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COMPLIANCE INFO
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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P
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PINE
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4100 – Safe Body Art
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PR0524524
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COMPLIANCE INFO
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Entry Properties
Last modified
3/20/2026 10:06:47 AM
Creation date
7/3/2020 10:15:18 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4100 – Safe Body Art
File Section
COMPLIANCE INFO
RECORD_ID
PR0524524
PE
4120 - BODY ART FACILITY-SINGLE USE
FACILITY_ID
FA0016445
FACILITY_NAME
HARD LUCK TATTOO (NGUYEN, BAO)
STREET_NUMBER
1
Direction
W
STREET_NAME
PINE
STREET_TYPE
ST
City
LODI
Zip
95240
CURRENT_STATUS
Active, billable
QC Status
Approved
Scanner
SJGOV\cfield
Supplemental fields
FilePath
\MIGRATIONS\BA\BA_4120_PR0524524_1 W PINE_.tif
Site Address
1 W PINE ST LODI 95240
Tags
EHD - Public
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Client Name: I d and LUC tt o Return Trackin <br /> Status: ITREATED Received Dal <br /> Item ID: 80030 Treated Dal <br /> receive Weight: 34.70 Void Dal <br /> s Manifest Image <br /> Name:I <br /> D: Signatu <br /> Name: Hard Luck atloo (M«P" <br /> Weight: <br /> Facility: <br /> Address: ran-iento St <br /> City: ILodi SHARPS <br /> Compliance, Inc. <br /> TakeAwayTM' Re <br /> State: C;A Complete sections 1 through 5 o <br /> completed form for your records. <br /> the boo- For detailed Instnrdlons <br /> Pacfra9ing and Shipping instruct, <br /> ZIP: 95240 All I.sh.rpebekn . <br /> All items below must be <br /> .. versa..... <br /> Hard Luck Tattoo <br /> 7 N Sacramento St <br /> Lodi, CA 95240 <br /> 2.posaioean of Conienn tisso wsew+ <br /> 'T�t-Z-ma NEB <br /> TRACKING FORM(MANIFEST) <br /> Gneok above.everANno must be <br /> tom Field 1 . Keep- a <br /> �., ,",� <br /> I1Rake ewa iD�a t arm <br /> P'W»Ni Tracking errn in me provia <br /> kom Field 2: F <br /> tom Field 3: <br /> TO BE CONiI <br /> Printed certification of receipt and t <br /> reccivoiLtom Field 4: Treatment <br /> t Faclatod ty:prbceasod in e <br /> T'reatesent IFad11q:ere<w n..srw <br /> 0 as..s. s—kr r... <br /> C-9b.9%TIC'r/tzt <br /> sr w:.nir ara <br /> no.w rsaw rear <br /> t Version <br /> IN CASE OF EMERCENCY,OR D <br /> White-File/Yef ow-1 <br />
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