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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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�7 �g YC4�%; Doc. No. HYST/QR2-25-06 <br />NI, C_1 �W � i` 7Uc GI } **9 Version No.: 0/B <br />❑UA" 5nXILIZA1104 Certification of EO Sterilization tnrft Qjiii Effective date: 2021-04-05 <br />It41N,TWEM & AgiEA <br />Sterility Testing of Bls Record <br />1P IM <br />Customer <br />Yiwu Limem tattoo equipment co., Ltd <br />XMFM <br />Sterilization date <br />2022-08-24Sterilization2022082405A <br />Sterilization batch <br />PCDAf <br />0EPCD; ❑IPCD <br />BI$II]jj A <br />t1111 AAifPRoa �-j <br />PCD Type <br />Manufacturer <br />Hangzhou Fujie Disinfection Products Co., Ltd <br />_M#_4VTP_f1� <br />ATCC9372 <br />BI At4j <br />Strain <br />Bacillus atrophaeus <br />Lot no. <br />20220615 <br />WgJNH <br />)EIu�1 <br />WMA (PCs) <br />Test Item <br />Sterility testing <br />Test Qty. <br />20 <br />&A91�M <br />69IJ7M <br />ARuz� <br />Test basis <br />ISO 11138-2:2017 <br />Test method <br />Direct immersion <br />A.r <br />i z (TSB) <br />�IWV' <br />201214 <br />Culture medium <br />Medium batch <br />*rFM1 <br />JAM _n17 <br />Incubation temp. <br />35°C <br />I Incubation period <br />7 days <br />a'i IR;M <br />M iq r-rfij Electric Constant -temp Incubation Container; <br />Apparatus <br />ASI ( 7 Ultra -Clean Bench; <br />&9 Q M <br />Test date <br />2022-08-252022-09-01 <br />11aT1fnF1G BI incubation and examination record <br />BI# <br />1 2 3 4 5 6 7 <br />8 <br />9 10 it 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 />— — — I — — — — <br />— <br />— — — — — — — — — — — — <br />144h <br />— — — — — — — <br />— <br />— — — — — — — — — — — — <br />168h— <br />I — I — — — — — <br />— <br />— — — — — — — — — — — — <br />BI# <br />Positive control Negative control <br />i Note: <br />24h + — <br />48h + — <br />72h + — <br />I <br />(c�Gtic, is meaning <br />no growth"; "+" is meaning "growth". <br />96h + — <br />120h + — <br />144h + — <br />168h <br />+��((qq <br />n qq µ qq {{yfir p� y L R❑ F �} { y p{ J <br />kM A <br />Result <br />There are no growth with testing items and negative control, while positive control is growth well after specific Incubation <br />period. <br />n l <br />n n <br />A Conformity; ❑ T A non -conformity. ,;. �y <br />Conclusions <br />milli .M <br />A YI—'i 1l ,v <br />691 Inspector: <br />V_j'OA� Reviewer: Date: <br />li t JUE- .' QUALITY RECORD 2/2 <br />
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