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Body Art Inspect Report � S <br /> 11b 11 1, <br /> San Joaquin County Environmental Health Department Program <br /> 1868 E.Hazelton Ave.,Stockton,CA 95205 Record: Plio Z.I <br /> 209 468-3420 <br /> ciF R�'�p www.siogv.org/ehd Program <br /> Element: "t <br /> PR Number PRACTITIONERIARTIST NAME PR Number PRACTITIONER/ARTIST NAME <br /> PR0537098 Lieu Thi Nguyen <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 /> 19. At the completion of the procedure, the practitioner shall provide postprocedure instructions that include all elements listed in <br /> Form B. HSC 119308(b)-Signs and symptoms of infection. <br /> Unless Otherwise Noted, Corrective Action Due in 30 days. <br /> Reinspecion onlabout: A reinspection fee of$130 per hour may be charged. Page 2 of 2 <br /> EH-03/2015 <br />