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COMPLIANCE INFO
Environmental Health - Public
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EHD Program Facility Records by Street Name
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H
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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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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 />Medical Waste Hauler�D)7a) <br />Street Address __�Uo C___ <br />City, ST, Zipts'��,'l m2 (, 14 f C;7;t<=Z S_ <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 />'5FP. W►D P14C1� �c��✓2 vl rv, n�l�- �'� j { �� <br />_0 <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)) <br />i-I"MtfI TtS, <br />yuny(_S 8 eF V_lv—1Al" hu Ltt T1L��Cr)��< 1�lF�C1A� <br />D 7 G IJ <br />I „• 3e 1 A <br />1t zi c �' U�� �i D/t�.v r?c.« c; N't1 Ct "y.( <br />K. Disin eft on 'r���t c L` {tie disif�tectaht p d ctu s use atkt�e�b� d art�n k- T�y ia <br />Health and Safety Code 119301 (k).and 119308 (b)(6)) <br />X1;9 IiN (i D F A I.L'i?ox i ep e N <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 wf ether each sterilization load is tested using Class 5 integrators. (California Health and <br />Safety Code 119315 (b)(3)(5)) <br />Time j <br />Temperature Z:_ <br />Psi <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 />
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