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COMPLIANCE INFO_NGUYEN, LIEU THI
Environmental Health - Public
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EHD Program Facility Records by Street Name
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4100 – Safe Body Art
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PR0537421
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COMPLIANCE INFO_NGUYEN, LIEU THI
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Last modified
8/3/2023 2:39:17 PM
Creation date
7/3/2020 10:13:24 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4100 – Safe Body Art
File Section
COMPLIANCE INFO
RECORD_ID
PR0537421
PE
4120
FACILITY_ID
FA0021287
FACILITY_NAME
FRESHER NAILS & SPA LLC (NGUYEN, LIEU THI)
STREET_NUMBER
221
Direction
W
STREET_NAME
YOKUTS
STREET_TYPE
AVE
City
STOCKTON
Zip
95207
APN
10224004
CURRENT_STATUS
01
SITE_LOCATION
221 W YOKUTS AVE STE #A
P_LOCATION
01
P_DISTRICT
002
QC Status
Approved
Scanner
SJGOV\cfield
Supplemental fields
FilePath
\MIGRATIONS\BA\BA_4120_PR0537421_221 W YOKUTS_.tif
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EHD - Public
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I understand that actual color of the pigment may be modified slightly,due to the tone <br /> and color of my skin. I understand that I might need multiple services to achieve the desire look. <br /> I understand that this procedure is an art, not an exact science. <br /> I understand that tattooing is considered permanent;however, it may fade in time. That <br /> tattoo can only remove with a surgical procedure, and that any effective removal may leave <br /> permanent scarring or disfigurement. <br /> I understand that many factors can affect the outcome of these beauty services. Which <br /> includes,but are not limit to, issues such as stress,hormonal changes and certain medications? <br /> I have received post procedure instructions and I will strictly adhere to such <br /> instructions. I understand that my failure to do so may jeopardize my chances for a successful <br /> procedure and may result in loss of pigment. <br /> I realize that there is a potential discomfort and pain during and healing process. <br /> Exact color cannot be determined and may need to be adjusted. All skin is different <br /> and more touch-ups may be needed.No re on permanent make-up. <br /> I consent to having before and after photographs for the purposes of documentation. <br /> STATEMENT OF ACKNOWLEGEMENT <br /> By signing below, I agree that I have read and fully understand the questions,terms,and <br /> disclosure conditions of this CLIENT release agreement for permanent make-up procedures,was <br /> completed by me and that all entries information in it, are true and complete to the best of my <br /> knowledge. <br /> Client Signature Date <br /> Print name <br /> Technician Signature Date <br />
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