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EHD Program Facility Records by Street Name
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4100 – Safe Body Art
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PR2500145
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Entry Properties
Last modified
2/9/2026 11:41:44 AM
Creation date
7/17/2025 10:10:59 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4100 – Safe Body Art
File Section
BILLING
RECORD_ID
PR2500145
PE
4120 - BODY ART FACILITY - SINGLE USE
FACILITY_ID
FA0002556
FACILITY_NAME
SKIN & SHADES STUDIO (RODRIGUEZ, JENNIE)
STREET_NUMBER
37
Direction
W
STREET_NAME
YOKUTS
STREET_TYPE
AVE
City
STOCKTON
Zip
95207
CURRENT_STATUS
Active, billable
QC Status
Approved
Scanner
SJGOV\cfield
Supplemental fields
Site Address
37 B W Yokuts AVE Stockton 95207
Suite #
B STUDIO
Tags
EHD - Public
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I do not have acne, freckles, moles, or sunburn in the area to be tattooed that <br /> might be agitated by the tattoo process (healing excluded). <br /> I acknowledge that I am not pregnant. <br /> I acknowledge that I have truthfully represented to the associates, agents, <br /> and representatives of Skin & Shades Studio. <br /> I am at least eighteen (18) years of age. <br /> I acknowledge it is not reasonably possible for the associates, agents, and <br /> representatives of Skin & Shades Studio to determine whether I might have an allergic <br /> reaction to the dyes, pigments, or processes used in my tattoo and I agree to accept <br /> that such risks are possible. <br /> I acknowledge that infection is always possible because of obtaining a tattoo, <br /> particularly if I do not take proper care of my tattoo, and that I have been advised of the <br /> signs and symptoms of infection that indicate a need to seek medical care. <br /> I acknowledge receipt of aftercare instructions advising me of proper care of <br /> my tattoo and recognize the absolute necessity of following these aftercare instructions. <br /> All questions about the body art procedure have been answered to my <br /> satisfaction. <br /> I acknowledge that variations in color and design may exist between any <br /> cosmetic tattoos as ultimately applied to my body. <br /> I acknowledge that cosmetic tattooing is a permanent change to my <br /> appearance and that no representations have been made to me as to the ability to later <br /> change, alter, or remove my tattoo. <br /> I acknowledge that the obtaining of my cosmetic tattoo is my choice alone <br /> and I consent to the application of the tattoo and to any actions or conduct of the <br /> associates, agents, or representatives of Skin & Shades Studio that are reasonably <br /> necessary to perform the tattoo procedure. <br /> I agree to release and forever discharge and forever hold harmless Skin & <br /> Shades Studio and its associates, agents, officers, and shareholders from any claims, <br /> damages, or legal actions arising from or connected in any way with my tattoo or the <br /> procedures, and conduct used to apply my tattoo and any and all tattoos applied by <br /> Skin & Shades Studio and its associates, agents, and representatives in the future. <br /> I agree to follow all instructions concerning the care of my cosmetic tattoo, <br /> and that any touch-ups needed because of my negligence will be done at my own <br /> expense. <br />
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