HomeMy WebLinkAbout2019 Tanning Facilities Inspection, Cleaning Instructions, Floor PlanTOWN OF '`
1146 ROUTE 28 SOUTH YARMOUTH MASSACHUSETTS 02664
Tel (508) 398-2231 - Fax (508) 398-2365
BOARD OF HEALTH
TEMPORARY INSPECTION FORM FOR TANNING FACILITIES
IN ACCORDANCE WITH MGL111 SEKTION 207-214
UNTIL SUCH A TIME STATE REGULATIONS ARE PROMULGATED
NAME OF FACILITY: 15 \G el-0 TG n
ADDRESS: a,3 -z� PHONE: 15Z I ' Jr ` 1
PERSON IN CHARGE: Kee -rl.e 1J���— TITLE: ow,\EA
NUMBER OF TANNING DEVICES: A/ 1a n',t ^` Q--,P�s `, Z 54-C. r),j L 1D
yes no
no
Customers given a written statement of warning.....
Notice posted in conspicuous in every area
that a tanning device is used .....................
Notice meets wording as required................. t/
Knowledgeable operator present .................... ✓ .
Maximum temperature 100 F in tanning facility...... ✓ ...
Accurate timer +/- 10% ..... ��. 1��' �... ✓
wo-2Y-Qn
Customers use protective eyewear................... ✓ ...
Written consent for patrons 14-17 years of age .....
No patrons under 14 years of age without parent or
�
C
�E3 y-J,
guardian.......................................%�
No material claiming use
of tanning device is safe
andfree from risk ................................
Sanitize Agent available
for disinfection..........
✓ ...
Comments:
40 oys
You have seven days after receipt of this notice to correct any violations noted
above. The Board of Health may revoke the license of a tanning facility which fails
to comply after said seven days (MGL111 s208) or may impose a fine of $200 to $2000.
If you are aggrieved by a determination of the Department of Public Health within
twenty days of said determination.
Ins ector DV -a Person in Charge
Printed on
-� Recycled
Paper
2/92
BED CLEANING INSTRUCTIONS
Thoroughly cover the bed acrylic with the disinfectant*
spray and let sit. while waiting for the disinfectant to sit for
a minute, spray the towel and wipe off the pillow, the bed
handle, the top acrylic and the sides of the bed. Wipe down
the chair and check the rest of the room for cleanliness
including the floor, vacuum when necessary. When
finished, thoroughly wipe down the bottom acrylic being
sure to apply pressure and remove all the disinfectant spray
from the bed (two or more towels may be necessary). Reset
the timer, and wipe down the door handles for that room.
Put a clean towel on the bed and place the "Sanitized" sign
on top of the towel.
Disinfectant Spray:
Australian Gold pH Neutral Disinfectant Sanitizer
Use 2 ounces per gallon of water
ACTIVE INGREDIENTS:
aidecyl dimethyl ammonium chloride............................................................2.54%
n-Alkyl (C14, 50%, C12, 40%, C16,10% dimethyl benzyl ammonium chloride ...... 1.69%
INERTINGREDIENTS:.........................................................................95.77%
TOTAL: ........................................................................... 100.00%
For use in tanning salons:
A multi -purpose, neutral pH, germicidal detergent and deodorant effective in hard
water up to 200 ppm (calculated as CaQg) in the presence of a moderate amount
of soil (9% organic serum) according to the AOAC. Use -dilution Test Desinfects,
cleans and deodorizes in one labor-saving step.
BOOTH CLEANING INSTRUCTIONS
Spray a clean towel with the disinfectant* spray.
Thoroughly wipe the door handle, the handles inside the
booth and the floor of the booth, wipe down the chair and
check the rest of the room, for cleanliness including the
floor, vacuum when necessary. Reset the timer, and wipe
down the door handles for that room. Put a clean towel on
the table.
Disinfectant Spray:
Australian Gold pH Neutral Disinfectant Sanitizer
Use 2 ounces per gallon of water
ACTIVE INGREDIENTS:
Didecyl dimethyl ammonium chloride............................................................2.9%
n-Alkyl (C14, 50%, C12, 40%, C16,10% dimethyl benzyl ammonium chiodde...... 1.69%
INERT INGREDIENTS:.........................................................................95.77%
TOTAL: ........................................................................... 100.00%
For use in tanning salons:
A multi -purpose, neutral pH, germicidal detergent and deodorant effective in hard
water up to 200 ppm (calculated as CaQg) in the presence of a moderate amount
of soil (9% organic serum) according to the AOAC. Use -dilution Test Desinfects,
cleans and deodorizes in one labor-saving step.
Fv�
l3CrS��'�v"CsD
NOV 09 2017
HEALTH DEPT.
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