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COMPLIANCE INFO_2023
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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1600 - Food Program
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PR0547668
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COMPLIANCE INFO_2023
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Entry Properties
Last modified
9/21/2023 2:44:53 PM
Creation date
9/21/2023 2:44:16 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
COMPLIANCE INFO
FileName_PostFix
2023
RECORD_ID
PR0547668
PE
1608
FACILITY_ID
FA0027138
FACILITY_NAME
MAMA'S TOUCH SPECIALTY COOKIES
STREET_NUMBER
21600
Direction
N
STREET_NAME
KENNEFICK
STREET_TYPE
RD
City
ACAMPO
Zip
95220
CURRENT_STATUS
01
SITE_LOCATION
21600 N KENNEFICK RD
QC Status
Approved
Scanner
SJGOV\ymoreno
Tags
EHD - Public
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FGL Environmental Doc ID: 3D0900002_SOP_12.DOC <br />Revision Date: 10/09/14 Page 1 of 1 <br /> Do the number of bottles received agree with the COC? No <br /> Were samples received intact? (i.e. no broken bottles, leaks etc.) 4 No <br /> VOAs checked for Headspace? Yes No <br /> Were sample custody seals intact? Yes No <br /> If required, was sample split for pH analysis? Yes No <br /> Were all analyses within holding times at time of receipt? No <br /> Verify sample date, time and sampler name No <br />Sign 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): C6? <br />Sample Receipt at SP: <br />( Were samples received in a chilled condition? Temps: 1, - / / / / <br />S l <br />Acceptable is above freezing to 6® C. If itiAnt,:l 6eile'ved at one time check for tests/H.T.'s/rushes/ <br />Shipping tracking numbers: T5U <br />ei <br /> Were all requested analyses understood and acceptable? Yes No <br /> Did bottle labels correspond with the client's ID's? No <br /> Were all bottles requiring sample preservation properly preserved? Yes No <br />!Exception: Oil & Grease, VOA and CrVI verified in labl <br /> VOAs checked for Headspace? Yes <br /> Have rush or project due dates been checked and accepted? Yes No <br /> Were all analyses within holding times at time of receipt? No <br />Attach labels to the containers and include a copy of the COC livery. <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 />1. Person Contacted: Phone Number: <br />Number of ice chests packages received: 1 Shipping tracking # <br />Were samples received in a chilled condition? Temps: /D. 5 / / / / <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 />N/A <br />Inter-Li. <br />Receipt at: <br />4.1„tory Condition Upon Receipt (Attach to COC) 2.335 2-Sq <br />CC CH VI <br />Do the number of bottles received agree with the COC? a> No N/A <br />Were samples received intact? (i.e. no broken bottles, leaks etc.) No <br />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 />SZZE) FGL <br />Initiated By: Date: <br />Problem: <br />Resolution: <br />2. Person Contacted: <br />Initiated By: <br />Problem: <br />Resolution: <br />(Please use the back of this sheet for additioni <br />contacts) <br />'lumber here
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