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COMPLIANCE INFO
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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PR0548004
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COMPLIANCE INFO
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Entry Properties
Last modified
4/27/2026 11:14:46 AM
Creation date
3/5/2024 9:14:00 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4100 – Safe Body Art
File Section
COMPLIANCE INFO
RECORD_ID
PR0548004
PE
4121 - BODY ART FACILITY-STERILIZATION
FACILITY_ID
FA0027381
FACILITY_NAME
LOST DREAMS TATTOOS & PIERCING (CARTER, MICHAEL)
STREET_NUMBER
5920
STREET_NAME
PACIFIC
STREET_TYPE
AVE
City
STOCKTON
Zip
95207
CURRENT_STATUS
Active, billable
QC Status
Approved
Scanner
SJGOV\sballwahn
Supplemental fields
Site Address
5920 PACIFIC AVE STOCKTON 95207
Tags
EHD - Public
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Lost Dreams Tattoo and Piercing Infection Prevention and Control Plan Employee Training <br /> By signing this document, I hereby certify that I have been formally trained in Lost Dreams <br /> Tattoo and Piercing infection prevention and Control plan (IPCP) and learned the procedures <br /> used in the IPCP. I am fully aware of the proper sanitizing and sterilizing of the procedure area <br /> and everything in it, as well as the procedures for use of the clean room. Lost Dreams Tattoo <br /> and Piercing has trained me in cross contamination and proper storage of equipment and <br /> proper workstation set up and tear down. By signing this document, I take full responsibility in <br /> following all procedures outlined in the company's IPCP. <br /> Print Name G <br /> r-Ar44�- <br /> Signature <br /> Date o?Lf <br /> Print Name hqe`0 <br /> Signature 'DECEIVED <br /> Date <br /> Print Name <br /> JUL 2 9 2024 <br /> Signature <br /> ENVIRONME VIA L IIEALTH <br /> Date p DEPARTIliENT <br /> Print Name 1wtv <br /> Signature <br /> Date Z <br /> Print Name r <br /> Signature <br /> Date a ��-r <br /> Print Name A/A ,Qqf � <br /> Signature <br /> Date <br /> Print Name <br /> Signature <br /> Date u <br /> Print Name <br /> Signature <br /> Date <br />
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