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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
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EHD - Public
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C. <br />disposable instruments. Describe the record keeping logs and procedure logs maintained on-site <br />when using 100% pre -sterilized, single -use and disposable instruments. (California Health and <br />Safety Code 119309 and 119315) <br />1. Needle tubes: <br />ALL _LIZ' 6CU L _iTN- j oyi tJ ()KI ri, I c k C otk;ja L.) — F'2iq ti J) <br />%4 Wj VM �Ft��� t 1"✓1 iazv' 1 +-r�tc i �l riz �?2 <br />2. Calipers: <br />3. Other instruments: <br />Storage: Describe the storage location and equipment used for the storage of clean and sterilized <br />in:3trument peel packs to protect the packages from exposure to dust and moisture. (California <br />Health and Safety Code 119315 (c)) <br />`U fi � A <br />�.i'T\V01 1.11 r_'' 60 X V v t_ I 1 A % <br />Jv "_ U� �L�) <br />AV K 1;= � r�-ii�h DIl�r A i�i> iav-1 i J ����5 P C iJ �T' ir% <br />D. Set Up and Tear Down of Workstation: Describe the procedure for setting up and tearing down <br />tha workstation for the following procedures. (California Health and Safety Code 119308, 119309 <br />(c 1, 119311, and 119313 (b)(4)) <br />1. Tattoo: <br />iv <br />t<ti AC'41�S /41�'D <br />K�C}}t Pi`v � ���W �p 1-1-5► 1CZ �1��C-Li. c-"�B6 <br />n2 <br />1 <br />2. ercmg: 'i A��'-ACc-i� vi <br />i��'E� <br />A1.4 <br />�- 11 F� <br />a E lNII D UUttl, . /JSIIVF `vyjKjA1Jj>Lc_�'TV <br />3. Permanent Cosmetics- <br />-1 Gam" r ni r= <br />KeT _ <br />ys <br />" %ice <br />PF1 <br />�!,A �PV171 O i� <br />/&Li1P17/t1vAMKAFAR 9A9 44MWAi�dI�UI1l� <br />I <br />Page 3 d IC <br />
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