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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
8/13/2025 3:24:30 PM
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\cfield
Supplemental fields
Site Address
5920 PACIFIC AVE STOCKTON 95207
Tags
EHD - Public
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tCtdog Doc. No. HYST/QR2-25-06 <br />W*A ; Version No.: 0/B <br />IIUMYI SnA: UMVION Certification of EO Sterilization ±,k H M Effective date: 1 2021-04-05 <br />Sterility Testing of Bis Record <br />_� rrP-Z*I <br />tM <br />Yiwu Limem tattoo equipment co., Ltd <br />Customer <br />STter�ilizHatiM date <br />2022-08-26 <br />x Sterilization batch <br />2022082605A <br />PCD Al' <br />BI $11AA7 <br />M011I 1.1 bUMM P1311 <br />R EPCD; ❑ IPCD <br />PCD Type <br />Manufacturer <br />Hangzhou fujie Disinfection Products Co., Ltd <br />M,`--J%FfNffM <br />ATCC9372 <br />81 W� <br />Strain <br />Bacillus atrophaeus <br />Lot no. <br />20220615 <br />4MVH <br />�cMttA9 <br />*9901 (PCs) <br />Test Item <br />Sterility testing <br />Test Qty. <br />20 <br />fl, M4:�1W <br />49MM <br />A4&&M <br />Test basis <br />Iso 11138-2:2017 <br />Test method <br />Direct immersion <br />(TSB) <br />PA, <br />1 <br />201214 <br />Culture medium <br />Cu <br />u9mbatvch <br />*1Y*FaI <br />:I&. n�Ifr7 <br />Incubation temp. <br />35`C <br />Incubation period <br />7da s <br />y <br />&Will A <br />*.AfF Apj$�j Electric Constant -temp Incubation Container; <br />Apparatus <br />Ultra -Clean Bench; <br />6M H M <br />Test date <br />2022-08-27^-2022-09-03 <br />Aa:TJJinFi' BI incubation and examination record <br />BI# <br />1 2 3 4 5 6 7 1 <br />8 <br />9 10 11 12 13 14 15 16 17 18 19 20 <br />24h— <br />— — — — — — <br />— <br />— — — — — — — — — — — — <br />48h— <br />— — — — — — <br />— <br />— — — — — — — — — — — — <br />72h— <br />— — — — — — <br />— <br />— — — — — — — — — — — — <br />96h— <br />— — — — — — <br />— <br />— — — — — — — — — — — — <br />120h <br />— — — — — — — <br />— <br />— — — — — — — — — — — — <br />144h— <br />— — — — — — <br />— <br />— — — — — — — — — — — — <br />168h <br />— — I — — — — — <br />— <br />— — — — — I — — — — — — — <br />BI# <br />Positive control Negative control <br />Note: <br />24h + — <br />48h + — <br />72h + — <br />is meaning <br />no growth"; "+" is meaning "growth". <br />96h + — <br />12011 + — <br />144h + — <br />168h — <br />+RR <br />qq F y { { y �y µ ❑ } { y p� L <br />" <br />There are no growth with testing items and negative control, while positive control is growth well after specific Incubation <br />Result <br />period. <br />Mit <br />C � conformity; ❑ T� non -conformity. <br />Conclusion <br />�- <br />Inspector: 1 m QM <br />Y -;c Reviewer: MA <br />F] M Date: <br />fylj jj?-; (11 JAI ITY RECORD 2/2 <br />
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