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/�r ala fl Body Art Inspeca Report Date: Hh IIS <br />QA? San Joaquin County Environmental Health Department Program <br />1868 E. Hazelton Ave., Stockton, CA 95205 Record: Ms <br />(209) 468-3420 Program <br />www.siogv_orq/end Element: 1 u <br />PR Number PRACTITIONER/ARTIST NAME <br />PR0537419 John Holquin <br />Observations and Corrective Actions: <br />PR Number PRACTITIONER/ARTIST NAME <br />Notes: 1. Facility can now be open to the public. <br />2. Submit the discussed attachment to the IPCP. <br />3. Submit the updated consent form, medical questionnaire, and after care instructions. <br />4. Post the shop/practitioner permits and bloodborne pathogen training certificates. <br />5. Submit the certificate of sterilization for the needles and needle tubes. <br />Reinspecion on/about: A reinspection fee of $130 per hour may be charged. Page 2 of 2 <br />EH -03/2015 <br />