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COMPLIANCE INFO_2022
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_2022
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Entry Properties
Last modified
10/18/2022 1:45:55 PM
Creation date
8/30/2022 11:43:19 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
COMPLIANCE INFO
FileName_PostFix
2022
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
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SJGOV\jcastaneda
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EHD - Public
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•FGL Environmental Doc ID: 3DO900002_SOP_12.DOC <br /> Revision Date: 10/09/14 Page 1 of 1 <br /> Inter- o tory Condition Upon Receipt (Attach to COC) <br /> Sample Receipt at C CH VI <br /> 1. Number of is ages received: Shiping tracking# <br /> 2. Were samples received in a chilled condition? Temps:n r [ <br /> Surface water SWTR bact samples: A sample that has a temperature upon receipt of >10'C,whether iced or not, <br /> should be flagged unless the time since sample collection has been less than two hours. <br /> 3. Do the number of bottles received agree with the COC? No N/A <br /> 4. Were samples received intact? (i.e. no broken bottles, leaks et . o <br /> 5. VOAs checked for Headspace? Yes <br /> 6. Were sample custody seals intact? Yes <br /> 7. If required, was sample split for pH analysis? <br /> 8. Were all analyses within holding times at time of receipt? No <br /> 9. Verify sample date,time and sampler name Yes No <br /> Sign and date the COC, place in a ziplock and put ' ame ice ch a samples. <br /> Sample Receipt Review completed by (initials): <br /> Sample Receipt at SP: <br /> 1. Were samples received in a chilled condition? Temps: <br /> Acceptable is above freezing to 60 C. If many packages are received at one time check for testsM.T.'s/rushes/ <br /> 2. Shipping tracking numbers: 55 TUU 14())-L -3693 <br /> 31447 <br /> 3. Do the number of bottles received agree with the COC? No 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 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? e No <br /> 3. Were all bottles requiring sample preservation properly preserved? Yes No FGL <br /> (Exception:Oil&Grease,VOA and CM verified in labs <br /> 4. VOAs checked for Headspace? Yes No <br /> 5. Have rush or project due dates been checked and accepted? Yes No / <br /> � <br /> 6. Were all analyses within holding times at time of receipt? c. eNo <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): A-QL <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: Date: <br /> Problem: <br /> Resolution: <br /> 2. Person Contacted: Phone Number: <br /> Initiated By: (3017263) <br /> Problem: <br /> Resolution: Aeea "werdei <br /> (Please use the back of this sheet for additional comr STU237569 <br /> contacts) iv D����I�I0UIf�lll�l��l�2i; <br /> SM 237569 <br />
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