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H. List the Medical Waste Hauler, Mail-Back System or Alternative Treatment Technology for <br /> the disposal of sharps containers: <br /> (California Health and Safety Code 119314 (e)) <br /> cr 1 tile e tA ia- 7-C4 l l <br /> Medical Waste Hauler (► CLA'kec Wa,S{e- C-e-M of <br /> Street Address OLI O W eA mo ir- <br /> City, ST, Zip /Actvw/_e_A C-A RS33 <br /> I. Sterilization of Jewelry: Describe the procedure for the sterilization of jewelry prior to placing into <br /> newly pierced skin. (California Health and Safety Code 119310 (a) and 119315) <br /> ��ay ._,.,.s,..• TWr tii '� �t ,.:.+W ._.r _� -� gso ' .,t E=, ,.`��'�t" , ��'C.. <br /> J 1yItl.i <br /> J. Sterilization Equipment: List the equipment used in the decontamination and sterilization room <br /> and describe the procedure for decontaminating instruments prior to placing inside the autoclave. <br /> Indicate whether instruments are manually washed or machine washed, such as with an <br /> Ultrasonic machine. Include the material used for soaking dirty instruments in the machine, <br /> such as Tergazyme. (California Health and Safety Code 119309 (b)(e)(g), 119314 (c), and <br /> 119315 (b)) r <br /> +0 S&kr � LLS I V.5 � l.K 4ct s o w"c O r.d CLt,.'k 0 r-(4V a <br /> Se '�v.�, c,�o S�'Le� `2�� o►n roaS cthl'� <br /> ncedlcs -Qer 1aA+W►r1A -- Gr P►e.vc ,"G 6►.-+,1 ort -.Side, -Te .,Jei(� - <br /> vve ed I1S Bras•J ntw ►,t rc, , <br /> K. Disinfection Products: List the disinfectant products used at the body art facility. (California <br /> Health and Safety Code 119301 (k) and 119308 (b)(6) <br /> Ma c z l� t v�tsc 1 - �K ie e, It✓ <br /> L. Time and Temperature: List the duration of time and temperature of the autoclave required for <br /> the sterilization of clean instruments. Indicate whether a sterilization log is maintained on-site. <br /> Indicate whether each sterilization load is tested using Class 5 integrators. (California Health and <br /> Safety Code 119315 (b)(3)(5)) <br /> Time <br /> Temperature a-7rH' <br /> Psi t P5 <br /> U.S Yn o n.�40 ( Sr w k p s GL 10!5 <br /> M. Personal Protective Equipment: List the personal protective equipment used during a body art <br /> procedure. (California Health and Safety Code 119308 (a) and 119309 (j)) <br /> Page 5 of 10 <br />