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COMPLIANCE INFO
Environmental Health - Public
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EHD Program Facility Records by Street Name
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5920
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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
8/13/2025 3:24:30 PM
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\cfield
Supplemental fields
Site Address
5920 PACIFIC AVE STOCKTON 95207
Tags
EHD - Public
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Lost Dreams Tattoo and Piercing Infection Prevention and <br />Control Plan Employee Training <br />By signing this document I hereby certify that I have been <br />formally trained in Lost Dreams Tattoo and Piercing Infection <br />Prevention and Control Plan (IPCP) and learned the procedures <br />used in the IPCP. I am fully aware of the proper sanitizing and <br />sterilizing of the procedure area and everything in it, as well as <br />the procedures for use of the clean room. Lost Dreams Tattoo <br />and Piercing has trained me in cross contamination and proper <br />storage of equipment and proper workstation set up and tear <br />down. By signing this document I take full responsibility in <br />following all procedures outlined in the company's IPCP <br />Print Name 2 <br />Signature <br />Date �/,0 s- l a - <br />Print Nan <br />Signature <br />Print Nan <br />Signature <br />Print Nan <br />Signature <br />Print Nan <br />Signature <br />Print Nan <br />Signature <br />Print Nan <br />Signature <br />Print Nan__ <br />Signature <br />Date <br />Print Name <br />Signature <br />Date <br />
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