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SR0086863
EnvironmentalHealth
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88 (STATE ROUTE 88)
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14051
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4100 – Safe Body Art
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SR0086863
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Entry Properties
Last modified
11/20/2024 9:24:02 AM
Creation date
9/1/2023 9:47:39 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4100 – Safe Body Art
File Section
COMPLIANCE INFO
RECORD_ID
SR0086863
FACILITY_NAME
LUCKY YOU TATTOO LOCKEFORD
STREET_NUMBER
14051
Direction
E
STREET_NAME
STATE ROUTE 88
City
LOCKEFORD
Zip
95237
APN
01937032
ENTERED_DATE
6/20/2023 12:00:00 AM
SITE_LOCATION
14051 E HWY 88
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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SJGOV\cfield
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EHD - Public
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I acknowledge that I am free of communicable disease. <br />I acknowledge that I have truthfully represented to the associates, agents and representatives of <br />Lucky You Tattoos that I am over EIGHTEEN (18 years of age). <br />I acknowledge it is not reasonably possible for the associates, agents and representatives of Lucky <br />You Tattoos to determine whether I have an allergic reaction to dyes, pigments or processes used in <br />my tattoo and I agree to accept that such risk are possible. <br />I acknowledge that infection is always possible as a result of obtaining a tattoo particularly in that <br />event that I do not take proper care of my tattoo, and I have been advised of the signs and symptoms <br />of infections that indicate a need to seek medical care. <br />I acknowledge receipt of written instructions advising me of proper care of my Tattoo and recognize <br />the absolute necessity of following those written instructions. All questions about the body art <br />procedure have been answered to my satisfaction. <br />I acknowledge that variations in color and design may exist between any tattoos as selected by me <br />and ultimately applied to my body. <br />I acknowledge that tattooing is a permanent change to my appearance and that no representations <br />have been made to me as to the ability to later change, alter or remove my tattoo. <br />I acknowledge that the obtaining of my tattoo is my choice alone and I consent to the application of <br />the tattoo and to any actions or conduct of the associates, agents or representatives of Lucky You <br />Tattoos that are reasonable necessary to perform the tattoo procedure. <br />I agree to release and forever discharge and forever hold harmless Lucky You Tattoos and its <br />associates, agents officers and shareholders from any and all claims, damages, and legal actions <br />arising from or connected in anyway with my tattoo or the procedures and the conduct used to apply <br />my tattoo and any and all tattoos applied by Lucky You Tattoos and its associates, agents and <br />representatives in the future. <br />I awknowledge that there are no refunds on tattoos/deposits. <br />I acknowledge that tattoo inks, dyes and pigments have not been approved by the federal food and <br />drug administration and the health consequences of using these productions are unknown. <br />
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