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EHD Program Facility Records by Street Name
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ST MARKS PLAZA
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1503
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4100 – Safe Body Art
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PR2500682
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COMPLIANCE INFO
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Entry Properties
Last modified
3/9/2026 10:14:51 AM
Creation date
10/20/2025 10:07:14 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4100 – Safe Body Art
File Section
COMPLIANCE INFO
RECORD_ID
PR2500682
PE
4120 - BODY ART FACILITY - SINGLE USE
FACILITY_ID
FA0004239
FACILITY_NAME
YATTED BY VONIE (WILLIAMS, SASHA)
STREET_NUMBER
1503
STREET_NAME
ST MARKS PLAZA
City
STOCKTON
Zip
95207
CURRENT_STATUS
Active, billable
QC Status
Approved
Scanner
SJGOV\cfield
Supplemental fields
Site Address
1503 ST MARKS PLAZA STOCKTON 95207
Tags
EHD - Public
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3 <br /> Tattoo Consent Form & Aftercare Instructions <br /> Hi,I'm Yatted byvon ie! Pregnancy/Breastfeed ing <br /> Welcome! This form includes your tattoo aftercare instructions and important information about <br /> your procedure. W goal is to make sure you're comfortable, informed, and confident about your <br /> tattoo experience. 0 I confirm that I am not pregnant or breastfeeding. I understand that tattooing is not <br /> recommended during these tunes due to potential health risks. <br /> = Please check each heart and initial (Example: Client Initials: <br /> Client Information Non-Refundable Deposit & Liability <br /> Full Name: Z) I understand that all deposits and payments for tattoo services are non- <br /> Date of Birth: refundable under any circumstances. <br /> Phone/Email: <br /> Client Initials: <br /> What a Tattoo Is <br /> A tattoo is a permanent mark created by inserting ink into the skin using needles.The procedure involves 0 I release the tattoo artist,studio,and any associated staff from liability for any <br /> penetrating the skin,which may cause discomfort,bleeding,and risk of infection.Tattoos are permanent injury,allergic reaction, infection,or other complications that may result from the <br /> and may only be removed with costly,painful medical procedures that may not fully remove the tattoo. <br /> tattoo procedure. <br /> d I understand that tattoos are permanent and may only be removed with costly and potentially <br /> ineffective medical procedures. Client Initials: <br /> Client Initials: <br /> I understand that I am responsible for following all aftercare instructions and <br /> Risks&Important Notices that failure to do so may result in infection, fading,scarring, or other complications. <br /> 0 Tattoo inks/pigments are not FDA-approved; long-term effects unknown. <br /> Client Initials: <br /> Risks: infection, allergic reactions, scarring, keloids, dissatisfaction with appearance. <br /> 0 Blood-borne pathogen exposure is possible if aftercare is not followed. <br /> No Guarantee of Results <br /> 0 This procedure is not reversible without medical intervention. Q I understand that tattoo results may vary based on skin type,placement, healing, and <br /> I understand that tattoo inks are not FDA-approved and long-term health effects are lifestyle. The artist cannot guarantee exact replication of designs, colors, or likenesses. <br /> 0 <br /> unknown. Client Initials: <br /> Client Initials: <br />
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