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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 Doc ID: F3REC005 002 <br /> Revision Date 10/J.1102 Page: 1 of 1 <br /> Stockton r Condition Upon Receipt (Attach to COC) <br />' Sample Receipt at STK: <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 atone time check for tests/H T 's/rushesBacti's to <br /> prioritize further review Please notify Microbiology personnel immediately of back samples received <br /> 3 Do the number of bottles received agree with the COC? Yes No N/A <br />' 4 Were samples received intact? (i e no broken bottles, leaks etc } No <br /> 5 Were sample custody seals iLtact? N/ Yes No <br /> Sign and date the COC, place in a ziplock and put in the same ice chest asAlwsamules <br /> Sample Receipt Review completed by(initials) <br />' Sample Receipt at SP, <br /> 1 Were samples received in a chilled condition? Temps /41—"/ <br />' Acceptable is above freezing to 6° C If many packages are received atone time check for tests/H T's/rushesBacti'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 COC? tesNo <br /> o N/A <br /> 3 Were samples received intact? (i e no broken bottles, leaks etc ) <br /> 4 Were sample custody seals intact? es No <br /> Sign and date the COC, obtain LINTS sample numbers, select methods/tests and print labels <br /> Sample Verification, Labeling and Distribution, <br /> 1 Were all requested analyses understood and acceptable? es No <br /> 2 Did bottle labels correspond with the client's ID's? No <br />' 3 Were all bottles requiring sample preservation properly preserved? Yes No 1�fA) FGL <br /> 4 Were all analyses within holding times at time of receipt? 2� No <br /> 5 Have rush or project due dates been checked and accepted? �A Yes 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) f <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 PhonP Tr„ri-'- <br /> Initiated By (3-14996) <br /> Problem Ground zero AnaYSiS <br /> Resolution STK0 4 3 6 5 0 3 <br /> IV-09/17/24-09-15.19 <br /> ALt,,t h Lbel with lah number h-(-.i(_ <br />
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