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Environmental Health - Public
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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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® jC�}dog Doc.No. HYST/QR2-25-06 <br /> Z,X Ui %� 7V� Ace$ ;versionNco.: 0/B <br /> IIUMYI SnA:UMVION Certification of EO Sterilization ±,k H M Effective date: 2021-04-05 <br /> tf041M1�11WE_M <br /> Sterility Testing of Bls Record <br /> Yiwu Limem tattoo equipment co.,Ltd <br /> Customer <br /> STter�ilizHatiM date 2022-08-26 x Sterilization batch 2022082605A <br /> PCD Al' R EPCD; ❑IPCD BI$11AA7 M011I I.,bUMM P1311 <br /> PCD Type Manufacturer Hangzhou Pujie Disinfection Products Co.,Ltd <br /> M, `_j ATCC9372 61 W� 20220615 <br /> Strain Bacillus atrophaeus Lot no. <br /> 4MVH �cMttA9 *9901 (PCs) 20 <br /> Test Item Sterility testing Test Qty. <br /> �M4:�1W ISO11138-2:2017 49MM A4&&M <br /> Test basis Test method Direct immersion <br /> Culture medium (TSB) PA, <br /> 1 u9m1tV 201214 <br /> Cu <br /> j 1&1 Y*FaI 35`C :I&.n�Ifr7 7da s <br /> Incubation temp. Incubation period y <br /> &Will RA *.A'faMfgrF�j Electric Constant-temp Incubation Container; <br /> Apparatus Ultra-Clean Bench; <br /> 6M H M 2022-08-27^-2022-09-03 <br /> Test date <br /> Aa:TJJ1nFi' BI incubation and examination record <br /> BI# 1 2 3 4 5 6 7 1 8 9 10 11 12 13 14 15 16 17 18 19 20 <br /> 24h — — — — — — — — — — — — — — — — — — — — <br /> 48h — — — — — — — — — — — — — — — — — — — — <br /> 72h — — — — — — — — — — — — — — — — — — — — <br /> 96h — — — — — — — — — — — — — — — — — — — — <br /> 120h — — — — — — — — — — — — — — — — — — — — <br /> 144h — — — — — — — — — — — — — — — — — — — — <br /> 168h — — I — — — — — — — — — — — — — — — — — — <br /> BI# Positive control Negative control <br /> 24h + — <br /> 48h + — <br /> 72h + — Note: <br /> is meaning <br /> 96h + — "no growth";"+"is meaning"growth". <br /> 12011 + — <br /> 144h + — <br /> 168h + — <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 " p* y ❑T-6- non-conformity. <br /> Conclusion C Conformity; A y. �- <br /> Inspector: <br /> p <br /> it <br /> c Reviewer: MA Date: a <br /> l�l�j (11IAI ITY RECORD 2/2 <br />
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