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COMPLIANCE INFO_2025
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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JACK TONE
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1600 - Food Program
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PR0548956
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COMPLIANCE INFO_2025
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Entry Properties
Last modified
10/8/2025 2:13:50 PM
Creation date
10/8/2025 2:13:05 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
COMPLIANCE INFO
FileName_PostFix
2025
RECORD_ID
PR0548956
PE
1608 - CLASS A COTTAGE FOOD-DIRECT SALES
FACILITY_ID
FA0028074
FACILITY_NAME
DOGTOWN COTTAGE KITCHEN
STREET_NUMBER
24400
Direction
N
STREET_NAME
JACK TONE
STREET_TYPE
RD
City
ACAMPO
Zip
95220
CURRENT_STATUS
Active, billable
QC Status
Approved
Scanner
SJGOV\ymoreno
Supplemental fields
Site Address
24400 N JACK TONE RD ACAMPO 95220
Tags
EHD - Public
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Laboratory Report <br />Case Narrative <br />This Case Narrative pertains to the following samples: <br />DWSTK2534915-00104/08/2025Sample Port 04/08/2025 <br />Sampling and Receipt Information: <br />Preparation and analysis performed by FGL-Santa Paula (FGL-SP ELAP# 1573) <br />KD: MEP <br />Approved By Kelly A. Dunnahoo, B.S. <br />Page I of3Section: Case Narrative <br />.. 2670 <br />FGL Lab No.Date Received MatrixSample Description Date Sampled <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 />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 />The Sample was received in acceptable condition and within temperature requirements, unless noted on the Condition <br />Upon Receipt (CUR) form. The Sample was received, prepared and analyzed within the method specified holding times. <br />All samples arrived at 13. 0 C. All samples were checked for pH if acid or base preservation is required (except for <br />VOAs). For details of sample receipt information, please see the associated Chain of Custody and Condition Upon <br />Receipt Form. <br />Abbey Water Well Service <br />10706 Highway 26 <br />Valley Springs, CA. 95252 <br />Case Narrative <br />Sample Results <br />Quality Control <br />(1 page) <br />(1 page) <br />(1 page) <br />Lab No. <br />Customer No. <br />Test Summary <br />SM 4500-N03 F <br />Office & Laboratory <br />563 E. Lindo Avenue <br />Chico. CA 95926 <br />TEL: (530)343-5818 <br />CA ELAP Certification No. <br />Office & Laboratory <br />3442 Empresa Drive, Suite D <br />San Luis Obispo, CA 93401 <br />TEL: (805)783-2940 <br />CA ELAP Certification No. 2775 <br />Corporate Offices & Laboratory <br />853 Corporation Street <br />Santa Paula, CA 93060 <br />TEL: (805)392-2000 <br />CA ELAP Certification No. 1573 <br />Office & Laboratory <br />2500 Stagecoach Road <br />Stockton. CA 95215 <br />TEL: (209)942-0182 <br />CA ELAP Certification No. 1563 <br />: STK2534915 <br />:3017541 <br />Page 1 of 3 <br />Office & Laboratory <br />9411 W. Goshen Avenue <br />Visalia. CA 93291 <br />TEL: (559)734-9473 <br />CA ELAP Certification No. 281 <br />' ■ . ■ ’ ■ . ' <br />April 11, 2025 <br />Digilally signed by Kelly A. Dunnahoo. B.S <br />Title: Laboratory Director <br />Date: 2025-04-11 <br />ENVIRONMEriTAL AGRICULTURAL <br />Analytical Chemists <br />Introduction: This report package contains a total of 3 pages divided into 3 sections: <br />: An overview of the work performed at FGL. <br />: Results for each sample submitted. <br />: Supporting Quality Control (QC) results.
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