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Body Art ���������'�����V� n�� Date: ^� <br /> San Joaquin County Environmental Health Department pmonam <br /> 1000s.Hazelton Ave..Stockton,oAoocuo n000m: <br /> (209)468-3420 Program - ' <br /> uwums oqv.om/uhd Element: <br /> NAM CTI MART!, AME <br /> Observations and Corrective Actions: <br /> G. 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 of9Udays 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. HGC118303 <br /> 27. Products applied to skin prior to tattooing or application ofpermanent cosmetics, including, but not limited to, stencils, <br /> marking and transfer agents, shall be single use and discarded into a waste container at the end of the procedure. HSC <br /> 119311(a) <br /> withinUnless otherwise noted, all violations must be corrected <br /> noinspocipnvmauout: Areinspection fee of$1xoper hour may uocharged. Page umu <br /> sH'O:xcO15 <br />