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COMPLIANCE INFO
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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1010
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4100 – Safe Body Art
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PR0541621
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COMPLIANCE INFO
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Entry Properties
Last modified
6/10/2025 10:17:48 AM
Creation date
4/12/2023 3:50:04 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4100 – Safe Body Art
File Section
COMPLIANCE INFO
RECORD_ID
PR0541621
PE
4120 - BODY ART FACILITY-SINGLE USE
FACILITY_ID
FA0023856
FACILITY_NAME
VERSAILLES SALON (GREEN-FRESE, ERICA)
STREET_NUMBER
1010
STREET_NAME
CENTRAL
STREET_TYPE
AVE
City
TRACY
Zip
95376
CURRENT_STATUS
Active, billable
QC Status
Approved
Scanner
SJGOV\cfield
Supplemental fields
Site Address
1010 CENTRAL AVE TRACY 95376
Tags
EHD - Public
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DocuSign Envelope ID: 3576800E-E470-4407-ABF5-80DOC3F5A285 <br />•1 <br />.� Stericycle' <br />• iwtwing hot, atoxilngRlsk: <br />Mailback Service Agreement <br />Service Address: <br />Name: Versailles Salon and Day Spa <br />Address 1: 1010 N Central Ave <br />Address 2: <br />City/State/Zip: Tracy, CA 953763915 <br />E -Mail: erica_ freseayahoo.com <br />Phone: (209) 275-9133 Fax: NA <br />Sales Rep: Tim Johnson <br />Account has multiple sites locations. Yes* El No <br />*If yes see attachment B for list of locations covered by this agreement. <br />BilliMY Address: <br />Name: Versailles Salon and Day Spa <br />Address 1: 1010 N Central Ave <br />Address 2: <br />City/State/Zip: Tracy, CA 953763915 <br />E -Mail: erica_ frescr+yahoo.com <br />Phone: Fax: <br />Generator ID #: <br />Account/Site # <br />SCOPE OF SERVICES: <br />1. The effective date of this Agreement is 1/1/2022. <br />2. Service includes the provision and use of Stericycle Mailback Program products and services for Regulated Medical, Sharps and Amalgam/Mercury Waste. <br />3. Any additional services or products purchased by Customer shall be billed separately according to then -current Stericycle pricing but subject to the terms and <br />conditions of this Agreement. <br />Mailback Services Provided <br />Total <br />Product Item N <br />Product Description <br />Quantity <br />Item Price <br />Item Price <br />IGWMV4 <br />I I - I Gallon Widemouth Container <br />1.0 <br />63.75 <br />63.75 <br />By signing belmv I acknowledge that 1 am the Customer's authorized officer nr agent and thatl have the antburity to bind Customer [o this Agreement. <br />Customer agrees to ���jilyylerms and conditions [hat appear un follmving pages hereof. <br />CUSTOMER: o i p• Name Erica Frese Title Tattoo artist Date 12/30/2021 <br />"e�� 9j888� S4d'2.. <br />STERICYCLE: �w Name Tim Johnson Title Inside Sales Executive Date 12/30/2021 <br />46M5134FEANEF... <br />4010 Commercial Ave., Northbrook, 1L 60062 Phone: (847) 943-6654 Fax: (800) 432-2813 <br />1-6-2022 <br />Generated by Tim Johnson Contac[ Number SRCL-01428833 <br />
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