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SALMON N Environmental Health Department <br /> — COUNTY— <br /> Body Art Inspection Report <br /> Facility Name: Facility Address: Date: <br /> XOCHICALCO TATTOOS & COSMETICS 5308 PACIFIC AVE, STOCKTON August 20, 2021 <br /> Overall Inspection Comments: <br /> OBSERVATIONS <br /> Bloodborne pathogen training source: <br /> Chemical disinfectant used: Cavicide Wet contact time: 3 mins <br /> ON SITE PRACTITIONERS <br /> PRO543740 — Yecenia Rosas - BBP 10-20-21 PRO539789 — Gerardo Rivera - BBP 10-16-21 <br /> PRO547127 — Christopher Seagram - BBP 1 -6-22 <br /> Correct all violations and submit evidence of correction to the EHD by September 3 , 2021 , <br /> Notes: <br /> 1 . Inspection report emailed to Gerardo Rivera (owner) at gerardo52rivera@yahoo.com and to Yecenia Rosas (owner at <br /> rosasy92@gmail.com . <br /> 2 . GRP is used for sharps waste disposal. Sharps waste was last mailed back on 7/20/21 . <br /> 3. Client records were reviewed. Ensure client records are available for 3 years and client photo ID is attached. <br /> 4. Owners will contact EHD for consultation when the sterilization room is ready. <br /> THIS FACILITY IS SUBJECT TO REINSPECTION AT ANY TIME AT EHD'S CURRENT HOURLY RATE. <br /> Received by: Date: 8-20-21 Inspector: �a„t,� ,�,i., Inspector Phone: <br /> � ' " ' Printed Name and Title: SANDIP SINGTTH, _RENS (209) 468-3526 <br /> Gerardo Rivera, Owner , <br /> FAM25033 PR0544021 scent 08/200021 <br /> END Rev. 61152021 Page 3 of 3 Body Ad DIR <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209468-3420 1 F 209464-0138 1 www.sjgov.org/EHD <br />