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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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PR0546753
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COMPLIANCE INFO_2022
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Entry Properties
Last modified
5/20/2025 10:50:40 AM
Creation date
5/20/2025 10:41:47 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
COMPLIANCE INFO
FileName_PostFix
2022
RECORD_ID
PR0546753
PE
1608 - CLASS A COTTAGE FOOD-DIRECT SALES
FACILITY_ID
FA0026501
FACILITY_NAME
ELLIOTT ROAD BARN
STREET_NUMBER
23228
Direction
N
STREET_NAME
ELLIOTT
STREET_TYPE
RD
City
ACAMPO
Zip
95220
CURRENT_STATUS
Active, billable
QC Status
Approved
Scanner
SJGOV\jcastaneda
Supplemental fields
Site Address
23228 N ELLIOTT RD ACAMPO 95220
Tags
EHD - Public
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April 6, 2023 Lab No. : STK2333692 <br />Julie Edsell <br />23216 N. Elliott Rd <br />Acampo, CA 95220 <br />Customer No. :3018723 <br />Laboratory Report <br />Introduction: This report package contains a total of 4 pages divided into 4 sections: <br />Case Narrative <br />(1 page) <br />: An overview of the work performed at FGL. <br />Sample Results <br />(1 page) <br />: Results for each sample submitted. <br />Interpretation <br />(1 page) <br />: Drinking water Interpretation for each sample submitted. <br />Quality Control <br />(1 page) <br />: Supporting Quality Control (QC) results. <br />Case Narrative <br />This Case Narrative pertains to the following samples: <br />Well <br />03/24/2023 03/24/2023 STK2333692-001 DW <br />Sampling and Receipt Information: The Sample was performed by FGL. <br />The Sample was received, prepared and analyzed within the method specified holding times. All samples arrived at 8.2 e <br />C. All samples were checked for pH if acid or base preservation is required (except for VOAs). For details of sample <br />receipt information, please see the associated Chain of Custody and Condition Upon Receipt Form. <br />Quality Control: All samples were prepared and analyzed according to established quality control criteria. Any exceptions are noted <br />in the Quality Control Section of this report. <br />Test Summary <br />SM 4500-NO3 F Preparation and analysis performed by FGL-Santa Paula (FGL-SP ELAP# 1573) <br />Certification: I certify that this data package is in compliance with ELAP standards, both technically and for <br />completeness, except for any conditions listed above and in the QC Section. Release of the data contained in this data <br />package is authorized by the Laboratory Director or his designee, as verified by the following electronic signature. This <br />report shall not be reproduced except in full, without the written approval of the laboratory. <br />KD: SMH <br />Section: Case Narrative <br />Digitally signed by Kelly A. Manatee, B.S. <br />Approved By Kelly A. Dunnahoo, B.S. ® Title. lahoretery, Director <br />Datc:2023.044?6 <br />Page I of4 <br />Page 1 of 4 <br />Corporate Offices & Laboratory <br />Office & Laboratory <br />Office & Laboratory <br />Office & Laboratory <br />Office 8 Laboratory <br />853 Corporation Street <br />2500 Stagecoach Road <br />563 E. Linda Avenue <br />3442 Empresa Drive, Suite D <br />9415 W. Goshen Avenue <br />Santa Paula, CA 93060 <br />Stockton, CA 95215 <br />Chico, CA 95926 <br />San Luis Obispo, CA 93401 <br />Visalia, CA 93291 <br />TEL (805)392-2000 <br />TEL: (209)942-0182 <br />TEL: (530)343-5818 <br />TEL (805)783-2940 <br />TEL: (559)734-9473 <br />Env FAX: (805)525-4172 1 Ag FAX: (805)392-2063 FAX: (209)942-0423 <br />FAX: (530)343-3807 <br />FAX: (805)783-2912 <br />FAX: (559)734-8435 <br />CA ELAP Certification No. 1573 <br />CA ELAP Certification No. 1563 <br />CA ELAP Certification No. 2670 <br />CA ELAP Certification No. 2775 <br />CA ELAP Certification No. 2810 <br />
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