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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
标签
EHD - Public
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DocuSign Envelope ID:9A9DFCD4-6566-4FAF-A840-81198DF04AC1 <br /> • Account/Site# <br /> Satericycl e 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 Lost Dreams Tattoo And Piercing <br /> Name: <br /> Address 1: 5920 Pacific Ave Address 1: 5920 Pacific Ave <br /> Address 2: Address 2: <br /> City/State/Zip: Stockton,CA 952074704 City/State/Zip: Stockton,CA 952074704 <br /> Phone#: (209)696-5757 Phone#: <br /> Fax: Fax: <br /> E-Mail: lostdreamstattooandpiercing@gmail.com E-Mail: lostdreamstattooandpiercing@gmail.com <br /> Seri-ices Included checked beloNi(Reference Additionai container I <br /> Attachment"Scri ice • A[lotted Annual Additional • <br /> details) Stops Charge Fee <br /> Biohazardous Regulated Medical Waste <br /> QDisposal 13 13 $75 Current container rate plus $97.16 <br /> Service Level:Budget Plan 10% <br /> Stericycle Reusable Sharps Program <br /> G (Oidy available wRh purclusc of"Biohuudcus $0-00 <br /> Regulated Medical waste Dispwar services) - - - <br /> E] Fixer/Developer-Photo Processing <br /> Disposal Service 0 $0.00 <br /> j� Pathological/Trace Chemotherapy <br /> Disposal Service 0 $0.00 <br /> h� Pharmaceutical Waste Disposal 0 - $0.00 <br /> CsRx Controlled Substance Waste <br /> Service 0 0 $0.00 <br /> (Only available aNh phase of"HI)DT'spices) <br /> J HIPAA Steri-Safe - _ $0,00 <br /> Container T�pe(\VA *Price per Min.Cont-per Scheduled M—No —Mininiurn <br /> j Biohazardous Regulated Medical Waste <br /> Disposal-Transactional <br /> *Price per Box:IVA only=Based on il'UTC Tariff pricing <br /> **Minintmnr PickpFee:WA only=$10.00 mininnmj 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 /> During the first 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 Accownt Care department at the address listed below. If Stericycle fails to resolve any material service oamplaint within thirty(30)days,the customer may temrinete <br /> this Agreement provided all equipment is paid for at the then cturent replacement values or returned to Stericycle in good and itsable condition. <br /> IN FITNESS'HEREOF,this Agreement has been duly executed on the day,month and year *The offer ivill 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 5StdVScVNt9NVti ve Title: Owner DocuSigned by: <br /> Date: 10/6/20 � l t�lMb Date: re: 10 �O� <br /> Signature: ABM Signature: <br /> By signing above I acknow e MAR�n earner's authorized officer or agent and that I have the authority to bind Custaner AV-MgVbustomer 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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