797 Main Street, Suite B, El Centro, CA 92243 BODY ART EVENT ORGANIZERS The Public Health Department, Division of Environmental Health, will work closely with all event organizers to assist them in ensuring a safe body art event. Organizers of community events having temporary body art booths are required to apply for and obtain a permit to hold the event and must comply with the California Health and Safety Code s Safe Body Art Act requirements. The event organizer is responsible for ensuring the availability of body art support facilities and supplies for body art practitioners participating in the event. Persons organizing or controlling community events must ensure that all body art practitioners comply with applicable requirements. Please submit the following to Imperial County Division of Environmental Health, 797 Main Street, Suite B, El Centro, CA 92243 Monday through Friday, 8AM-12PM & 1PM-5PM, holidays excluded. Application and supporting document must be submitted a minimum of two (2) weeks prior to the event. Failure to do so may result in denial of your permit application. In order to have a complete application package, the following information must be submitted: a. A completed APPLICATION FOR BODY ART EVENT ORGANIZER PERMIT (attached) b. LIST OF PROPOSED BODY ART BOOTHS (attached) which must include: 1) Name of body art booth 2) Name and phone number of body art practitioner in-charge of body art booth c. SITE PLAN which must include the location of: 1) Each body art booth 2) Potable water supply 3) Dumpsters/trash receptacles 4) Public restrooms 5) Body art practitioner-only hand wash facilities 6) Cleaning and sterilization units (if provided by organizer) 7) Back-up supply purchase station All body art booth operators must submit a separate permit application to operate at the event. Each body art practitioner operating at the event must have a valid certificate of registration prior to the event. Please note that practitioners may not operate in a body art booth for greater than 7 days in a 90 day period. It is the responsibility of the event organizer to provide all permit applications to body art booths and any applicable guidelines for compliance, and returning such applications to Environmental Health two (2) weeks prior to the event. Practitioners are not permitted to operate without having first obtained their permit from Environmental Health. Please check with the local jurisdiction in which the event will take place in for any additional requirements. If you would like more information, please contact our office to schedule a meeting with Environmental Health staff at (760) 336-8530.
797 Main Street, Suite B, El Centro, CA 92243 APPLICATION FOR A BODY ART EVENT ORGANIZER PERMIT EVENT ORGANIZER INFORMATION Event organizer (business, organization, or entity): Event organizer contact person: Mailing address: Contact number: Alternative number: ( ) ( ) E-mail address: Fax number: Alternative number: ( ) ( ) EVENT INFORMATION Name of event: Date(s): Site address of event: Time when body art booths will set up: Event start time: Event stop time: Expected number of body art booths: Expected number of body art practitioners: Expected public attendance : Event will be held: Indoors Outdoors Both Will food/beverages/alcohol be sold or given away at the event? **permits may be required If a meeting for body art practitioners is planned, do you want a Health Department representative present? Yes No If yes, Date: Time: Location: OPERATION INFORMATION How will potable water be supplied to body art practitioners? **restrooms must be fully stocked with toilet paper, hand soap, and paper towels during the length of the event and within 200 feet from body art booths Provide the number of flush-toilets to be available at the event: Provide the number of portable toilets to be available at the event: Provide the number of hand sinks for toilet use to be available at the event: Provide the number of hand wash stations for toilet use (not plumbed) to be available at the event: Will the event organizer provide a sharp waste container to each individual body art booth? Yes Provide the number of eye wash stations to be available for practitioner usage: No Will the event organizer provide body art practitioner-only hand wash stations? Yes No If so, how many?
Indicate the type of hand-washing facilities to be provided for practitioner usage: A permanently installed hand-washing sink, with warm running water, liquid hand soap, and single use paper towels. A portable hand-washing station with warm running water, liquid hand-washing soap, and single use paper towels. A five (5) gallon gravity flow container with a valve that can remain open, liquid hand soap, single use papers, and a container for wastewater holding. How will wastewater generated from hand washing be collected and disposed of? Check one: Wastewater will be collected in water-tight receptacles and disposed at the event through a plumbing system. Wastewater will be collected in water-tight receptacles and disposed through a plumbing system outside event premises. Disposing water on the ground is prohibited. Please check the applicable box(s) for the sources/items to be provided to practitioners by the event organizer: Approved flooring Electricity Lighting Trash receptacles Wastewater holding container How will garbage/trash be stored on site, and how will it be properly disposed at the end of the event? Provide contact information of the medical waste disposal company collecting medical waste at the event: Will cleaning and sterilizing facilities be provided for body art practitioners? Yes No **If no, the event organizer must communicate the necessity for each practitioner to bring sufficient single-use supplies for the operation of the entire event. Adequate back-up supplies must be available for practitioners throughout the length of the event. Provide contact information of the person/business providing body art supplies: Please read the following statement, then sign and date below: I am familiar with operational requirements for temporary body art facilities and event organizers and will comply with all legal requirements. I understand that any person who operates a body art booth and each event organizer shall obtain all necessary permits to participate in the community event, including but not limited to this permit issued by Imperial County Division of Environmental Health. PRINT NAME OF AUTHORIZED REPRESENTATIVE TITLE SIGNATURE OF AUTHORIZED REPRESENTATIVE DATE Please submit application package to: Imperial County Environmental Health 797 Main Street, Suite B El Centro, CA 92243 Please note that the application package will not be deemed complete if the following documents are not complete and submitted two (2) weeks prior to the event: (1) Application for Body Art Event Organizer Permit (2) List of Proposed Body Art Booths (3) Site Plan FOR OFFICE USE ONLY FA#: PR#: IN#: DISTRICT#: AMOUNT RECEIVED: $ PAID : CASH CHECK CHECK #: DATE RECEIVED: RECEIVED BY: APPLICATION: APPROVED REJECTED BY: DATE:
LIST OF PROPOSED BODY ART BOOTHS (Please note, body art booths must also apply for an individual booth permit) Name of Event: Event Organizer Contact Person: Date(s) of Event: Site Address of Event: Event Organizer: Contact Number: NAME OF BOOTH PERSON-IN-CHARGE Name & contact phone number BODY ART PRACITIIONERS Name & contact phone number
797 Main Street, Suite B, El Centro, CA 92243 EVENT SITE PLAN Please sketch a site plan below or attach a site plan indicating proposed locations of body art booths, eye wash stations, dumpsters, garbage receptacles, shared decontamination/sterilizationfacilities, practitioner-only hand wash stations, wastewater holding containers and disposal points, potable and non-potable water supply, and restrooms located within a distance of 200 feet of all temporary body art booths. Name of Event: Date of Event: Site Address of Event:
797 Main Street, Ste. B, El Centro, CA 92243 EVENT SITE PLAN-EXAMPLE garbage disposal public portable toilets wastewater holding receptacle eye wash Hand wash decontamination/ sterilization area back-up supplies hand-washing facilities Participating body art booths: Booth 1- CRAZY DESIGNS Booth 2- TATTOO & PIERCING Booth 3- MAGIC PIERCING Booth 4- ANN S COSMETIC SHOP Booth 1 Booth 2 Booth 3 Booth 4 BODY ART BOOTHS Inside Building potable water Restrooms wastewater disposal Body art booths must be located within 200ft from restroom facilities. _ gutter _ Main St. _