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COMPLIANCE INFO
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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ELEVENTH
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4100 – Safe Body Art
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PR0539015
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COMPLIANCE INFO
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Entry Properties
Last modified
11/19/2024 10:21:04 AM
Creation date
6/13/2023 1:18:13 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4100 – Safe Body Art
File Section
COMPLIANCE INFO
RECORD_ID
PR0539015
PE
4120
FACILITY_ID
FA0021597
FACILITY_NAME
FOREVER YOURS TATTOO (HULLAR, JOHN J)
STREET_NUMBER
606
Direction
W
STREET_NAME
ELEVENTH
STREET_TYPE
ST
City
TRACY
Zip
95376
APN
23502302
CURRENT_STATUS
02
SITE_LOCATION
606 W 11TH ST
P_LOCATION
03
P_DISTRICT
005
QC Status
Approved
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EHD - Public
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96VII <br /> CONSENT TQ <br /> ..TATTOO. . <br /> EVERYPLEASE RMMD INIMALIHESPACES BEFORE y <br /> I acknowk4ge tkatI have been kdomied#W a t&M in ft nabmisa <br /> -Tsitoo in,Its, dyes&pigments haven't been approved by the FDA&the health <br /> consequences <br /> I acknowledge that it IS NOT possible fbr the artist or-employee,of Forever <br /> Yours to determme whether or not I may taw an a#er&feacficm i'o my of the <br /> materials used durkV the procedure. I accept ft risk ffmd"a readkWrdk�tion is <br /> ill not holdForever Yours or it's-artists responsible ff a reactior0infection is <br /> I agree to hold harmless Forever Yoursifs.aTtployees or anyone associated u <br /> aftercare c m <br /> �' <br /> ions have been givert <br /> . .,.9... d. <br /> ave <br /> wstarfd'tiem and have no-f'urther questforrs. In short,tattoo <br /> must be kept clew and protected for -1days to prevent ird6ofim. .. <br /> correcL <br /> obtaining my MY own free Wi'�11 and trat all of my questiorm have been <br /> ..fo,rny best of kvwkxte. <br />
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