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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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PR0546977
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COMPLIANCE INFO
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Entry Properties
Last modified
10/10/2024 1:59:28 PM
Creation date
6/7/2023 2:20:57 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4100 – Safe Body Art
File Section
COMPLIANCE INFO
RECORD_ID
PR0546977
PE
4120 - BODY ART FACILITY-SINGLE USE
FACILITY_ID
FA0022860
FACILITY_NAME
PURE FORM GALLERY & TATTOO (EDGINGTON,WILLIAM)
STREET_NUMBER
213
Direction
W
STREET_NAME
YOSEMITE
STREET_TYPE
AVE
City
MANTECA
Zip
95336
CURRENT_STATUS
Active, billable
QC Status
Approved
Scanner
SJGOV\cfield
Supplemental fields
Site Address
213 W YOSEMITE AVE MANTECA 95336
Tags
EHD - Public
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eo Body Art Inspection Report Date: June 11 , 2021 <br /> I San Joaquin County Environmental Health Department Program <br /> 1868 E. Hazelton Ave., Stockton, CA 95205 Record: PR0546977 <br /> (209) 468-3420 <br /> F' + w .sioay.oro/ehd Program <br /> �4LIFF' i ?% Element: 4120 <br /> ,PR Number PRACTITIONER/ARTIST NAME PR Number PRACTITIONER/ARTIST NAME <br /> PRO540005 William Edgington (BBP exp. 5/5/22 <br /> Observations and Corrective Actions : <br /> No violations noted . <br /> Facility may now open . <br /> Notes: <br /> 1 . Inspection report emailed to the facility owner, William Edgington, at billythekidd5(ftmail.com . <br /> 2 . Stericycle will be used as the sharps waste hauler. <br /> 3 . Ensure there is no food or drinks in the procedure area. <br /> 4. Label all spray bottles with content. <br /> 5 . Post Bloodborne Pathogen Certificate and health permit in a conspicuous place. <br /> Reinspection on/about: A reinspection fee of $152 per hour may be charged. Page 2 of 2 <br /> EH-11/17 <br />
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