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COMPLIANCE INFO
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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1600 - Food Program
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PR0538896
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COMPLIANCE INFO
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Entry Properties
Last modified
7/24/2019 11:18:07 AM
Creation date
12/7/2018 2:36:55 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
COMPLIANCE INFO
RECORD_ID
PR0538896
PE
1609
FACILITY_ID
FA0022347
FACILITY_NAME
BAM TREATS
STREET_NUMBER
9
Direction
N
STREET_NAME
HUTCHINS
STREET_TYPE
ST
City
LODI
Zip
95240
APN
10529001
CURRENT_STATUS
01
SITE_LOCATION
9 N HUTCHINS ST
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
JCastaneda
Supplemental fields
FilePath
\MIGRATIONS\F\FINE\735\PR0538896\COMPLIANCE.PDF
QuestysFileName
COMPLIANCE
QuestysRecordDate
3/3/2016 6:14:54 PM
QuestysRecordID
2832353
QuestysRecordType
12
QuestysStateID
1
Tags
EHD - Public
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FGL Environmental Doc II 0900002 SOP 10.DOC <br /> Revision Date: 11/18/13 'ti„' Page 1 of 1 <br /> Inter-Laboratory Condition Upon Receipt (Attach to COC} <br /> Sample Receipt at: STK CC CH VI <br /> 1. Number of ice chests/packages received: Shipping tracking 8 <br /> 2. Were samples received in a chilled condition? Temps: <br /> Surface water SWTR batt samples:A sample that has a temperature upon receipt of >10'C,whether iced or not, <br /> should be flagged unless the time since sample collection has been less than two hours. <br /> 3. Do the number of bottles received agree with the COC? No N/A <br /> 4. Were samples received intact? (i.e.no broken bottles, leaks etc.) A No <br /> 5. VOAs checked for Headspace? Yes No <br /> 6. Were sample custody:seals intact? Yes No N%A! <br /> 7. If required, was samp]e split for pH analysis? No / <br /> 8. Were all analyses within holding times at time of receipt? No <br /> 9. Verify sample date, time sampler s ) No <br /> Sign and date the COC,place in a ziplock and p l e same ice chest as the samples. <br /> Sample Receipt Review completed by(initials): <br /> Sample Receipt at SP: <br /> 1. Were samples received in a chilled condition? Temps: <br /> Acceptable is above freezing to 6' C. If many packages are received atone time check for tests/H.T.'s/mshes/ <br /> 2. Shipping trackin numbers: <br /> DI UO( (jgcf D W I00000S-1v70PY <br /> 3. Do the number of bottles received agree with the COC? No N/A <br /> 4. Were samples received intact? (i.e.no broken bottles, leaks etc.) es No <br /> 5. Were sample custody seals intact? es No N/A <br /> Sign and date the COC, obtain LIMS sample numbers, select methods/tests and print labels. <br /> Sample Verification,Labeling and Distribution: <br /> I. Were all requested analyses understood and acceptable? No <br /> 2. Did bottle labels correspond with the client's ID's? es. No No <br /> 3. Were all bottles requiring sample preservation properly preserved? es <br /> 4. VOAs checked for Headspace? �� FGL <br /> Yes No <br /> 5. Have rush or project due dates been checked and accepted? Yes No <br /> Attach labels to the containers and include a copy of the COC for lab / <br /> Sample Receipt, Login and Verification completed by(initials): <br /> Discrepancy Documentation: <br /> Any items above which are"No"or do not meet specifications (i.e, temps) must be resolved. <br /> 1. Person Contacted: Phone Number: <br /> Initiated By: Date: <br /> Problem: <br /> Resolution: <br /> 2. Person Contacted: <br /> Initiated By: <br /> Problem: PtmNi ilof��pian <br /> Resolution <br /> lfiit 7 A <br /> (Please use the back of this sheet for additional comm ✓ 1 i L`' <br /> contacts) _ �L�1 <br />
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