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APPLICATION FOR A CERTIFICATE OF APPROVAL TO OPERATE A TATTOO AND ...


Source: www.ccbh.net
Topic: Tattoo

Sort Desciption: (i.e., first aid, blood borne pathogen, infectious disease prevention, tattoo and body piercing aftercare...) 4.) Written statements of attestation by all ...

Content Inside: APPLICATION FOR A CERTIFICATE OF APPROVAL TO OPERATE A TATTOO AND/OR BODY PIERCING FACILITY CUYAHOGA COUNTY BOARD OF HEALTH 5550 Venture Dr. Parma, OH 44130 INSTRUCTIONS: 1.) Complete the applicable sections. Make any corrections if necessary. 2.) Sign and date the application. 3.) Make check payable to: Cuyahoga County Board of Health Before this application can be processed the application must be completed and the indicated fee submitted. SECTION I Name of Establishment: Address:_____________________________________________________________________ City:_____________ Phone: OwnerOperator of Establishment: Please check an appropriate box: Type I. Body Piercing Facility Only $100.00/year Type II. Tattooing Facility Only $100.00/year Type III. Combination Body Piercing and Tattooing $125.00/year Type IV. Time-Limited Body Piercing/Tattooing $25.00/day for a specific event *If this is a renewal of a license and there has been no change to your facility, equipment, employees, or standard operating procedures from the time of the last application then skip SECTION II. SECTION II Submit the following information: 1.) Plans and specifications submitted for approval by the Board of Health shall be legible, be drawn reasonably to scale, and shall include: < The total area to be used for the business; < Entrances and exits; < Number, location and types of plumbing fixtures including all water supply facilities; < A lighting plan; < A floor plan showing the general layout of fixtures and equipment; < Listing of all equipment to be used. 2.) Names of each person who has an ownership interest of five percent or more in the business. 3.) Records of completion of courses or seminars by all individuals performing tattooing or body piercing. (i.e., first aid, blood borne pathogen, infectious disease prevention, tattoo and body piercing aftercare.) 4.) Written statements of attestation by all individuals performing tattooing or body pi ...



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