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Body Art Ins4ion Report • Date: 31.5111 <br /> San Joaquin County Environmental Health Department Program <br /> 1868 E.Hazelton Ave.,Stockton,CA 95205 Record: NR.W PF- <br /> (209)468-3420 <br /> \ tpK• `'• www.siogv.org/ehd Program <br /> y ' 20 <br /> Element: <br /> PR Number PRACTITIONER/ARTIST NAME PR Number PRACTITIONER/ARTIST NAME <br /> New PR Emmanuel Maldonado <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)—Provide evidence of sterilization for Beyond Needles. Send a copy of the <br /> sterilization certificate to the EHD. <br /> Note: <br /> 1. If you have any question, please contact me at(209)468-3284 or mvue@sjcehd.com <br /> 2. Keep record of purchase for the needles/blades in the facility. <br /> 3. Keep evidence of sterilization for the blades/needles in the facility. <br /> 4. Facility is ok to permit. <br /> Correct all violations and pay all applicable fees before permit can be issued. <br /> Reinspecion on/about: A reinspection fee of$152 per hour may be charged. Page 2 of 2 <br /> EH-11/17 <br />