HomeMy WebLinkAboutEHPR-10-2023-45784.tif ENVIRONMENTAL HEALTH
Catawba County Government Center
catawba county 25 Government Drive I P.O. Box 389 I Newton, NC 28658
health Phone: (828) 465.8270 I Fax: (828) 465-8276
Email: EHAdmin<' CatawbaCountyNC.gov
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Plan Review for New Tattoo Establishment
Submit application, contact sheet, and $265.00 fee to Environmental Health for approval before
beginning any construction or renovation. Applications must be reviewed and approved before we
can look at the establishment. Insufficient information will delay plan review.
• Is the proposed location service by public sewer and water, or is it serviced by septic and
well?
• Attach a diagram to scale of the layout of the establishment complete with furnishings and
storage for the tattoo artist in their individual areas.
"Tattoo fstablisbmeat"means any location where tattooing is engaged in or where the
business of tattooing is concluded or any part thereof.For purposes of this Section,
"Tattoo Parlor"falls within this definition.
(8) 'Tattooing Room"means a room in the tattoo establishment where tattooing is
performed.
'Please note that once your establishment is approved,each tattoo artist must be permitted at the establishment. A$225 permit fee will apply.
Business Name: -!AL (� 0 F- e r U() K
Business Address: AD s e c c> n v v
Business Owner Name: K G1,( 1 a.- .13`e 11 0 w `e( U'f- +"1 C{ 11 VI toes -1---6,-)47y)
Business Owner Mailing Address: t CQ I711vd 1( 1ST 1 a/K. ,
04,61 L vie
Telephone Number(s): 1041 -7 f 2 q 3 r 2-
Email Address: s V L r)-f-s p 016 11 V i be S t-1-41:3 C"
Applicant Signature Date: ID 1 l9.2 2
Please Fill Out and Turn in for New Tattooing Establishment
The NC tattoo rules require tattoo and permanent makeup artists to meet certain minimum
sanitation standards.These standards include:each studio having an autoclave(for the sterilizing
of tattoo instruments),a sink(s)for hand washing,proper storage&disposal of solid waste,studio
kept clean&in good repair,maintaining records of all autoclave tests&also of each client.In
addition,each artist must be able to demonstrate knowledge of proper aseptic techniques. (There
is no testing of artistic ability).Upon meeting these standards the artist is issued a permit.
The Catawba County Health Department locally enforces the North Carolina state rules(15NCAC
18A.3200)for the practice of tattooing. Tattooing is defined as"the inserting of permanent
markings or coloration,or the producing of scars,upon or under human skin through puncturing
by use of a needle or any other method."
It is important to understand that the permit is issued to a specific artist at a specific location.That
is,the studio&the individual artist must both meet regulations.An artist who practices at more
than one studio,or who moves to another studio,must get a new permit at each location.
Conversely,at a studio with more than one artist each artist must have a separate permit.
Apprentices cannot work under an artist's permit;they must have their own permits.
NOWill you use an autoclave to sterilize your equipment? If yes,thea please pat the make and model of tie unit.Please rote that before a
permit can be issued,there must be a spore test done by a certified lab to deck and mope me the nail works. �.
Make Model# C 1VI( I yl C( ( S cs ) n0 (e
2. How may artists inducing you are you planning on caring is tie tattoo establishment? 1
3. Does your facility bare prblit water and sewer?'S ff sat,a septic tank check and water sample must be done prior to permitting.
4. floor,wall and ceiling Nisbet? Ord Wood {ZoOr
5. Number of bathrooms: (This includes customer and artist'esteems.)
6. Please draw to scale(either in the spate below or on a separate piece of graph paper)the establishment,with all areas;herbed,including:
location of all equipment,coupler tops,bathrooms,hand sinks,waiting areas,tattooing areas and anything else that is associated with tie facility.
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Application for Tattoo
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Date of Applicationf ��►
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Tattoo Artist Information: -
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First Name K Ct( I a_ Last Name_ tpiesc
Mailing Address: (.0ti f0 I 1 ,/► io . 1' r\/\4 c - tre) Pt
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City W ► VLhI C)4 Tc., State Vv C/ Zip Z — —
�°41 • 1IZ 9 '51 2—
Telephone Humber: E•rral: Ve 1 "1 J e v { 10t3 r"l�a• co.
1.rttuu t::.italilrshtnenl information. ( p� V\
Name of Establishment: I tr 1.K.. C V &` �t 00
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Street Address: .7'0 2nCt $ 1 U_t t v Vv
State w(Zip 2 ° ) ^�
Business Hours: 1' 6kY F010 utp II YN- fo Li()rLi() " 21 2-3 `I SOY I L' S
Number of Tattoo Artists in Establishment Anticipated Date to Begin Tattooing: (0' 2. !' 2' 3
Tattoo Artist Signature:
Instructions
Purpose: To allow tattoo artists to apply for tattooing permits a s required in General Statute J 30A•283 and I5A NCAC 18A.3202. A
separate application must be completed for each permit.
Preparation: Each tattoo artist must complete and sign a separate application for each location where he or she will engage in tattooing
within the State of North Carolina. The completed application must include the full name, mailing address and
signature of the tattoo artist, the name and street address of the tattoo establishment,and the anticipated date of
commencing operation.
Submission: the completed application must be submitted to the local health deportment in the county where the tattoo establishment is
located at least 30 days before commencement of operation. The local health department may require payment of fees or
additional information upon submission of the application.
Disposition: This form may be destroyed in accordance with Standard 7 of the Records Disposition Schedule.Published by the N.C.
Division of Archives and History.
DENR 4015(Revised 11/00)
Environmental Health Service Section (Review 11/03)
CATAWBA COUNTY
�' �✓ 100A SOUTHWEST BLVD
C NEWTON,NORTH CAROLINA 28658 RECEIPT
A� ( PHONE:828.465.8399
11�7� �'� Tuesday,October 17,2023
18 4 Z 5M www.catawbacountync.gov
PAYOR:
Bell,Kayla
PAYMENTS
TRANSACTION NUMBER: TRC-75617989-17-10-2023
PAYMENT DATE: 10/17/2023
PAYMENT TYPE: Credit Card
312037623
INVOICE NUMBER ACCOUNT FEE NAME FEE AMOUNT
10-23-429336 110-580200-663000 New Tattoo Establishment Fee $75.00
TOTAL PAYMENTS: $75.00
EHPR-10-2023-45784
CASE TYPE: Environmental Health Plan Review WORK CLASS: Other FLI
SITE ADDRESS: 20 2ND ST NW,HICKORY NC 28601
Applicant KAYLA BELL,6216 AMBER MIST LN,CHARLOTTE NC 28211
C:7047129342 EVENTS n HIGHVIBESTATTOO.COM
**NO PEOPLESOFT ACCOUNT ASSIGNED**
receipt 10/17/2023 08:48 Page 1 of 1