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COMPLIANCE INFO
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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5759
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4100 – Safe Body Art
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PR0548626
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COMPLIANCE INFO
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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
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Browse Files <br /> Drag and drop files here <br /> **if you book an appointment with any of the above restrictions and are unable to be treated,the full price of the treatment will be charged <br /> for time reserved.All payments are non-refundable. <br /> If any provision,section,subsection,clause or phrase of this release is found to be unenforceable or invalid,that portion shall be severed from <br /> this contract The remainder of this contract will then be construed as though the unenforceable portion had never been contained in this <br /> document.I hereby declare that I am of legal age(and have provided valid proof of age and identification)and am competent to sign this <br /> Agreement. <br /> I HAVE READ THE AGREEMENT, I UNDERSTAND IT,AND I AGREE TO BE BOUND BY IT.**PLEASE ASK YOUR ARTIST ABOUT THE PRICE <br /> OF YOUR TATTOO BEFORE BEGINNING THE PROCEDURE -it is your responsibility to confirm the price of the tattoo,and we assume no <br /> responsibility for any misunderstanding in this regard. <br /> FOR ARTIST TO FILL OUT:Needle:/Expiration Date/Lot# I Pigment Expiration Date/Brand/Lot:/color: <br /> Body Artist Signature <br /> SNP Here <br /> Clear <br /> Powered by jotform <br /> https://form.jotform.com/231451878214154 5/12/25, 2:10 AM <br /> Page 8 of 9 <br />
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