Delaware Health and Social Services Division of Public Health Environmental Health Field Services Kent County Phone: (302) 744-1220 Fax: (302)-739-1957 PLAN REVIEW AND APPROVAL FOR BODY ART ESTABLISHMENTS INTRODUCTION This information packet describes the requirements to open a body art establishment. A copy of the "State of Delaware Regulations Governing Body Art Establishments" is included: Submit the following to: Environmental Health Field Services Office – Kent County Thomas Collins Building 540 S. DuPont Highway, Suite 5 Dover, DE 19901 Phone No. (302) 744-1220 Fax No. (302) 739-1957 1. One completed Application for Body Art Establishments 2. One completed Information Sheet for Body Art Establishments 3. Equipment schedule: * Specify manufacturers and model numbers. * Correlate equipment to floor plans. 4. Two copies of the proposed plans for the entire facility (drawn to scale ¼"=1') Plans will be reviewed within thirty (30) days in the order they are received. If further information is needed you will be notified. For applicants who wish to apply in person, an appointment is required. Pre-operational inspections are required before the issuance of the operating permit and commencement of body art establishment operations. No construction or alteration shall commence prior to Certificate of Approval issuance. No body art operations are approved prior to satisfactory pre-operational inspection. Doc.# 35-05-20/07/11/13 INFORMATION SHEET BODY ART ESTABLISHMENTS IDENTITY OF PLANS Name of Body Art Establishment ________________________________________________________________ Address of Body Art Establishment ______________________________________________________________ ________________________________________________________________________________________________ Phone _____________________________________________ Applicant ______________________________________________________________________________________ Address of Applicant ___________________________________________________________________________ ________________________________________________________________________________________________ Phone _____________________________________________ Plan Review for ____ New Construction ____ Conversion ____ Renovation Indoor Areas (82.301.2) Floors__________________________________________________________________ (list materials) Smooth, easily cleanable? Yes No Solid Partitions, floor-to-ceiling? Yes No Separate from food prep, hair salon & private residences? Yes No Ceilings________________________________________________________________ (list materials) Smooth, easily cleanable? Yes No Chairs, benches and other procedural surfaces smooth, easily cleanable? Yes No Outer Openings (82.301.3) Protection at entrance from insects, rodents and vermin? Yes No Space (82.301.4) 45 square feet of procedure space per operator? Yes No Screening for client privacy? Yes No Partitions, curtains, dividers for multiple body art stations? Yes No Lighting and Ventilation (82.301.5) Artificial light source of 20 footcandles at 3 ft. above floor? Yes No Artificial light source of 100 footcandles at level where body art procedure is performed? Yes No Animals (82.301.6) Live animals excluded from procedure areas? Yes No Handwashing and Toilets (82.301.7) Handsink with hot/cold running water? Yes No Wrist or foot controls (preferred over hand controls) on handsinks? Yes No Soap, towels and trash receptacle at handsink? Yes No One handsink for every three operators? Yes No Minimum of one toilet and lavatory? Yes No Waste Receptacles (82.301.8) Waste receptacle at each operator station? Yes No Waste receptacle in toilet room? Yes No Refuse containers cleanable? Yes No Receptacles in operator areas emptied daily? Yes No Solid waste removed from premises weekly? Yes No Supplies (82.301.9) (82.301.10) Instruments and supplies stored in clean, dry, covered containers? Yes No Washer and dryer on premises? Yes No Reusable cloth items machine washed with detergent and dried after each use? Yes No Utilization of processing launderer? Yes No Cloth items stored in a clean, dry place until used? Yes No Soiled items stored separately from clean items? Yes No Sterilization (82.305.3) Access to steam autoclave for sterilization? Yes No Sterilizer located away from work or public areas? Yes No Access to ultra sonic unit? Yes No Non single-use, non-disposable instruments cleaned and sanitized after each use? Yes No BODY ART ESTABLISHMENTS OPERATING CHARACTERISTICS 1. Total square footage of body art establishment premises: ______________ sq. ft. 2. Number of floors where body art procedures are performed: _____________ floor(s) 3. Type of body art procedures performed: Tattoo Scarification Ear piercing Subdermal implants Body piercing Liplines/lidlines Braiding Tattoo removal Other (specify) __________ 4. Number of operator stations: 5. Hours of operation: ________ Sunday ________ Monday ________ Tuesday ________ Wednesday ________ Thursday ________ Friday ________ Saturday 5. If seasonal, specify approximate dates of operation: From _____________________ To ________________________ BODY ART ESTABLISHMENT EQUIPMENT SCHEDULE NAME OF BODY ART ESTABLISHMENT DATE: ____ / ____ /____ SUBMITTED BY: ITEM # ITEM DESCRIPTION MANUFACTURER MODEL # 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 BODY ART ESTABLISHMENT FLOOR PLAN & EQUIPMENT LAYOUT Scale ¼" = 1 foot (If other scale, notify:_____________) BODY ART ESTABLISHMENT ______.____________________________Submitted by:__________________________