APPROVAL REVIEW PROCEDURES

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Summit County Public Health 1867 West Market Street Akron, Ohio 44313 Phone: (330) 923-4891 Toll-free: 1 (877) 687-0002 Fax: (330) 923-6436 www.scphoh.org APPROVAL REVIEW PROCEDURES Ohio Law requires that every business offering Tattooing or Body Piercing Services be approved prior to operating. Ohio Law also requires as part of the approval process that plans and specifications for the place of business be submitted and approved by the Summit County Combined General Health District. These plans and specification must clearly show that applicable provisions of sections 3730.01 to 3730.11 of the Ohio Revised Code and 3701-9-01 to 3701-9-09 of the Ohio Administrative Code can be met and shall include the following: 1. A completed application for Approval Review. 2. Scale drawings - the smallest scale to be used is 1/4" equal one foot - showing the general layout of fixtures and equipment, entrances and exits, number location and types of plumbing fixtures and all water supply facilities. 3. A numbered equipment list indicating the manufacturer's name and model number for all equipment to be used. 4. A lighting plan indicating foot-candles for critical surfaces. 5. A copy of the written care instructions to be provided to patrons following a tattooing or body piercing procedure. 6. A copy of the customer record sheet to be used to maintain a record of service. 7. A written procedure for maintaining a written record of dye colors, manufacturer, and any available lot number or other identifier of each pigment used for each service performed. 8. Provide proof that all artists on staff who will be performing services are current in their certifications for training in: first aid, preventing transmission of infectious diseases, universal precautions against blood borne pathogens and appropriate tattoo or body piercing after-care. 9. Records of completion of courses or seminars in body art offered by authorities recognized by the board of health as qualified to provide such instruction; or written statements of attestation by individuals offering body art apprenticeships that the person has received sufficient training of adequate duration to completely perform body art services 10. A written infection prevention and control plan prepared in accordance with paragraph (B) (8) of rule 3701-9-02 of the Administrative Code. The plan shall kept up to date and resubmitted to the board of health as necessary. If these approval requirements need clarification, or you want to schedule pre-approval inspections, contact Samantha Mellott at 330-812-3947. An approval will not be issued until all approval requirements are completed and a pre-approval inspection shows that you are in compliance with applicable rules. Before requesting the pre-approval inspection be sure that you are able to show written documentation that plumbing, electrical, building, zoning, sewage disposal and well final approval inspections, when applicable, are completed. L:\ehlth\tb\SOGs\Plan Approval Application 06.doc 8/19/15

Summit County Public Health 1867 West Market Street Akron, Ohio 44313 Phone: (330) 923-4891 Toll-free: 1 (877) 687-0002 Fax: (330) 923-6436 www.scphoh.org Operation Name: Address: APPLICATION FOR INITIAL APPROVAL OF BUSINESSES OFFERING TATTOOING OR BODY PIERCING SERVICES City/Village/Township: State: Zip: Name Of Operator: Address: City/Village/Township: State: Zip: Phone Number Of Operator: E-Mail: Name Of Corporation/Association/Partnership: Names, Addresses And Telephone Numbers Of All Persons Having An Ownership Interest Of Five Percent Or More In The Corporation/Association/Partnership: Mailing Address For Approval Notification And Renewal: Anticipated Date For Starting Construction: Anticipated Hours Of Operation: Anticipated Date For Beginning Operation: Total Size Of Operation In Square Feet: Please Check The Type Of Approval Requested: Tattooing Services: Body Piercing Services: Combined Tattooing/Body Piercing: Time-Limited Event: Submit $ 80.00 Non-Refundable Approval Fee If A Time Limited Event, Name And Address Of Event: Date And Time of Event:

PLEASE SUBMIT THIS COMPLETED FORM AND THE APPROVAL FEE WITH YOUR PLANS Will procedures be maintained and documented that ensure all persons performing body piercing or tattooing services on the business premises have received appropriate training in: Tattooing or body piercing: Preventing transmission of infectious diseases: Appropriate tattoo and body piercing after-care: First Aid: Universal precautions against blood borne pathogens: Will written records of equipment utilized by the business be maintained? Will procedures be maintained that ensure that all non-disposable equipment, parts of equipment or instruments used in performing procedures are disinfected and sterilized in accordance with rule 3701-09-08 of the Administrative Code? Will weekly biological monitoring tests of the business s heat sterilization devices be completed Will a record of all tests performed on the heat sterilization devices be maintained for at least two years? Will procedures be maintained that ensure the general health and safety of all individuals employed by the business? Each area in which tattooing or body piercing is conducted will have an area of how many square feet? Will all areas used for performing services be separated from each other and from waiting customers or observers by a panel, privacy screen or door? Is at least 40 foot-candles of light provided at all areas where tattooing or body piercing services are performed Is at least 20 foot-candles of light provided at all other areas? Describe the floor finish material directly under equipment used for tattooing or body piercing services: Will all tables and other equipment be constructed of easily cleanable material, with a smooth washable finish PLEASE SUBMIT THIS COMPLETED FORM AND THE APPROVAL FEE WITH YOUR PLANS Will toilet room facilities be available to the employees and customers of the business Are all toilet rooms equipped with the following? A toilet: Toilet paper installed in a holder: A handwashing sink: Will all tattooing or body piercing areas be provided with a hand washing sink that is accessible at all times?

Are all hand sinks equipped with the following? Liquid or granular soap: Single use towels or mechanical hand dryer: Hot and cold running water: Are there any overhead or otherwise exposed sewerage lines so as to create a potential hazard to the sanitary environment of the business? Will sufficient and appropriate receptacles be provided for the disposal of refuse and single-use instruments? Will all waste items including but not limited to needles, razors and other supplies capable of causing lacerations or punctures be disposed of in accordance of the applicable standards of Chapter 3745-27 of the Administrative Code? Will indoor and outdoor refuse containers have lids? Is your water provided by a public authority ( ) or private well ( ) If a private well, you must attach Ohio EPA approval. Is the building connected to a municipal sewer ( ) or a private sewage disposal system ( ) If a private system, you must attach Ohio EPA approval Will all plumbing work be done under permit from the plumbing authority? Will a mop sink be provided for the disposal of mop water? Will the mop sink be located out of the tattooing and body piercing area? Is the potable water supply protected from cross-contamination? Will a separate area be provided where employees and patrons may consume food or beverages? Describe your procedures to assure that individuals under eighteen years of age will not be served without proper consent: PLEASE SUBMIT THIS COMPLETED FORM AND THE APPROVAL FEE WITH YOUR PLANS Will disposable latex gloves be available and changed accordingly? When shaving of a site or area is necessary, will you use disposable razors. Describe how and where sterilized instruments and equipment will be stored. Please describe how non-disposable needles and instruments will be cleaned and disinfected.

Please describe how non-disposable needles and instruments will be sterilized. Please describe how you will monitor and document the sterilizer function. I hereby certify that the above information is true and accurate and I am the approval recipient or the authorized representative of the establishment for which this application is being filed. I intend to comply with all requirements established by Sections 3730.01 to 3730.11 of the Ohio Revised Code and the rules of this chapter. Signature: Date: