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ARCHIVED REPORTS_XR0005624
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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N
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99 (STATE ROUTE 99)
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8200
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3500 - Local Oversight Program
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PR0545621
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ARCHIVED REPORTS_XR0005624
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Entry Properties
Last modified
11/19/2024 1:50:29 PM
Creation date
4/28/2020 2:13:34 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0005624
RECORD_ID
PR0545621
PE
3528
FACILITY_ID
FA0003977
FACILITY_NAME
SPEEDY FOOD #2*
STREET_NUMBER
8200
Direction
N
STREET_NAME
STATE ROUTE 99
City
STOCKTON
Zip
95212
CURRENT_STATUS
02
SITE_LOCATION
8200 N HWY 99
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\sballwahn
Tags
EHD - Public
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FGL Environmental Doc ID. F3REC005 002 <br /> Revision Date 01/20/04 Page I of 1 <br /> '• Stockton - Condition Upon Receipt (Attach to COC) <br /> Sample Receipt at STK: �1 <br /> 1 Number of ice chests/packages received <br /> 2 Were samples received in a chilled condition9 Temps <br /> Acceptable is above freezing to 6°C Also acceptable is received on ice(ROI) for the same day of sampling or <br /> received at room temperature(RRT)if sampled within one hour of receipt Client contact for temperature failures <br /> must be documented below If many packages are received at one time check for tests/H T 's/rushes/Bacti's to <br /> prioritize further review Please notify Microbiology personnel immediately of bacti samples received <br /> 3 Do the number of bottles received agree with the COC9 es No N/A <br /> 4 Were samples received mtact9 (i e no broken bottles, leaks etc ) No <br /> 5 Were sample custody seals intact? N/A Yes No <br /> y <br /> Sign and date the COC, place in a ziplock and put in the same ice chest as the sam les <br /> Sample Receipt Review completed by(initials) <br /> Sample Receipt at SP: <br /> 1 Were samples received in a chilled condition9 Temps <br /> Acceptable is above freezing to 6° C If many packages are received atone time check for tests/H T's/rushes/Bacti's to <br /> prioritize further review Please notify Microbiology personnel immediately of bacti sample received <br /> 2 Do the number of bottles received agree with the COC9 No N/A <br /> 03 Were samples received intact`? (i e no broken bottles, leaks etc } Ye No <br /> 4 Were sample custody seals intact'? N/A es No <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 acceptable9 JeN <br /> 2 Did bottle labels correspond with the client's ID's? <br /> 3 Were all bottles requiring sample preservation properly preserve NIA FGL <br /> 4 Were all analyses within holding times at time of receipt?5 Have rush or project due dates been checked and accepted? s 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 /> I <br /> Discrepancy Documentation: <br /> Any items above which are "No" or do not meet specifications (i a temps) must be resolved <br /> 1 Person Contacted Phone Number <br /> Initiated By Date <br /> • Problem <br /> (3-14996 <br /> Resolution <br /> Ground Zero Analysis <br /> STK0431887 <br /> SRP-03/19/2004-12.19.09 <br />
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