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COMPLIANCE INFO
Environmental Health - Public
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EHD Program Facility Records by Street Name
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PESCADERO
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1005
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4100 – Safe Body Art
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PR2500286
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COMPLIANCE INFO
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Entry Properties
Last modified
3/20/2026 10:00:04 AM
Creation date
10/20/2025 11:59:41 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4100 – Safe Body Art
File Section
COMPLIANCE INFO
RECORD_ID
PR2500286
PE
4120 - Single Use
FACILITY_ID
FA0027261
FACILITY_NAME
STUDIO 111 (CHAVES, FABIAN)
STREET_NUMBER
1005
Direction
E
STREET_NAME
PESCADERO
STREET_TYPE
AVE
City
TRACY
Zip
95304
CURRENT_STATUS
Active, billable
QC Status
Approved
Scanner
SJGOV\cfield
Supplemental fields
Site Address
1005 155 E PESCADERO AVE TRACY 95304
Suite #
155
Tags
EHD - Public
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disposable instruments. Describe the record keeping logs and procedure logs maintained on-site <br /> when using 100% pre-sterilized, single-use and disposable instruments. (California Health and <br /> Safety Code 119309 and 119315) <br /> 1. Needle tubes: <br /> This business will use all ore-sterilized, single-use disposable instruments. Record keeping logs <br /> and procedure logs will include but not limited to manufactures sterilization logs and <br /> CompanyName /Needle Type /Lot Number/Batch Number/Expiration Date. <br /> 2. Calipers: <br /> This business will not be using any calipers or clasps. (Not applicable) <br /> 3. Other instruments: <br /> Not applicable. All instruments used are already notated. <br /> C. Storage: Describe the storage location and equipment used for the storage of clean and sterilized <br /> instrument peel packs to protect the packages from exposure to dust and moisture. (California <br /> Health and Safety Code 119315 (c)) <br /> Storage will consist of the use of closed cabinet storage, open shelving for closed boxed <br /> items and toolbox drawers for procedure equipment. <br /> D. Set Up and Tear Down of Workstation: Describe the procedure for setting up and tearing down <br /> the workstation for the following procedures. (California Health and Safety Code 119308, 119309 <br /> (c), 119311, and 119313 (b)(4)) <br /> Tattoo: <br /> Only after the procedure area is thoroughly disinfected, gloves must be worn at all times. Start <br /> with applying barrier film to workstation surface. Wrap the bottles containing green soap and <br /> water with plastic. Apply barriers to light fixture and chair adjustment handle. Apply plastic barrier <br /> o armrest it needed. pp y barrier tilm, plastic cover, co-band o mac nine and plastic i m o wrap <br /> battery with. Place disposable razor and ink caps to workstation. Use tongue depressor to take <br /> ointment from ointment container. Use some ointment to stabilize ink caps in place on <br /> wul kstatlai r Tea, X a,, ou,it of pape, towels , eeded. Place [wedle cai tj idge(s) ti idt will be used <br /> OPGO Gompleto, YQ61 WHI romove gloves, apply AQW glQVQ6 op aAd GlQQA tho dients skin With the <br /> bottle of green soap and paper towel. Carefully use the razor to help clean the tattooed area and <br /> remc:e any hair.-, it ohy. Apply stencil solution to clients skin and apply the stencil paper to the <br /> desirad Inratinn then remrye stencil paper_ Allow stenril to dry at least 5 mimitPs nn rlients skin <br /> before tattooing. Remove gloves and discard. Apply new gloves on and start the tattoo <br /> procedure. <br /> Page 3 of 10 <br />
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