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ARCHIVED REPORTS_XR0005651
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_XR0005651
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Last modified
11/19/2024 1:50:30 PM
Creation date
4/28/2020 2:18:35 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0005651
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
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SJGOV\sballwahn
Tags
EHD - Public
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IFGL Environmental Doc lye 1F3RECO05 002 <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 I I I 1 <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/HT 's/rushesBacti's to <br /> pnontize further review Please notify Microbiology personnel immediately of back samples received <br /> 3 Do the number of bottles received agree with the COC? No NIA <br /> 4 Were samples received intact? (i e no broken bottles, leaks etc ) 1 No <br /> 5 Were sample custody seals mtact? Yes No <br /> iSign and date the COC, place in a ziplock and put in the same ice chest as the samples <br /> Sample Receipt Review completed by(initials) <br /> Sample Receipt at SP: <br /> 1 Were samples received in a chilled condition'? Temps ✓ I I I 1 <br /> Acceptable is above freezing to 6° C If many packages are received atone time check for tcsts/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? es � No N/A <br /> 3 Were samples received intact9 (i e no broken bottles, leaks etc ) es + No <br /> 4 Were sample custody seals intact? Yes No <br /> Sign and date the COC, obtain LMS sample numbers, select methods/tests and print labels <br /> Sample Verification, Labeling and Distribution: <br /> 1 Were all requested analyses understood and acceptable Ye No <br /> 2 Did bottle labels correspond with the client's ID's ee No <br /> 3 Were all bottles requiring sample preservation properly preserved? Yes No C-IQ FGL <br /> 4 Were all analyses within holding times at time of receipt? es No <br /> 5 Have rush or project due dates been checked and accepted NI 1 Yes No <br /> Attach labels to the containers and include a copy of the COC for lab deliva�' , <br /> Sample Receipt, Login and Verification completed by(initials) r <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 T2:;F;9�e) <br /> Resolution Ground Zero - Stockton <br /> SP 0406525 <br /> SH-06/28/2004-11 41 11 <br />
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