Laserfiche WebLink
oZ` Body Art InspectiO Report Date: Z 7 1 <br /> San Joaquin County Environmental Health Department <br /> a, /1 <br /> 1868 E.Hazelton Ave.,Stockton,CA 95205 Program <br /> c'')Record: T ✓V S3 0 y <br /> (209)468-3420 <br /> pig <br /> t,�oRcv WWW.siogv.org/ehd Pro ram <br /> Element: —1 <br /> PR Number PRACTITIONER/ARTIST NAME PR Number PRACTITIONER/ARTIST NAME <br /> PRO530665 Eddy Reyes <br /> PRO537477 Jose Garcia <br /> PRO537907 Eddy Re es Jr. <br /> PR0537476 Marcos Adame <br /> Observations and Corrective Actions: <br /> 6. A facility that uses single use instruments shall maintain record of purchase, log of procedures, names of practitioner and <br /> client, date of procedure, instruments used, and written evidence from the manufacture that the instruments have undergone <br /> sterilization. The record of purchase, evidence of sterilization, type and number of instruments used shall be maintained for a <br /> minimum of 90 days after use. HSC 119315(f) <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 119303. Maintain a months worth of consent forms and medical questionaires, not less <br /> than 50 on site for inspection. <br /> Unless otherwise noted, Corrective Action Due in 30 days. <br /> 1. Failure to correct violations observed above will result in a penalty of$152.00 and an re-inspection. <br /> Reinspecion on/about: A reinspection fee of$125 per hour may charged. Page 2 of 2 <br /> EH-04/2014 <br />