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BodyArt Ins ecti�2e ort <br /> P P Date: II 2 fi <br /> San Joaquin County Environmental Health Department <br /> Program <br /> 1868 E.Hazelton Ave.,Stockton,CA 95205 g <br /> Record: <br /> c (209)468-3420 Program <br /> F6K��,.-.. www.siogy.org/ehd /2U <br /> Element: <br /> PR Number PRACTITIONERAARTIST NAME PR Number PRACTITIONER/ARTIST NAME <br /> PR0515393 John Highland PR0537376 Nephtali Bru ueras <br /> PR0541553 Leanna Martinez PRO537371 Daniel Ju e <br /> PRO541902 Jessica Orsua PR0537374 Ricardo Cardenas <br /> PR0539346 Kristal Betancourt <br /> Observations and Corrective Actions: <br /> 9. No food, drink, tobacco product, or personal effects are permitted in the procedure area. HSC 119309 Do not allow <br /> customers to take food and beverages into the procedure area. <br /> 18. The facilities client consent form and medical questionnaire must include all of the information listed in Form B, and are <br /> available for inspection. HSC Clients must completely fill-out forms and provide proper identification. <br /> 25. Disinfectant shall be used according to the manufacturer's instructions. HSC 119309(b) Provide wet contact time for <br /> disinfectant inlePP� <br /> Unless otherwise noted, corrections are to be completed by December 11, 2018. <br /> Reinspecion on/about: A reinspection fee of$152 per hour may be charged. Page 2 of 2 <br /> EH-11/17 <br />