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01/15/2013 17:04 209836' 2 TIP PRINTING 0 PAGE 06 <br /> H. List the Medical Waste Hauler, Mail-Back System or Alternative Treatment Technology for <br /> the disposal of sharpscontainers: 9Y <br /> (California Health and Safety Code 119314 (e)) <br /> Medical Waste Hauler <br /> Street Address p, 6 <br /> City, ST, Zip C s - <br /> I. Sterilization of Jewelry: Describe the procedure for the sterilization of jewelry <br /> newly pierced skin. (California Health and Safety Code 119310 (a) and11931 )rior to piecing into <br /> N <br /> J. Sterilization Equipment: List the equipment used in the decontamination and sterilization room <br /> and describe the procedure for decontaminating instruments prior to placing inside the autoclave, <br /> Indicate whether instruments are manually washed or machine washed, such as with an <br /> 09 (b)(e) machine, <br /> Ultrasonic machine. Include the material used for soaking dirty instruments in t <br /> such as Tergazyme. (California Health and Safety Code 1193e 119he he (c), and <br /> 119315 (b)} <br /> a c� <br /> s <br /> K. Disinfection Products: List the disinfectant products used at the body art facility. (California <br /> Health and Safety Code 119301 (k) and 119308 (b)(6)) <br /> NM.,+C i F <br /> L. Time and Temperature: List the duration of time and temperature of the autoclave required for <br /> the sterilization of clean instruments. Indicate whether as #e. <br /> Safety Code 119315 (b)(3)(5)) teriliza tion log is maintained on-si <br /> Indicate whether each sterilization load is tested using Class 5 integrators. (California Health and <br /> Time --- it <br /> Temperature <br /> Psi ' <br /> M. Personal Protective Equipment: List the personal protective <br /> equipment procedure. (California Health and Safety Code 119308 (a) and 11193pg (j))used during a body art <br /> Page 5 of lo <br /> Received Time Jan. 15. 2013 5: 09PM No, 0422 <br />