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COMPLIANCE INFO_TARYN WAGNER
Environmental Health - Public
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EHD Program Facility Records by Street Name
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4100 – Safe Body Art
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PR0543786
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COMPLIANCE INFO_TARYN WAGNER
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Entry Properties
Last modified
5/23/2024 9:23:53 AM
Creation date
4/1/2021 4:01:55 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4100 – Safe Body Art
File Section
COMPLIANCE INFO
RECORD_ID
PR0543786
PE
4110
FACILITY_ID
FA0024896
FACILITY_NAME
SALON TWO TWENTY (WAGNER, TARYN)
STREET_NUMBER
220
Direction
S
STREET_NAME
CHURCH
STREET_TYPE
ST
City
LODI
Zip
95240
CURRENT_STATUS
02
SITE_LOCATION
220 S CHURCH ST
P_LOCATION
02
QC Status
Approved
Scanner
SJGOV\cfield
Tags
EHD - Public
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0 0 1 . <br /> Body Art Facility Infection Prevention And Control Plan Guideline <br /> T. Permanent Cosmetic Machine Name and Manufacturer: Provide the model name and number <br /> for the permanent cosmetic machine(s)used (California Health and Safety Code 119311 (i)a)). <br /> 0\pr <br /> U. Service Animals: Describe the facility's policy regarding service animal presence in procedure, <br /> decontamination, and sterilization areas (California Health and Safety Code 119314 (f)). <br /> N)L <br /> Maintain a copy of this completed document in your files. Submit one copy to the Local Enforcement <br /> Agency. <br /> I hereby certify that all body art practitioners performing body art at this facility and employees <br /> or individuals involved with decontamination and sterilization procedures have been trained with <br /> the procedures and information contained in this document. To the best of my knowledge and <br /> belief, the statements made herein are correct and true. <br /> Signature: Date: <br /> Title: <br /> -T- <br /> Page 8 of 11 <br />
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