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Emerald Tattoo & Piercing — 2525 S Hutchins St. #8, Lodi CA 95240 <br />April 29, 2022 <br />PHOTO 2: "Guest' noted for guest artist on the client records, instead of the name. <br />PR0537388 <br />[PIERCING] Emerald Tattoo Lodi Consent Form (Responses) <br />File Edit View Insert Format Data Tools Extensions Help <br />.-a C5 up 100% $ % .0 .0o 123- Default (Ad.. 10 <br />IO httpsl/alive <br />Dgle.com/open?id=lWbT6TF8rkXsr6EYAYpEwW=bS <br />B c <br />TlmestampA Haw did you hear about I Receiving BODY PIERCI Looelior <br />� d o <br />pkrcing or n. Type of jewelry <br />$ <br />4/2820229:31:46 <br />Referral <br />Guest <br />nil <br />a. <br />®.� -'. _- i - <br />I-- <br />C -o <br />D'onysta <br />Mitered <br />- 3140 <br />0-30 min ago <br />Cheyenne <br />Means <br />1324 <br />0-30 min ago <br />Gabriella <br />Teayskis <br />1324 <br />30 1hour ago <br />Madison <br />Mason <br />pkrcing or n. Type of jewelry <br />$ <br />4/2820229:31:46 <br />Referral <br />Guest <br />4p <br />Madem <br />Rios <br />1¢24 <br />1-2 hours ago <br />D'onysta <br />Mitered <br />- 3140 <br />0-30 min ago <br />Cheyenne <br />Means <br />1324 <br />0-30 min ago <br />Gabriella <br />Teayskis <br />1324 <br />30 1hour ago <br />Madison <br />Mason <br />0.18 <br />0-30 min ago <br />Anilu <br />Floras <br />19-24 <br />+hours ago <br />Melissa <br />Anufano <br />0.18 <br />3Orrin -1 lour ago <br />Griseoa <br />Navaho <br />19-24 <br />0.30 min ago <br />Patrick <br />Gonaales <br />0-18 <br />2+ hours ago <br />Steven <br />Blankenship <br />3140 <br />3Orrin -1 hour ago <br />Svlwa <br />Bazsier <br />2530 <br />How long since you last. Customer First Name <br />Customer Last Name <br />Customer Age: Cliff <br />30min-1 hour ago <br />Madem <br />Rios <br />1¢24 <br />1-2 hours ago <br />D'onysta <br />Mitered <br />- 3140 <br />0-30 min ago <br />Cheyenne <br />Means <br />1324 <br />0-30 min ago <br />Gabriella <br />Teayskis <br />1324 <br />30 1hour ago <br />Madison <br />Mason <br />0.18 <br />0-30 min ago <br />Anilu <br />Floras <br />19-24 <br />+hours ago <br />Melissa <br />Anufano <br />0.18 <br />3Orrin -1 lour ago <br />Griseoa <br />Navaho <br />19-24 <br />0.30 min ago <br />Patrick <br />Gonaales <br />0-18 <br />2+ hours ago <br />Steven <br />Blankenship <br />3140 <br />3Orrin -1 hour ago <br />Svlwa <br />Bazsier <br />2530 <br />Sandip Singh, REHS Page 2 of 13 <br />