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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
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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DocuSign Envelope ID: 9A9DFCD4-6566-4FAF-A840-81198DF04AC1 <br />• <br />•:• <br />SatericycleD <br />Account/Site # <br />Generator ID#: <br />Service Agreement <br />Effective Date 10-1-2022 between Stericycle, Inc and Lost Dreams Tattoo And Piercing <br />Service Address Billing Address <br />Customer/Company <br />Lost Dreams Tattoo And Piercing <br />Name: <br />Additional <br />Charge <br />Additionai container I <br />0, er Weight I Envelope <br />Address 1: <br />5920 Pacific Ave <br />Address 1: <br />Address 2: <br />Address 2: <br />City/State/Zip: <br />Stockton, CA 952074704 <br />City/State/Zip: <br />Phone #: <br />(209)696-5757 <br />Phone #: <br />Fax: <br />Fax: <br />E -Mail: <br />lostdreamstattooandpiercing@gmail.com <br />E -Mail: <br />5920 Pacific Ave <br />Stockton, CA 952074704 <br />lostdreamstattooandpiercing@gmail.com <br />Seri -ices <br />Attachment <br />Included checked beloNi (Reference <br />"Seri ice 1 <br />details) <br />A [lotted Annual <br />Stops <br />Additional <br />Charge <br />Additionai container I <br />0, er Weight I Envelope <br />Monthiv Seri ice <br />Fee <br />QDisposal <br />Biohazardous Regulated Medical Waste <br />Cha rge <br />Current container rate plus <br />13 <br />13 <br />$75 <br />$97.16 <br />Service Level:Budget Plan <br />10% <br />C(oidy <br />Stericycle Reusable Sharps Program <br />available witli purclusc of"Biuhuudcus <br />$0.00 <br />Regulated Medical waste Disposal" services) <br />- <br />- <br />- <br />E]Fixer <br />/ Developer - Photo Processing <br />0 <br />Disposal Service <br />$0.00 <br />j� <br />Pathological / Trace Chemotherapy <br />0 <br />Disposal Service <br />$0.00 <br />h� <br />Pharmaceutical Waste Disposal <br />0 <br />- <br />$0.00 <br />CsRx Controlled Substance Waste <br />Service <br />00 <br />$0.00 <br />(Only available aNh piuchase of"HDDS" spices) <br />J HIPAA Steri -Safe <br />- <br />_ <br />$0,00 <br />Container Type (\VA *Price per <br />On]%.) Container <br />Price per Stop <br />Min. Cont- per <br />Pickup <br />Scheduled -No <br />Frequency Waste Fee <br />—Mininiurn <br />Pickup Fee <br />j Biohazardous Regulated Medical Waste <br />Disposal - Transactional <br />* Price per Box: IVA only = Based on il'UTC Tariff pricing <br />** Mininumi PickpFee: WA only =$10.00 m#iinnmj monthlyfee. <br />***No Waste Fee: WA only = $25.00 <br />Total Monthly Service Fee: $97.16 <br />Monthly Service Fee Total: $97.16 Billing Schedule: Monthly <br />Minimum Pickup Fee Total: N/A Includes All Fees (Additional taxes 114ay Apply) <br />Daring the fust 12 months of the Agreement, Stericycle will not increase the above fees. <br />Thereafter, fees will not increase by more than 7.00% annually. <br />Service Guarantee: Stericycle guarantees to deliver the highest quality service at all times. Any complaints about the quality of service which have not been resolved in the normal course of business should be <br />communicated to Stericycle by written notice to the Accomit Care department at the address listed below. If Stericycle fails to resolve any material service cauplaint within thirty (30) days, the customer may temrinete <br />this Agreement provided all equipment is paid for at the then cutrent replacement values or returned to Stericycle in good and usable condition <br />IN FITNESS' HEREOF, this Agreement has been duly executed on the day, month and year *The offer will expire 10-13-2022 <br />written below. <br />Stericycle: Customer: <br />Contracting Entity: Steticycle. Inc. Customer/Company Name: Lost Dreams Tattoo And Piercing <br />Name: Haley Fittanto Name: Michael Carter <br />Titl'd 5Std11ScVNt9NVtive Title: Owner DocuSigned by: <br />ature <br />Date: 10/6/20 � l t�lMb Date: 10 �O� <br />Sign: ASM Signature: re: <br />By signing above I acknow e MAR�n earner's authorized officer or agent and that I have the authority to bind C�stotner AV-MgMt usto mer agrees to be bound by these terms and <br />conditions and canply with Stericycle's Waste Acceptance Policy, both of which are integral parts of this Agreement. <br />Stericycle Inc. • 2355 Waukegan Rd., Bannockburn, IL 60015; • Phone: (847) 943-6920 • Fax <br />Office Use Only: Code#:S97.16..50.00 <br />
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