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Environmental Health - Public
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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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Electronic Record and Signature Disclosure created on:11/2/2017 9:01:51 AM <br /> Parties agreed to: Michael Carter, Haley Fittanto <br /> CONSUMER DISCLOSURE <br /> From time to time, Stericycle Inc. (we,us or Company)may be required by law to provide to <br /> you certain written notices or disclosures.Described below are the terms and conditions for <br /> providing to you such notices and disclosures electronically through the DocuSign,Inc. <br /> (DocuSign) electronic signing system.Please read the information below carefully and <br /> thoroughly, and if you can access this information electronically to your satisfaction and agree to <br /> these terms and conditions,please confirm your agreement by clicking the `I agree' button at the <br /> bottom of this document. <br /> Getting paper copies <br /> At any time,you may request from us a paper copy of any record provided or made available <br /> electronically to you by us. You will have the ability to download and print documents we send <br /> to you through the DocuSign system during and immediately after signing session and, if you <br /> elect to create a DocuSign signer account,you may access them for a limited period of time <br /> (usually 30 days) after such documents are first sent to you.After such time, if you wish for us to <br /> send you paper copies of any such documents from our office to you,you will be charged a <br /> $0.00 per-page fee.You may request delivery of such paper copies from us by following the <br /> procedure described below. <br /> Withdrawing your consent <br /> If you decide to receive notices and disclosures from us electronically,you may at any time <br /> change our mind and tell us that thereafter you want to receive required notices and disclosures <br /> g Y Y <br /> only in paper format. How you must inform us of your decision to receive future notices and <br /> disclosure in paper format and withdraw your consent to receive notices and disclosures <br /> electronically is described below. <br /> Consequences of changing your mind <br /> If you elect to receive required notices and disclosures only in paper format, it will slow the <br /> speed at which we can complete certain steps in transactions with you and delivering services to <br /> P P P Y g <br /> you because we will need first to send the required notices or disclosures to you in paper format, <br /> and then wait until we receive back from you your acknowledgment of your receipt of such <br /> paper notices or disclosures.To indicate to us that you are changing your mind,you must <br /> withdraw your consent using the DocuSign `Withdraw Consent' form on the signing page of a <br /> DocuSign envelope instead of signing it. This will indicate to us that you have withdrawn your <br /> consent to receive required notices and disclosures electronically from us and you will no longer <br /> be able to use the DocuSign system to receive required notices and consents electronically from <br /> us or to sign electronically documents from us. <br /> All notices and disclosures will be sent to you electronically <br /> Unless you tell us otherwise in accordance with the procedures described herein, we will provide <br /> electronically to you through the DocuSign system all required notices, disclosures, <br /> authorizations, acknowledgements, and other documents that are required to be provided or <br /> made available to you during the course of our relationship with you. To reduce the chance of <br /> you inadvertently not receiving any notice or disclosure, we prefer to provide all of the required <br /> notices and disclosures to you by the same method and to the same address that you have given <br /> us.Thus,you can receive all the disclosures and notices electronically or in paper format through <br /> the paper mail delivery system.If you do not agree with this process,please let us know as <br /> described below. Please also see the paragraph immediately above that describes the <br /> consequences of your electing not to receive delivery of the notices and disclosures <br />
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