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COMPLIANCE INFO_2016-2019
EnvironmentalHealth
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1600 - Food Program
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PR0540888
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COMPLIANCE INFO_2016-2019
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Entry Properties
Last modified
8/5/2020 4:52:38 PM
Creation date
5/7/2019 9:45:00 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
COMPLIANCE INFO
FileName_PostFix
2016-2019
RECORD_ID
PR0540888
PE
1609
FACILITY_ID
FA0023386
FACILITY_NAME
SUBURBAN HARVEST
STREET_NUMBER
5151
Direction
E
STREET_NAME
MORADA
STREET_TYPE
LN
City
STOCKTON
Zip
95212
CURRENT_STATUS
01
SITE_LOCATION
5151 E MORADA LN
P_LOCATION
01
QC Status
Approved
Scanner
JCastaneda
Tags
EHD - Public
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.—._._.._ <br /> FGL Environmental Doc ID:Ab900002_SOP 12-1.DOC <br /> Revision Date: 1.0/09/14 ~--,P i of i <br /> Inter-L tory Condition Upon Receipt (Attach to COC) <br /> Sample Receipt at: TK CC CH VI <br /> 1. Number of ice chess packages received: f Shipping tracking# <br /> 2. Were samples.received'in a chilled condition? Temps: I 1 I I <br /> Surface water SWTR batt samples:A sample that has a temperature upon receipt of >lo°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 NIA <br /> 4. Were samples received intact? (i.e. no broken bottles, leaks etc.) Ye No <br /> 5. VOAs checked for Headspace? No <br /> 6. Were sample custody seals intact? Yes No <br /> 7. If required, was sample split for pH analysis? No <br /> S. Were all analyses within holding times at time of receipt? No <br /> 9. Verify sample date, time and sampler name resarm <br /> No <br /> Sign and date the COC,place in a ziplock and put in a ice chest asples. <br /> Sample Receipt Review completed by(initials): <br /> Sample Receipt at SP: <br /> 1. Were samples received in a chilled condition? Temps: 4:;1) I I I I <br /> Acceptable is above freezing to 6w C. If many packages are received at one time check for tests/H.T.'s/rushes/ <br /> 2. Shipping tracking numbers: 7 �3_33� Lim <br /> 35'3 `AUT <br /> 3. Do the number of bottles received agree with the COC? No NIA <br /> 4. Were samples received intact? (i.e. no broken bottles, leaks etc.) No <br /> 5. Were sample custody seals intact? Yes No N/ <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? Ye No <br /> 2. Did bottle labels correspond with the client's ID's? a No <br /> 3. Were all bottles requiring sample preservation properly preserved? es No NIA FGL <br /> ]Exception.Oil&Grease,V0A and CrVI verified in lab] <br /> 4. VOAs checked for Headspace? Yes No <br /> 5. Have rush or project due dates been checked and accepted? Y No N/ <br /> 6. Were all analyses within holding times at time of receipt? 6No <br /> Attach labels to the containers and include a copy of the COC for lablivery. <br /> Sample Receipt, Login and Verification completed by (initials): �mn' <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: (3-17752)n;A�w <br /> Problem: �r i aInC <br /> Resolution: C M71 ,7 <br /> u l It l i J L. 2. •here <br /> (Please use the back of this sheet for additional cor <br /> contacts) 1V-03/10/2017-15:37:57 <br />
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