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COMPLIANCE INFO_CARRIE BLUBAUGH
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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L
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LUCILE
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1955
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4100 – Safe Body Art
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PR0544775
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COMPLIANCE INFO_CARRIE BLUBAUGH
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Entry Properties
Last modified
5/23/2024 9:12:51 AM
Creation date
7/3/2020 10:14:47 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4100 – Safe Body Art
File Section
COMPLIANCE INFO
RECORD_ID
PR0544775
PE
4120
FACILITY_ID
FA0025452
FACILITY_NAME
AESTHETICS LASH INK (BLUBAUGH, CARRIE)
STREET_NUMBER
1955
STREET_NAME
LUCILE
STREET_TYPE
AVE
City
STOCKTON
Zip
95209
CURRENT_STATUS
02
SITE_LOCATION
1955 LUCILE AVE STE B
P_LOCATION
01
QC Status
Approved
Scanner
SJGOV\cfield
Supplemental fields
FilePath
\MIGRATIONS\BA\BA_4120_PR0544775_1955 LUCILE_.tif
Tags
EHD - Public
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Sandip Singh [EH] <br /> From: carrieadrian@aol.com <br /> Sent: Tuesday,July 30, 2019 11:05 AM <br /> To: Sandip Singh [EH] <br /> Subject: Paperwork for Aesthetics Lash Ink. <br /> Attachments: Infection Prevention and Control Plan Aesthetics Lash Ink.pdf;After care.docx; Hep B <br /> Declination.pdf; Informed Consent Form.docx; Medical Questionaire.pdf <br /> Good Morning, <br /> I have attached my updated IPCP, Post Procedure Instructions, Hepatitis B Declination, Consent form, and Medical <br /> Questionnaire. If any need to be edited please let me know. <br /> Thank you, <br /> Carrie Blubaugh <br /> i <br />
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