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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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FGL Environmental Doc ID:3D0900002_SOP_12-1.DOC <br /> Revision Date: 10/09/14 Page 1 of 1 <br /> Inter-tory Condition Upon Receipt (Attach to COC) /g3166.3/ <br /> Sample Receipt at: STK CC CH VI <br /> 1. Number of ice ches packages received: I Shipping tracking# <br /> 2. Were samples received in a chilled condition? Temps: 71 <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 <br /> 7. If required, was sample split for pH analysis? No <br /> 8. Were all analyses within holding time's at time of receipt? No <br /> 9. Verify sample date,time and sampler ut in No <br /> Sign and date the COC,place in a ziplock andd put in a ice chest as the samples. <br /> Sample Receipt Review completed by(initials): <br /> Sample Receipt at SP: 22 <br /> 1. Were samples received in a chilled condition? Temps: <br /> Acceptable is above freezing to 0-C. if many packages are received at one[1104 <br /> e check for testsM.T.'slmshes/ <br /> 2. Shipping tracking numbers: / \ 2 � 2 I"t ' n <br /> 3. Do the number of bottles received agree with the COC? No lN/`A <br /> 4. Were samples received intact? (i.e. no broken bottles,leaks etc.) No <br /> 5. Were sample custody seals intact? Yes No QAi1� <br /> Sign and date the COC,obtain LIMS sample numbers, select methods/tests and print labels. <br /> Sample Verification,Labeling and Distribution: <br /> 1. Were all requested analyses understood and acceptable? Y(es No <br /> 2. Did bottle labels correspond with the client's ID's? s No <br /> 3. Were all bottles requiring sample preservation properly preserved? Yes No IC2b FGL <br /> lExeeption:Oil&Grease,VOA and CrVi verified in labl <br /> 4. VOAs checked for Headspace? Yes No <br /> 5. Have rush or project due dates been checked and accepted? Yes No <br /> 6. Were all analyses within holding times at time of receipt? IRP No <br /> Attach labels to the containers and include a copy of the COC forlab b delivery. <br /> Sample Receipt,Login and Verification completed by(initials):bL, <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: (3-17752) <br /> Initiated By: <br /> Problem: Diane Alley _ <br /> Resolution: STKI 834531 <br /> (Please use the back of this sheet for additional commen IV-04/09/2018-15:28:14 <br /> contacts) <br />
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