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COMPLIANCE INFO_2023
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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KENNEFICK
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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_12-1.DOC <br />Revision Date: 10/09/14 Page 1 of 1 <br />Inter-L atory Condition Upon Receipt (Attach to COC) olg 5Ma <br />Sample Receipt at: CC CH VI <br />Number of ice s packages received: Shipping tracking # <br />Were samples received in a chilled condition? Temps: 11 / <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 />Do the number of bottles received agree with the COC? <br />Were samples received intact? (i.e. no broken bottles, leaks e <br />VOAs checked for Headspace? <br />Were sample custody seals intact? <br />If required, was sample split for pH analysis? <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 ches pies. <br />Sample Receipt Review completed by (initials): <br />Sample Receipt at SP: <br />Were samples received in a chilled condition? Temps: 3 / 3 / 3 / <br />Acceptable is above freezing to 60 C. If many packages are received at one time check for tests/H.T.'s/rushes/ <br />Shipping tracking numbers: <br />S--7-tel7411cico 977#2&75-3.f 977,20ito. <br />Do the number of bottles received agree with the COC? :stip No N/A <br />Were samples received intact? (i.e. no broken bottles, leaks etc.) 410 No <br />Were sample custody seals intact? Yes No (22X <br />Sign and date the COC, obtain LIMS sample numbers, select methods/tests and print labels. <br />Sample Verification, Labeling and Distribution: <br />Were all requested analyses understood and acceptable? <br />Did bottle labels correspond with the client's ID's? <br />Were all bottles requiring sample preservation properly preserved? <br />[Exception: Oil & Grease, VOA and CrVI verified in labi <br />VOAs checked for Headspace? Yes No <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 for 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 />Person Contacted: Phone Number: <br />Initiated By: <br />Problem: <br />Resolution: <br />Person Contacted: <br />Initiated By: <br />Problem: <br />Resolution: <br /> <br />(Please use the back of this sheet for adi <br />contacts) <br /> <br />ber here <br />No <br />No <br />No N/A FGL
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