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COMPLIANCE INFO
Environmental Health - Public
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EHD Program Facility Records by Street Name
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5920
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4100 – Safe Body Art
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PR0548004
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COMPLIANCE INFO
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Entry Properties
Last modified
4/27/2026 11:14:46 AM
Creation date
3/5/2024 9:14:00 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4100 – Safe Body Art
File Section
COMPLIANCE INFO
RECORD_ID
PR0548004
PE
4121 - BODY ART FACILITY-STERILIZATION
FACILITY_ID
FA0027381
FACILITY_NAME
LOST DREAMS TATTOOS & PIERCING (CARTER, MICHAEL)
STREET_NUMBER
5920
STREET_NAME
PACIFIC
STREET_TYPE
AVE
City
STOCKTON
Zip
95207
CURRENT_STATUS
Active, billable
QC Status
Approved
Scanner
SJGOV\sballwahn
Supplemental fields
Site Address
5920 PACIFIC AVE STOCKTON 95207
Tags
EHD - Public
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V+fW� Doc.No. HYST/QR2-25-06 <br /> x Certification of EE0 Sterilization �E0'=version N <br /> I ILI�s1}�w•1�-h'�tDN �-XC fd M Effective date: 2021-0-04-OS <br /> Sterility Testing of Bls Record <br /> p Yiwu Limem tattoo equipment co.,Ltd <br /> Customer <br /> STterMilizH on date 2022-08-26 X_Miz*ation batch 2022082605A <br /> PCD Af X EPCD; ❑IPCD BI J rOH'I FAMMA*ffl Pori ifPR <br /> PCD Type Manufacturer Hangzhou Fujie Disinfection Products Co.,Ltd <br /> M# 3P L7 ATCC9372 BI 90 20220615 <br /> Strain Bacillus atrophaeus Lot no. <br /> J�.9JANI �E M T^2 P)?J MMIR (PCs) 20 <br /> Test Item Sterility testing Test Qty. <br /> tAHM ISO 11138-2:2017 t gJ71 F_ ATOR s'c/A <br /> Test basis Test method Direct immersion <br /> Cur medium Medium batch ree (TSB) A.rr 4 it 201214 <br /> l <br /> t&.rraI 35°C farrfil107 7days <br /> Incubation temp. I Incubation period <br /> *911 f(5 F ,%'J'ff m a,! t"J9 Electric Constant-temp Incubation Container; <br /> Apparatus ItVOV A Ultra-Clean Bench; <br /> *M H M 2022-08-27^2022-09-03 <br /> Test date <br /> 4-:041w-,TVA prFXQL3P�iZ:R*BI incubation and examination record <br /> BI# 1 2 3 4 5 6 7 8 1 9 1 10 it 12 13 14 15 16 17 18 19 20 <br /> 24h - - - - - - - - - - - - - - - - - - - - <br /> 48h - - - - - - - - - - - - - - - - - - - - <br /> 72h - - - - - - - - - - - - - - - - - - - - <br /> 96h - - - - - - I - - - - - - - - - - - - - - <br /> 120h - - - - - I - - - - - - - - - - - - - - - <br /> 144h - - - - - - - - - - - - - - - - - - - - <br /> 168h - - - - - - - - - - - - - - - - - - - - <br /> BI# Positive control Negative control <br /> 24h + - <br /> 48h + - <br /> 72h + - % Note: <br /> is meaning <br /> 96h + — no growth";"+"is meaning"growth". <br /> 120h + - <br /> 144h + - <br /> 168h + - <br /> ��' <br /> Result There are no growth with testing items and negative control,while positive control is growth well after specific Incubation <br /> period. <br /> Conclusion A Conformity; ElA non-conformity. <br /> �JgJ Inspector: Q Dat <br /> AeA Reviewer: Q Date: <br /> f$#i� QUALITY RECORn 2/2 <br />
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