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COMPLIANCE INFO_ANDREW SOLDANA
Environmental Health - Public
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EHD Program Facility Records by Street Name
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S
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SECOND
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1537
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4100 – Safe Body Art
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PR0547582
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COMPLIANCE INFO_ANDREW SOLDANA
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Entry Properties
Last modified
8/3/2026 2:06:22 PM
Creation date
3/16/2023 9:21:44 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4100 – Safe Body Art
File Section
COMPLIANCE INFO
RECORD_ID
PR0547582
PE
4120 - BODY ART FACILITY-SINGLE USE
FACILITY_ID
FA0022490
FACILITY_NAME
ARTISTIC BINGE STUDIO (SOLDANA, ANDREW)
STREET_NUMBER
1537
STREET_NAME
SECOND
STREET_TYPE
ST
City
ESCALON
Zip
95320
CURRENT_STATUS
Active, billable
QC Status
Approved
Scanner
SJGOV\sballwahn
Supplemental fields
Site Address
1537 SECOND ST ESCALON 95320
Tags
EHD - Public
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TATTOO FORM CHECKLIST <br /> ❑ Verify client is 18 years of age or older <br /> G Review valid government-issued photo I <br /> D Make photocopy of driver's Jlcense/ ID <br /> 1=' Attach ID copy to consent packet <br /> Consent& Medical Form Review <br /> [Li Confirm both pages of conseoUmedical forms are completed <br /> G Review medical information with client <br /> u Discuss allergies, medications, or medical conditions <br /> !J Answer any client questions regarding procedure <br /> Tattoo Documentation <br /> U Fill out tattoo description (placement/design/session} <br /> 0 Confirm placement with client <br /> ID Write artist name on consent form <br /> Signatures&Authorization <br /> i Verify client signed consent form <br /> I_ Verify client dated consent form <br /> i Confirm ale required fields are completed <br /> Procedure Documentation <br /> G Attach sterile blister packs used for procedure <br /> Q Confirm equipment lot numbers (if applicable) <br /> ❑ Ensure documentation is complete <br /> Final Verification <br /> ID ID copy attached <br /> Ii Consent form completed <br /> G Medical form reviewed <br /> ID Tattoo description completed <br /> G All signatures completed <br /> G Sterile packs attached <br />
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