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COMPLIANCE INFO_2021
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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1600 - Food Program
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PR0537882
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COMPLIANCE INFO_2021
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Entry Properties
Last modified
10/28/2021 1:51:05 PM
Creation date
8/26/2021 12:39:52 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
COMPLIANCE INFO
FileName_PostFix
2021
RECORD_ID
PR0537882
PE
1609
FACILITY_ID
FA0020758
FACILITY_NAME
ANNAS IRRESISTIBLES
STREET_NUMBER
18481
STREET_NAME
PARADISE
STREET_TYPE
RD
City
TRACY
Zip
95304-9421
APN
23505509
CURRENT_STATUS
01
SITE_LOCATION
18481 PARADISE RD
P_LOCATION
03
P_DISTRICT
005
QC Status
Approved
Scanner
SJGOV\jcastaneda
Tags
EHD - Public
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FGL Environm tal Doc ID:3DO900002_SOP_MI.DOC <br /> Revision Date: 1 /09/14 Page 1 of I 2 pp z <br /> I ter- atory Condition Upon Receipt (Attach to COC) 0231053 <br /> Sample Receip a STK CC CH VI <br /> 1. Number o is packages received: Shipping tracking# <br /> 2. Were sam ' es received in a chilled condition? Temps: Al/ <br /> Surface wati r SWTR bact samples:A sample that has a temperature upon receipt of >I0'C,whether iced or not, <br /> should be Flagged L nless the time since sample collection has been less than two hours. <br /> 3. Do the rau nber of bottles received agree with the COC? e No N/A <br /> 4. Were sam les received intact? (i.e. no broken bottles, leaks et es No <br /> 5. VOAs the Aed for Headspace? es No <br /> 6. Were sam le custody seals intact? Yes No <br /> 7. If required, was sample split for pH analysis? No OR <br /> 8. Were all a rialyses within holding times at time of receipt? Pe <br /> No <br /> 9. Verify s ple date, time and sampler name No <br /> Sign and date COC, place in a ziplock and put in a ame tce chest asamples. <br /> Sample Receipt Review completed by (initials): <br /> Sample Receip at SP: <br /> I. Were samples received in a chilled condition? Temps: <br /> Acceptable is above freezing to 69 C. If many packages ere received at one time check for tests/H.T.'s/rushes/ <br /> 2. Shipping tracking numbers: h- (4� ) <br /> J") +1��-3S�7Stil3a- <br /> 3. Do the nuinber of bottles received agree with the COC? No N/A <br /> 4. Were sam les received intact? (i.e. no broken bottles, leaks etc.) No <br /> 5. Were sam le custody seals intact? Yes No QD <br /> Sign and date tl e COC,obtain LIMS sample numbers, select methods/tests and print labels. <br /> Sample Verification, Labeling and Distribution: <br /> 1. Were all requested analyses understood and acceptable? No <br /> 2. Did bottle labels correspond with the client's ID's? a No <br /> 3. Were all ttles requiring sample preservation properly preserved? Yes No FGL <br /> [Exception:Oil&Grease,VOA and CM veriaed in labl <br /> 4. VOAs che eked for Headspace? Yes No <br /> 5. Have rush or project due dates been checked and accepted? Yes No <br /> 6. Were all a rialyses within holding times at time of receipt? ne No <br /> Attach labels to the containers and include a copy of the COC for lab d livery. <br /> Sample Receipt Login and Verification completed by (initials): <br /> Discrepancy Documentation: <br /> Any items abov which are"No"or do not meet specifications(i.e. temps)must be resolved. <br /> 1. Person Contacted: Phone Number: <br /> Initiated E y: Date: <br /> Problem: <br /> Resolution: <br /> 2. Person Contacted: Phone Number: <br /> Initiated y: Date: <br /> Problem: <br /> Resolutio : <br /> (Please use the back of this sheet for additional comments or Attach label with lab number here <br /> contacts) <br />
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