Body Art Facility Plan Review FORM – English Required Contact Information The Bear River Health Department requires a pre-construction plan review on all body art facilities opened after September 30, 2004. This plan review will ensure that all facility requirements comply with the BRHD Body Art Rule. This applies to any facility performing body art procedures to include permanent makeup, ear piercing, body piercing, tattooing, branding, and scarification. This requirement does not include medical facilities where a board certified medical practitioner (MD, DO, etc.) performs the procedure. Construction/Remodel Start Date Estimated Completion Date Body Art Procedures Performed at Facility (Please Check All Applicable Boxes): Ear Lobe PiercingPermanent CosmeticsBrandingBody PiercingTattooScarification Sterilization Method: All single-use, pre-sterilizedAutoclave Plan review package must contain the following: ___ Floor plan to include location all of the workstations, hand wash sinks, toilets, and drains ___ Exposure Control Plan (As outlined in Section 17 of BRHD Regulations for Body Art Facilities) ___ Aftercare instructions form ___ Consent form ___ Equipment schedule listing all equipment, instruments, and materials to be used Max File Size: 5MB Max File Size: 5MB Max File Size: 5MB
