My WebLink
|
Help
|
About
|
Sign Out
Home
Browse
Search
COMPLIANCE INFO
EnvironmentalHealth
>
EHD Program Facility Records by Street Name
>
P
>
PACIFIC
>
5759
>
4100 – Safe Body Art
>
PR0548626
>
COMPLIANCE INFO
Metadata
Thumbnails
Annotations
Entry Properties
Last modified
5/7/2026 2:42:03 PM
Creation date
4/3/2025 11:46:04 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4100 – Safe Body Art
File Section
COMPLIANCE INFO
RECORD_ID
PR0548626
PE
4120 - BODY ART FACILITY-SINGLE USE
FACILITY_ID
FA0026472
FACILITY_NAME
ADORN ME TATTOO (BOU, JENNIFER)
STREET_NUMBER
5759
STREET_NAME
PACIFIC
STREET_TYPE
AVE
City
STOCKTON
Zip
95207
CURRENT_STATUS
Active, billable
QC Status
Approved
Scanner
SJGOV\sballwahn
Supplemental fields
Site Address
5759 B145 PACIFIC AVE STOCKTON 95207
Suite #
B145
Tags
EHD - Public
There are no annotations on this page.
Document management portal powered by Laserfiche WebLink 9 © 1998-2015
Laserfiche.
All rights reserved.
/
51
PDF
Print
Pages to print
Enter page numbers and/or page ranges separated by commas. For example, 1,3,5-12.
After downloading, print the document using a PDF reader (e.g. Adobe Reader).
View images
View plain text
A tattoo is a permanent change to my appearance and can only be removed by laser or surgical means,which can be distiguring <br /> and/or costly and which in all likelihood will not result in the restoration of my skin to its exact appearance before being tattooed. <br /> (PLEASE INITIAL) <br /> I release the right to any photographs taken of me and the tattoo and give consent in advance to their reproduction in print or <br /> electronic form. (For assurance, if you do not initial this provision, please inform the Tattoo Studio NOT to take any pictures of you <br /> and your completed tattoo). (PLEASE INITIAL) <br /> I agree that the Tattoo Studio has a NO REFUND policy on tattoos,and/or retail sales and I will not ask for a refund for any reason <br /> whatsoever. (PLEASE INITIAL) <br /> I acknowledge that I have been given adequate opportunity to read and understand this document that it was not presented to me <br /> at the last minute and grasp that I am signing a legal contract waiving certain rights to recover damages against the Tattoo Studio. <br /> (PLEASE INITIAL) <br /> Provide a short description of the tattoo and placement location. (ex:flowers/script on left wrist) <br /> CLIENT INTAKE AND MEDICAL HISTORY <br /> Full Name <br /> First Name Last Name <br /> E-mail Address Contact Number <br /> ex: mynameerexample.com (000) 000-0000 <br /> exampleoexample.com <br /> Address <br /> https://for m.jotform.com/2 31451878214154 5/12/25, 2:10 AM <br /> Page 3 of 9 <br />
The URL can be used to link to this page
Your browser does not support the video tag.