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ARCHIVED REPORTS_XR0005650
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_XR0005650
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Entry Properties
Last modified
11/19/2024 1:50:30 PM
Creation date
4/28/2020 2:16:44 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0005650
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 F3REC005.402 <br /> Revision Date 10/11/02 Page: 1 of 1 <br /> Stockton - Condition Upon Receipt (Attach to COC) <br /> Sample Receipt at STK: <br /> 1 Number of ice chests/packages received y <br /> 2 Were samples received in a chilled condition? Temps I I 1 I <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 atone time check for tests/H T 's/rushes/Bach's to <br /> pnontize farther review Please notify Microbiology personnel immediately of back samples received <br /> 3 Do the number of bottles received agree with the COCA Ye No N/A <br /> 4 Were samples received intact9 (i e no broken bottles, leaks etc } No <br /> 5 Were sample custody seals ifitact9 CJS Yes No <br /> Sign and date the COC, place in a ziplock and put in the same ice chest a e samples <br /> Sample Receipt Review completed by(initials) <br /> Sample Receipt at SP <br /> 1 Were samples received m 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 received <br /> 2 Do the number of bottles received agree with the COC9 No N/A <br /> 3 Were samples received intact? (i e no broken bottles, leaks etc ) No <br /> 4 Were sample custody seals intact? Yes No <br /> Sign and date the COC, obtain LIMS sample numbers, select methods/tests and pnnt labels <br /> Sample Verification, Labeling and Distribution: <br /> I Were all requested analyses understood and acceptable 3t§ No <br /> 2 Did bottle labels correspond with the client's ID's9 r� �No <br /> 3 Were all bottles requiring sample preservation properly preserved? Yes No -20� FGL <br /> 4 Were all analyses within holding times at time of receipt9 YF--1 No <br /> 5 Have rush or project due dates been checked and accepted9 Ot"K I Y e s No <br /> Attach labels to the containers and include a copy of the COC for lab delivery <br /> 1 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 /> 1 Person Contacted Phone Number _ <br /> Initiated By n'*" <br /> Problem (3`14996) <br /> OMa Zero p�a��si� <br /> Resolution Gr <br /> 5 10 4365013 <br /> `� <br /> Atiacl--Ll-ihol tvtth l-,h hFz r-, <br />
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