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COMPLIANCE INFO
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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PR0523952
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COMPLIANCE INFO
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Entry Properties
Last modified
4/17/2026 2:33:54 PM
Creation date
4/25/2023 12:53:45 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4100 – Safe Body Art
File Section
COMPLIANCE INFO
RECORD_ID
PR0523952
PE
4121 - BODY ART FACILITY-STERILIZATION
FACILITY_ID
FA0014791
FACILITY_NAME
CANVAS TATTOO (BAMBULA-SANTOS, MELISSA)
STREET_NUMBER
304
Direction
W
STREET_NAME
HARDING
STREET_TYPE
WAY
City
STOCKTON
Zip
95204
APN
13708003
CURRENT_STATUS
Active, billable
QC Status
Approved
Scanner
SJGOV\kblackwell
Supplemental fields
Site Address
304 B W HARDING WAY STOCKTON 95204
Suite #
B
Tags
EHD - Public
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PEOPLE > SCIENCE > SOLUTIONS <br />STUDY TITLE <br />Test of Sterility <br />?EST ARTICLE NAME <br />B Lab testing for full cycle EO <br />TEST ARTICLE IDENTIFICATION <br />201 81 D30 <br />TEST ARTICLE PHYSICAL DESCRIPTION_ <br />Ste tat specification, <br />TEST ARTICLE RECEIVED <br />Novenbcr 16. 2018 <br />SPONSOR <br />Imam %tercet <br />Kingpin Tattoo Supply <br />9715 International Court North <br />St. Petersburg, FL 33716 <br />Test Facility <br />6750 Wales Road <br />Northwood OH 43619 <br />819 666 9455 <br />SUNWARY <br />Th s qualitative test �4as performed according to a NAMSA spccifcation todetermine ifthe biological indicators were sterile, <br />RESULTS <br />B oindicator. 8"Mus atropharus {410' BI Lot Number. RAI4 <br />Article Tested <br />Number of <br />Type of Medium Incubation <br />Number of <br />Number of <br />Articles Tested <br />Temperature <br />Days <br />Positive <br />(Degrees C) <br />Incubated <br />I Articles <br />Spore Strip <br />10 <br />SCDB - 15 mL 30-35 <br />7 <br />0 <br />Spore Strip Positi%c Control <br />1 <br />SCDB - 15 mL 30-35 <br />1 <br />1 <br />%k't)B • So)ttcan C'ascin Di pm Broth <br />Test Start Date: November 16. 2018 Test Termination Date: November 23. 2018 <br />Co-ltrol Start Date: November 19. 20 18 Control Termination Date: November 20. 2018 <br />METHOO <br />See the attached sterility test specification T0000732-05. <br />0A <br />4NOV M? <br />Elsa A. Schwalenberg, BS u Date <br />laboratory Supervisor. Sterility Assurance <br />kertlts 40, omh, to thr tela arrick tesud .Irn extra;x4 ium ofthese data t.# ,Nher wta les a the qxvtur s respmutbihor This test was prrfiw*ed ows*r all <br />n,-,0ttatrie (;A1P r*vwMrtats mod nt ccw P1k;Y r with the M) ijamird with the kit ,wrth,rt oc i rrdtred to the M)1 77125 samtdord <br />P O. No, Lab Number MS005 00S Pape t of 1 <br />311E 18T_7323701 i <br />
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