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Body Art Inspect Report Date: <br /> r °`z San Joaquin County Environmental Health Department <br /> Program <br /> ram <br /> 1868 E.Hazelton Ave.,Stockton,CA 95205 Record: <br /> (209)468-3420 Program <br /> ..cq ••••• �`p www.Sio4v.orq/ehd g <br /> Element: <br /> PR Number PRACTITIONER/ARTIST NAME PR Number PRACTITIONER/ARTIST NAME <br /> PR0537131 Victor Lara-Permit Posted, BBP Posted <br /> PR0537528 Joel Ruiz-Permit Posted,BBP Posted <br /> Observations and Corrective Actions: <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. Ensure DOB of parent/guardian is obtained for piercings of minors. HSC 119303 <br /> 35. Operation and employee training records shall be maintained for 3 years and made available for inspection. A written <br /> Infection Prevention and Control Plan (IPCP) shall be maintained, followed and updated. HSC 119313 <br /> Unless otherwise noted, Corrective Action Due in 30 days. <br /> Reinspecion on/about: A reinspection fee of$130 per hour may be charged. Page 2 of 2 <br /> EH-03/2015 <br />