <br />• Nouveau Contour Intelligent <br />• Nouveau Contour iQ <br />• Mei-Cha Sapphire Elite GM <br />• Mei-Cha Lumi <br />• Cheyenne Hawk <br />U. Service Animals: Describe the facility's policy regarding service animal presence in <br />procedure, decontamination, and sterilization areas (California Health and Safety Code 119314 <br />MY <br />Service or Emotional Support Animals must be contained in a portable, plastic kennel. <br />Outside of the kennel must be wiped down with Madacide before being placed on the <br />procedure room floor. Floor will be cleaned with Bleach after the animal has left the facility. <br />Service or Emotional Support Animals are not allowed to be on a leash or roaming free in a <br />procedure room. They may be kept behind closed doors in a back office that is not used for <br />procedures. Floor will be cleaned with Bleach after the animal has left the facility. <br />Maintain a copy of this completed document in your files. Submit one copy to the Local <br />Enforcement Agency. <br />1 hereby certify that all body art practitioners performing body art at this facility and <br />employees or individuals involved with decontamination and sterilization procedures have been <br />trained with the procedures and information contained in this document. To the best of my <br />knowledge a elief, t e stat ents made herein are correct and true. <br />Signature: Date: 10 <br />Title:' <br />