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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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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 Doe ID. F3REC005 pot <br /> Revision Date 10/11/02 Page 1 of 1 <br /> • Stockton - Condition Upon Receipt (Attach to COC) <br /> Sample Receipt at STK. <br /> I 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/rushesBacti's to <br /> prioritize further review Please notify Microbiology personnel unmediately of bacti samples received <br /> 3 Do the number of bottles received agree with the COC' Yes No N/A <br /> 4 Were samples received intact9 (i a no broken bottles, leaks etc ) Ye No <br /> 5 Were sample custody seals intact9 N/ Yes No <br /> Sign and date the COC, place in a ziplock and put in the same ice chest as the sa.Mples <br /> Sample Receipt Review completed by(initials) <br /> Sample Receipt at SP: <br /> 1 Were samples received in a chilled cbndition9 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 samples eived <br /> 2 Do the number of bottles received agree with the COC? No N/A <br /> 3 Were samples received intact9 (i a no broken bottles, leaks etc ) es o <br /> 4 Were sample custody seals intact9Yes No <br /> Sign and date the COC, obtain LMS sample numbers, select methods/tes s an pent labels <br /> Sai�nple Verification, Labeling and Distribution: - <br /> 1 � Were all requested analyses understood and acceptable9 Yes No <br /> 2 Did bottle labels correspond with the client's ID's7 es No <br /> 3 Were all bottles requiring sample preservation properly preserved es No N/A FGL <br /> 4 Were all analyses within holding times at time of receipts No <br /> 5 Have rush or project due dates been checked and accepted9 N/A Yes No <br /> Attach labels to the containers and include a copy of the COC for lab de <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 /> I Person Contacted Phone Number <br /> Initiated By nat.- <br /> Problem (3-14996) <br /> 0 Resolution Ground Zero Analysis <br /> STK0338053 <br /> SRP-12/18/2003-10:09 28 <br /> Attach libel with lab number heic <br />
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