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COMPLIANCE INFO
Environmental Health - Public
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EHD Program Facility Records by Street Name
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PACIFIC
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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
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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DocuSign <br /> Certificate Of Completion <br /> Envelope Id:9A9DFCD465664FAFA84081198DF04AC1 Status:Completed <br /> Subject:Stericycle Document(s)for your Signature on Lost Dreams Tattoo And Piercing <br /> Scurce Envelope: <br /> Document Pages:6 Signatures:2 Envelope Originator: <br /> Certificate Pages:5 Initials:0 Haley Fittanto <br /> AutoNav:Enabled 2355 Waukegan Road <br /> Envelopeld Stamping:Enabled Bannockburn, IL 60062 <br /> Time Zone:(UTC-06:00)Central Time(US&Canada) Haley.Fittanto@STERICYCLE.com <br /> IP Address:13.110.74.8 <br /> Record Tracking <br /> Status:Original Holder:Haley Fittanto Location:DocuSign <br /> 1 0/6/2022 1 1:29:19 AM Haley.Fittanto@STERICYCLE.com <br /> Signer Events Signature Timestamp <br /> DocuSiOeed by <br /> Michael CarterSent:10/6/2022 11:29:22 AM <br /> lostdreamstattooandpiercing@gmail.com 1"006F8Z9ED04'81_ <br /> Viewed:10/6/2022 11:31:51 AM <br /> Owner Signed:10/6/2022 11:32:17 AM <br /> Security Level:Email,Account Authentication <br /> (None) Signature Adoption:Drawn on Device <br /> Using IP Address:98.255.37.6 <br /> Signed using mobile <br /> Electronic Record and Signature Disclosure: <br /> Accepted:10/6/2022 11:31:51 AM <br /> ID:ac81232a-2cfl-4e5f-bcf2-8e60c4759b3e <br /> by: <br /> Haley Fittanto D—Sig-d Sent:10/6/2022 11:32:20 AM <br /> haley.fittanto@stedcycle.com [tAVAU�7CA34CB30A68438.Fiff' ." Viewed:10/6/2022 11:32:47 AM <br /> Inside Sales Executive . Signed:10/6/2022 1 1:33:00 AM <br /> Stericycle Inc.-Shred-it <br /> Security Level:Email,Account Authentication Signature Adoption:Pre-selected Style <br /> Using IP Address:172.58.139.85 <br /> Us ss <br /> {None) g <br /> Electronic Record and Signature Disclosure: <br /> Accepted:6/16/2021 11:27:14 AM <br /> ID:332bOb3b-feca-4932-bced-22672cdcOcbc <br /> In Person Signer Events Signature Timestamp <br /> Editor Delivery Events Status Timestamp <br /> Agent Delivery Events Status Timestamp <br /> Intermediary Delivery Events Status Timestamp <br /> Certified Delivery Events Status Timestamp <br /> Carbon Copy Events Status Timestamp <br /> Witness Events Signature Timestamp <br /> Notary Events Signature Timestamp <br /> Envelope Summary Events Status Timestamps <br /> Envelope Sent Hashed/Encrypted 10/6/2022 11:29:22 AM <br /> Certified Delivered Security Checked 1 0/6/2022 1 1:32:47 AM <br />
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