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COMPLIANCE INFO
Environmental Health - Public
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EHD Program Facility Records by Street Name
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1010
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4100 – Safe Body Art
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PR0541621
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COMPLIANCE INFO
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Entry Properties
Last modified
4/16/2026 9:04:47 AM
Creation date
4/12/2023 3:50:04 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4100 – Safe Body Art
File Section
COMPLIANCE INFO
RECORD_ID
PR0541621
PE
4120 - BODY ART FACILITY-SINGLE USE
FACILITY_ID
FA0023856
FACILITY_NAME
VERSAILLES SALON (GREEN-FRESE, ERICA)
STREET_NUMBER
1010
STREET_NAME
CENTRAL
STREET_TYPE
AVE
City
TRACY
Zip
95376
CURRENT_STATUS
Active, billable
QC Status
Approved
Scanner
SJGOV\kblackwell
Supplemental fields
Site Address
1010 CENTRAL AVE TRACY 95376
Tags
EHD - Public
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DocuSign Envelope ID: 3576800E-E470-4407-ABF5-80DOC3F5A285 <br /> •1 <br /> •s! Stericycle' Account/Site# <br /> Nowting hople.Ptdudnq AM. <br /> Mailback Service Agreement <br /> Service Address: Billing Address: <br /> Name: Versailles Salon and Day Spa Name: Versailles Salon and Day Spa <br /> Address 1: 1010 N Central Ave Address 1: 1010 N Central Ave <br /> Address 2: Address 2: <br /> City/State/Zip: Tracy,CA 953763915 City/State/Zip: Tracy, CA 953763915 <br /> E-Mail: erica_freserryahoo.com E-Mail: erica_frescr+yahoo.com <br /> Phone: (209)275-9133 Fax: NA Phone: Fax: <br /> Sales Rep: Tim Johnson Generator ID#: <br /> Account has multiple sites locations.Yes*El No 0 <br /> *If yes see attachment B for list of locations covered by this agreement. <br /> SCOPE OF SERVICES: <br /> 1. The effective date of this Agreement is I/I/2022. <br /> 2. Service includes the provision and use of Stericycle Mailback Program products and services for Regulated Medical, Sharps and Amalgam/Mercury Waste. <br /> 3. Any additional services or products purchased by Customer shall be billed separately according to then-current Stericycle pricing but subject to the terms and <br /> conditions of this Agreement. <br /> Mailback Services Provided <br /> Product Item N Product Description Quantity Item Price Total <br /> Item Price <br /> IGWMV4 I I - I Gallon Widemouth Container 1.0 63.75 63.75 <br /> By signing below I acknowledge that 1 am the Customer's authorized officer or agent and that have the authority to bind Customer to this Agreement. <br /> Customer agrees to &WMW11 h&V*.terms and conditions that appear on following pages hereof. <br /> CUSTOMER: D p„ l dbY Name Erica Frese Title Tattoo artist Date 12/30/2021 <br /> "e��3j883� 3349}... <br /> STERICYCLB: Name Tim Johnson Title Inside Sales Executive Date 12/30/2021 <br /> 46895134FEA74EF... <br /> 4010 Commercial Ave.,Northbrook, IL 60062 Phone: (847) 943-6654 Fax: (800)432-2813 <br /> 1-6-2022 <br /> Generated by Tim Johnson Contract Number SRCL-01428833 <br />
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