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COMPLIANCE INFO_2024
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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1600 - Food Program
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PR0548258
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COMPLIANCE INFO_2024
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Entry Properties
Last modified
3/8/2024 12:59:01 PM
Creation date
3/7/2024 2:39:57 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
COMPLIANCE INFO
FileName_PostFix
2024
RECORD_ID
PR0548258
PE
1609
FACILITY_ID
FA0027539
FACILITY_NAME
RED BARN RANCH FOODS
STREET_NUMBER
30773
Direction
S
STREET_NAME
TRACY
STREET_TYPE
BLVD
City
TRACY
Zip
95377
CURRENT_STATUS
01
SITE_LOCATION
30773 S TRACY BLVD
P_LOCATION
03
QC Status
Approved
Scanner
SJGOV\lsauers1
Tags
EHD - Public
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FGL Environmental Doc ID:3D0900002_SOP_14.DOC <br /> Revision Date: 10/10/23 Page 1 of 1 <br /> Inter-Laboratory Condit' on Receipt (Attach to COC) M 31�a q <br /> Sample Receipt at: CC CHSTK VI <br /> 1. Number of ice chests/packages received: 1 Shipping tracking#(s): <br /> 2. Temp IR Gun ID#: R� .Vr <br /> 3. Were samples received on is Yes o Temps: <br /> Surface water SWTR batt samples: ample 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 thantwo rs. <br /> 4. Do the number of bottles received agree with the COC? No N/A <br /> 5. Were samples received intact?(i.e. no broken bottles, leaks etc. - Ye No <br /> 6. VOAs checked for Headspace? Y No A <br /> 7. Were all analyses within holding times at time of receipt? No <br /> 8. Verify sample date, time and sampler namees No <br /> Sign and date the COC,place in a ziplock and put in th s e ice ches a samples. <br /> Sample Receipt Review completed by (initials): <br /> Sample Receipt at SP: <br /> 1. Number of ice chests/packages received: Shipping frac g#(s): <br /> 57SOV�(o3 ?(P3 7 373 6p I3 (o?SS <br /> 2. Temp IR Gun ID#: 94 <br /> 3. Were samples received on ice? es No Temps: <br /> Acceptable is above freezing to&C. If many packages are received at one time check for tests/H.T.'s/rushes/ <br /> 4. Do the number of bottles received agree with the COC? No N/A <br /> 5. Were samples received intact? (i.e. no broken bottles, leaks etc.) lZis 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? s No <br /> 2. Did bottle labels correspond with the client's ID's? s No <br /> 3. Were all bottles requiring sample preservation properly preserved? No /A FGL <br /> [Exception:Oil&Grease,VOA and CM verified in labl <br /> 4. VOAs checked for Headspace? Yes No N <br /> 5. Have rush or project due dates been checked and accepted? Yes No N <br /> 6. Were all analyses within holding times at time of receipt? es 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 /> 1. Person Contacted: Phone Number: <br /> Initiated By: Date: <br /> Problem: <br /> Resolution: <br /> 2. Person Contacted: Phone Number: <br /> Initiated By: Date: <br /> Problem: (3019291) <br /> Resolution: David Dyson <br /> (Please use the back of this sheet for additional comments or cor STK2131429 <br /> iv 02/01/2024 15:46:57 <br /> �I <br /> STA711{�I>rII�QII11B:5142-l��11111� <br /> 3 <br />
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