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COMPLIANCE INFO_2022
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1600 - Food Program
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PR0546753
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COMPLIANCE INFO_2022
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Entry Properties
Last modified
6/23/2022 1:57:52 PM
Creation date
6/23/2022 1:55:09 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
COMPLIANCE INFO
FileName_PostFix
2022
RECORD_ID
PR0546753
PE
1608
FACILITY_ID
FA0026501
FACILITY_NAME
ELLIOTT ROAD BARN
STREET_NUMBER
23216
Direction
N
STREET_NAME
ELLIOTT
STREET_TYPE
RD
City
ACAMPO
Zip
95220
CURRENT_STATUS
01
SITE_LOCATION
23216 N ELLIOTT RD
QC Status
Approved
Scanner
SJGOV\jcastaneda
Tags
EHD - Public
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FGL Environmental Doc ID: 3DO900002 SOP <br />12-1.D0C <br />Revision Date: 10/09/14 Page 1 of 1 <br />Inter -La tory Condition'Upon Receipt (Attach to COC <br />Were all requested analyses understood and acceptable? <br />Sample Receipt a • STK CC CH VI <br />No <br />1. Number of i e ages received: Ship�ping tracking # <br />2. <br />2. Were samples received in a chilled condition? Temps:"//,a / <br />Surface water SWTR bact samples: A sample that has a temperature upon receipt of >10* C, whed <br />er iced or not, <br />should be flagged unless the time since sample collection has been less than two hours. <br />Were all bottles requiring sample preservation properly preserved? <br />3. Do the number of bottles received agree with the COC?NoN/A <br />C <br />No <br />4. Were samples received intact? (i.e. no broken bottles, leaks etcNo <br />5. VOAs checked for Headspace? Yes No <br />6. Were sample custody seals intact? Yes No <br />7. If required, was sample split for pH analysis? No <br />VOAs checked for Headspace? <br />8. Were all analyses within holding times at time of receipt? es No <br />No <br />9. Verify sample date, time and sampler name es No <br />5. <br />Sign and date the COC, place in a ziplock and put in t same ice c e samples. <br />Ye <br />Sample Receipt Review completed by (initials): <br />Sample Receipt at SP: '^ <br />1 l 3 <br />a <br />I . Were samples received in a chilled condition? Temps: / / / <br />/ <br />Acceptable is above freezing to 6O C. If many packages are received at one time check for tests/H.T.'s) <br />shes/ <br />2. Shipping tracking numbers: <br />1�33o�3�i '"—VZ 3 l c P aq, i X33 `u (3, 033 ► <br />i�33c ca7t� <br />3. Do the number of bottles received agree with the COC? ae No <br />N/A <br />4. Were samples received intact? (i.e. no broken bottles, leaks etc.) No <br />5. Were sample custody seals intact? Yes No <br />Sign and date the COC, obtain LIMS sample numbers, select methods/tests and print lapels. <br />. <br />Sample Verification, Labeling and Distribution: <br />Initiated By: Date: <br />- <br />I. <br />Were all requested analyses understood and acceptable? <br />Resolution: Julie EOSell <br />No <br />2. Person Contacted: STK223350 <br />2. <br />Did bottle labels correspond with the client's ID's?$es� <br />No <br />3. <br />Were all bottles requiring sample preservation properly preserved? <br />5fAi2l1Pd <br />No <br />FGL <br />[Exception: Oil & Grease, VOA and CM verified in lab[ <br />4. <br />VOAs checked for Headspace? <br />Yes <br />No <br />5. <br />Have rush or project due dates been checked and accepted? <br />Ye <br />No <br />6. <br />Were all analyses within holding times at time of receipt? <br />C.7 <br />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.e. temps) must be resolved <br />I . Person Contacted: Phone Number: <br />Initiated By: Date: <br />- <br />Problem: - - - - <br />(3018723) <br />Resolution: Julie EOSell <br />2. Person Contacted: STK223350 <br />Initiated By: <br />Problem: Iv 0311512022 16:0 <br />p:24 <br />Resolution: pIIIII�IIIIIB�IuIIIIUI�VI <br />8 <br />5fAi2l1Pd <br />(Please use the back of this sheet for additional cot <br />contacts) <br />
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