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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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ni <br />Certificate Of Completion <br />Envelope Id: 9A9DFCD465664FAFA84081198DF04AC1 <br />Subject: Stericycle Document(s) for your Signature on Lost Dreams Tattoo And Piercing <br />Scurce Envelope: <br />Document Pages: 6 Signatures: 2 <br />Certificate Pages: 5 Initials: 0 <br />AutoNav: Enabled <br />Envelopeld Stamping: Enabled <br />Time Zone: (UTC -06:00) Central Time (US & Canada) <br />Record Tracking <br />Status: Original <br />10/6/2022 11:29:19 AM <br />Signer Events <br />Michael Carter <br />lostdreamstattooandpiercing@gmaii.com <br />Owner <br />Security Level: Email, Account Authentication <br />(None) <br />Electronic Record and Signature Disclosure: <br />Accepted: 10/6/2022 11:31:51 AM <br />ID: ac81232a-2cf1-4e5f-bcf2-8e60c4759b3e <br />Haley Fittanto <br />haley.fittanto@stedcycle.com <br />Inside Sales Executive <br />Stericycle Inc. - Shred -it <br />Security Level: Email, Account Authentication <br />(None) <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 <br />Editor Delivery Events <br />Agent Delivery Events <br />Intermediary Delivery Events <br />Certified Delivery Events <br />Carbon Copy Events <br />Witness Events <br />Notary Events <br />Envelope Summary Events <br />Envelope Sent <br />Certified Delivered <br />Holder: Haley Fittanto <br />Haley.Fittanto@STERICYCLE.com <br />Signature <br />D� netl Cby- <br />' <br />44006F889ED <br />Signature Adoption: Drawn on Device <br />Using IP Address: 98.255.37.6 <br />Signed using mobile <br />DocuSigned by: <br />7CA34CB30A58438... <br />Signature Adoption: Pre -selected Style <br />Using IP Address: 172.58.139.85 <br />Signature <br />Status <br />Status <br />Status <br />Status <br />Status <br />Signature <br />Signature <br />Status <br />Hashed/Encrypted <br />Security Checked <br />DmuSign <br />Status: Completed <br />Envelope Originator: <br />Haley Fittanto <br />2355 Waukegan Road <br />Bannockburn, IL 60062 <br />Haley.Fiftanto@STERICYCLE.com <br />IP Address: 13.110.74.8 <br />Location: DocuSign <br />Timestamp <br />Sent: 10/6/2022 11:29:22 AM <br />Viewed: 10/6/2022 11:31:51 AM <br />Signed: 10/6/2022 11:32:17 AM <br />Sent: 10/6/2022 11:32:20 AM <br />Viewed: 10/6/2022 11:32:47 AM <br />Signed: 10/6/2022 11:33:00 AM <br />Timestamp <br />Timestamp <br />Timestamp <br />Timestamp <br />Timestamp <br />Timestamp <br />Timestamp <br />Timestamp <br />Timestamps <br />10/6/2022 11:29:22 AM <br />10/6/2022 11:32:47 AM <br />
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