BODY ART FACILITY Plan Check Guide & Application for New Construction/Remodels. Sewage Disposal (public or private):

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COUNTY OF SISKIYOU Community Development Department Environmental Health Division 806 South Main Street Yreka, California 96097 (530) 841-2100 Fax (530) 841-4076 www.co.siskiyou.ca.us/page/environmental-health-division BODY ART FACILITY Plan Check Guide & Application for New Construction/Remodels Application Type (check all that apply) New Construction (New if not already a body art facility) Remodel Change of Ownership Facility Information Facility Name: Facility Address: Facility Owner: Mailing Address: Phone: Water Source: Sewage Disposal (public or private): Facility Type: (check all that apply) Piercing Tattoo Branding Permanent Cosmetics Other Single Use Instruments Only? Autoclave? Yes No Yes No PRIOR TO BEGINNING ANY WORK, ANYONE PROPOSING TO CONSTRUCT OR REMODEL A BODY ART FACILITY MUST FIRST OBTAIN APPROVAL FROM THE APPROPRIATE BUILDING DEPARTMENT, PLANNING DEPARTMENT, AND ENVIRONMENTAL HEALTH. PLANS AND SPECIFICATIONS MUST MEET ALL APPLICABLE HEALTH REQUIREMENTS INCLUDING, BUT NOT LIMITED TO THOSE LISTED BELOW. THE LOCAL BUILDING DEPARTMENT MAY REQUIRE PLANS AS WELL. ALL ITEMS MUST BE CHECKED. IF A SPECIFIC ITEM DOES NOT APPLY TO YOUR FACILITY, MARK THAT ITEM AS NA (NOT APPLICABLE). PLANS Submit 1 set of plans to Environmental Health with plan check fee of $130.00. Plans MUST include: scaled floor plan (including layout of procedure areas, cleaning and sterilization area, sinks, storage areas, equipment, and reception areas. See attached floor plan example), finish schedule (floors, walls, & ceilings), manufacturer specification sheets (cut sheets) for all equipment, and all other applicable categories on this checklist. Page 1 of 7

General Premises FACILITY CONSTRUCTION Floors in the work areas and restroom shall be constructed of materials that are smooth, nonabsorbent, free of open holes and washable. CHSC 119314(a)(2) The walls in work areas shall be smooth, free of open holes and washable. CHSC 119314(a)(2) The premises shall be constructed and maintained to be free from insect or rodent infestation. CHSC 119314(a)(3) The facility must have adequate toilet facilities that meet the specifications of the State Building Standards Code, local building standard codes and any other local ordinance. The sink shall be supplied with hot and cold running water, containerized liquid soap, and single-use paper towels that are dispensed from a wall-mounted, touchless dispenser. All sinks shall be permanently plumbed and meet local building and plumbing codes. CHSC 119314(a)(5), CHSC 119314(a)(5) All counter surfaces and service trays shall have a smooth, durable, and nonabsorbent finish. CHSC 119314(b)(6) Sinks used for hand washing and where there is a mixing valve or combination faucet, the temperature of the water shall be at least 100 degrees Fahrenheit. CHSC 119301(ac) The size of the facility water heater should allow for 5 gallons per hour for every sink in the facility. For example, if there is one hand sink in the service area for practitioner use, one in the restroom and one in the decontamination area, you would need a 15 gallon water heater. Note: To figure out the kilowatts or BTU s needed for the water heater you need, please see the charts below. Additionally you will need to know your average incoming water temperature. The tables below assume you are beginning with water of 60 degrees Fahrenheit. SIZING TABLE FOR GAS WATER HEATERS Gallons Per Hour Delivery At Indicated Temperature Rise BTU (X 1000) 60 F 5 8 10 15 15 23 20 30 25 38 30 45 35 53 Page 2 of 7

SIZING TABLE FOR ELECTRIC WATER HEATERS Gallons Per Hour Delivery At Indicated Temperature Rise KW 60 F 1 7 2 13 3 20 4 27 5 33 6 40 7 47 8 54 9 60 Procedure Areas The procedure areas must be separated by a wall or ceiling-to-floor partition, from nail and hair activities. Body art can only be performed in the procedure area of the facility and must be separated from all business not related to body art. CHSC 119314(b)(2), CHSC 119314(a)(3) This area must be equipped with an accessible sink supplied with hot and cold running water, containerized liquid soap, and single-use paper towels that are dispensed from a wall-mounted, touchless dispenser that is accessible to the practitioner. All sinks shall be permanently plumbed and meet local building and plumbing codes. CHSC 119314(b)(4), CHSC 119314(b)(5) The procedure area must be equipped with a light source that provides adequate light for procedures. CHSC 119314(b)(1) Lined waste containers shall be available in the procedure area. CHSC 119314(d) A sealable, rigid and puncture resistant sharps container must be provided in each procedure area for the disposal of single-use sharp objects that come in contact with blood and/or body fluids that is labeled with the words Sharps Waste or the international biohazard symbol and the word BIOHAZARD. CHSC 119301(x), CHSC 119314(e) & (e)(2) A sharps container shall either be portable or be installed at an appropriate height appropriate ppropriate height to ensure that it is within arm s reach of the practitioner. CHSC 119314(e)(1) Decontamination and sterilization areas Unless all equipment and supplies used in the course of a body art procedure are singleuse, purchased as pre-packaged and pre-sterilized, the body art facility shall have a decontamination room or area for cleaning instruments and equipment. 119315(f) The decontamination and sanitization area must be separated from the procedure area by a space of at least five feet or by a cleanable barrier. CHSC 119314(c)(1) Page 3 of 7

This area must be equipped with a sink, hot and cold running water, containerized liquid soap in a wall-mounted dispenser, and single-use paper towels dispensed from a wallmounted, touchless dispenser that is readily accessible to the practitioner. All sinks shall be permanently plumbed and meet local building and plumbing codes. CHSC 119314(c)(2), CHSC 119314(b)(5) This area must be equipped with an approved steam autoclave. Chemical and dry heat sterilizers are not accepted. CHSC 119315(b)(1), 119309(e) OPERATION Documents, including the Infection Prevention and Control Plan (IPCP), or any record, file, paper, process, invoice, or receipt for the purpose of determining compliance shall be available and maintained on-site. CHSC 119313(a) The IPCP shall be reviewed and approved prior to final approval to operate. CHSC 119313(d)1 Pets or other animals shall not be permitted in the procedure area of the business, except for trained service dogs for disabled clients or practitioners. CHSC 119314(f) No food, drink, tobacco product or personal effects shall be permitted in the procedure or decontamination and cleaning area. CHSC 119309(i) Clean instruments and sterilized instrument packs shall be placed in clean, dry, labeled containers or stored in a labeled cabinet that is protected from dust and moisture. CHSC 119315(c) Check with the local city zoning authority for other conditions or restrictions that may apply to the operation of a body arts facility. THE HEALTH DEPARTMENT WILL APPROVE OR REJECT PLANS AFTER RECEIPT OF COMPLETE PLANS. THE HEALTH DEPARTMENT MUST INSPECT THE FACILITY PRIOR TO OPENING FOR BUSINESS. PLEASE SCHEDULE AN APPOINTMENT 3-5 WORKING DAYS IN ADVANCE OF YOUR INTENDED OPENING DATE. A HEALTH DEPARTMENT PERMIT TO OPERATE WILL BE ISSUED UPON COMPLETION OF AN INSPECTION SHOWING THAT THE FACILITY CONFORMS WITH APPLICABLE CODES. THE HEALTH DEPARTMENT WILL NOTIFY THE LOCAL BUILDING DEPARTMENT OF APPROVAL. APPLICANT SIGNATURE_ DATE_ Page 4 of 7

Page 5 of 7

Room/Area Materials and Finishes ROOM OR AREA FLOOR WALLS Example: Restroom Smooth quarry tile Gypsum board; smooth; semi-gloss paint Swiss coffee Restroom Procedure Areas Decontamination and Sterilization Room Body Piercing Room Drawing/Stencil Area Reception and Waiting Area Equipment Information Part One ROOM OR AREA LOCATION MANUFACTURER MODEL NUMBER Example: Permanent Cosmetic Machine Station 2 Bella Co, Ltd BM-1 Laguna Machine Autoclave Ultrasonic Machine Permanent Cosmetic Machine Water Heater Capacity: gal. Note: Please provide specification sheets for all equipment. Page 6 of 7

Equipment Information Part Two ROOM OR AREA Example: Client Chair DESCRIPTION OF MATERIAL Vinyl Practitioner Chair Client Chair Piercing Table Stool Arm Rest Mayo Trays Counters Storage Cabinets Disposable Instruments ========================================================================================= Health Department Use Received by Fee _ Approved Date Denied REHS Date Page 7 of 7