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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 Doc ID F3REC005.002 <br /> Revision Date 10/11/02 Page 1 of 1 <br /> • Stockton - Condition Upon Receipt (Attach to COC) <br /> Sample Receipt at STK: n V� <br /> 1 Number of ice chests/packages received <br /> 2 Were samples received in a chilled condition? 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 firther review Please notify Microbiology personnel nrimediately of bacti s_aTples received <br /> 3 Do the number of bottles received agree with the COC? Ye No N/A <br /> 4 Were samples received intact? (i a no broken bottles, leaCs etc ) es No <br /> 5 Were sample custody seals mtact9 N/A Yes No <br /> Sign and date the COC, place in a ziplock and put in the same ice chest as the samples <br /> Sample Receipt Review completerd by(initials) . <br /> Sample Receipt at SP. <br /> I 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/rushes/Bacti's to <br /> prioritize further review Please notify Microbiology personnel immediately of bacti samples ived <br /> 2 Do the number of bottles received agree with the COC? Y o N/A <br /> . 3 Were samples received mtact9 (i e no broken bottles, leaks etc ) Yes No <br /> 4 Were sample custody seals intact? N/A�Yes No <br /> Sign and date the COC, obtain LLMS sample numbers, select methods/tests and print Iabels <br /> Saip>sple Verification, Labeling and Distribution: 1. <br /> I � Were all requested analyses understood and acceptable9 Yes No <br /> 2 Did bottle labels correspond with the client's ID's9 No <br /> 3 Were all bottles requiring sample preservation properly preserved9 Yes No NIA FGL <br /> 4 Were all analyses within holding times at time of receipt? e No <br /> 5 Have rush or project due dates been checked and accepted? es No <br /> Attach labels to the containers and include a copy of the COC for lab delivery , <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 a temps) must be resolved <br /> 1 Person Contacted Phone Number <br /> Initiated By Date <br /> Problem (5-14996 <br /> �d Zero p�a1y�ls <br /> Resolution GTO <br /> (� <br /> 5' <br /> X3396 <br /> 5RP�12I18I2�03�09.59 43 <br /> Attach label with lab number hese <br />
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