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L d0 b 96ed SHD2J `46uIS dlpueS <br /> PAYMENT �j a e'�� JT <br /> 0 e 3d t <br /> saa�'rce ero IQ, <br /> nn. .-.• s7 B.�' <br /> Ste)IlIzatle <br /> 'nremtiiapod wah nproceOf <br /> Body Art Facility Infection Prevention And Control Plan Guideline sterilizeddbOdr an/°a'e�r^in. <br /> lr <br /> T.Permanont Cosmetic Machine Name and Manufacturer: Provitle the modal name end number Ife sheu ry the foi <br /> rhperet Oral b <br /> for the pannsnant cosmetic machine(s) used (Callfomia Health and Safety Code 119311 (1)U)). <br /> N/A eant <br /> jelad ura I^d/cltloraTh�ovtpe� <br /> d air oil daCOnra <br /> r ra reel op o/I^erod e d for the slenliZer/O^lo a'fne al <br /> U.Se"Ico Animals: Describe the facill i decontamination, end sterilization areas(California Health and Safety Code 119314 ^/flat clad°air, r^odl° <br /> policy regarding service animal presence In procedure, <br /> We will ne our best to accommodate, as longas the service animal is to °f rn rellerroRma <br /> well trained and obedient. Once client leaves the area will swept and , wrhme'toraherlt,e rna/° <br /> whe hem. ciasan/car i °hoak, <br /> ^/n ertL afire s <br /> avea the at �inl Iceror <br /> o7thIts aha/�ba ZeoOn has bo <br /> Agency. a copy of this completed document In your files, Suhmit one copy to the Local Enforcement he ahal/area r� reCprdad IMai a A <br /> Agency. cle b <br /> !/ rela/rtep,pn cedu site for t <br /> p <br /> /hereby certify that a//body art practitloners performing body art at this facility and employees or <br /> th statem <br /> I dua/s Involved with decontaminatlon and sterilization procedures have been trained with the ! <br /> roceres and Information contained In this document To the best of my knowledge and bbelief,e ents made heroin are correct and true_ <br /> alOgical <br /> 9nd prop ofCaato,mo <br /> Signa (e: ,�J re Ball be Plac agative fesgti <br /> Date: y —) /-2t/� It cpd$Ornd ad In clean <br /> e <br /> Title: ss rn. an, <br /> n <br /> ^lam ry <br /> ina on o h E <br /> X ty 2—� 7— Z <br /> I/ \ the <br /> Ofst elan/f2ad.On <br /> X fay psgo <br /> before <br /> e°pOj11 n etdnhere the 1 <br /> the Pal <br /> i` Cie <br /> el <br /> Page a of 11 <br /> -pJ009J 6ulu1e4 pue dOdl :i7 OlOHd <br /> 9Z0Z `t1Z 40Jen <br /> t Z9ttgMd 0 6Z96 dO u01�301S `tr## aue-1 }SGM 0L �L — 00}}el Salel Ilel <br />