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COMPLIANCE INFO
Environmental Health - Public
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EHD Program Facility Records by Street Name
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JACK TONE
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14350
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1600 - Food Program
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PR0543586
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COMPLIANCE INFO
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Entry Properties
Last modified
5/21/2020 4:06:01 PM
Creation date
2/14/2019 4:17:00 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
COMPLIANCE INFO
RECORD_ID
PR0543586
PE
1609
FACILITY_ID
FA0021857
FACILITY_NAME
RATTO FAMILY FARMS
STREET_NUMBER
14350
Direction
S
STREET_NAME
JACK TONE
STREET_TYPE
RD
City
MANTECA
Zip
95336
APN
20305018
CURRENT_STATUS
01
SITE_LOCATION
14350 S JACK TONE RD
P_LOCATION
04
P_DISTRICT
004
QC Status
Approved
Scanner
JCastaneda
Tags
EHD - Public
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FGL Environmental <br />Revision Date: 10/09/14 <br />Inter- ratory Condition <br />Sample Receipt at: STK CC <br />1. Number of ice ch packages received: _ <br />Doc ID: 3D0900002_SOP_12-2.DOC <br />Page 1 of 1 <br />Upon Receipt (Attach to COC) l CJ3CJd Z1 <br />' CH VI <br />Shinningg�acking 4 <br />2. Were samples received in a chilled condition? Temps: ' b / <br />P P <br />Surface water S WTR bact samples: A sample that has a temperature upon receipt of >I 0' C, whether iced or not, <br />should be flagged unless the time since sample collection has been less than two hours. <br />3. <br />Do the number of bottles received agree with the COC? <br />ra <br />No N/A <br />4. <br />Were samples received intact? (i.e. no broken bottles, leaks etc.) <br />No <br />5. <br />VOAs checked for Headspace? <br />Yes <br />No <br />6. <br />Were sample custody seals intact? <br />Yes <br />No <br />7. <br />If required, was sample split for pH analysis? <br />Y <br />No / <br />8. <br />Were all analyses within holding times at time of receipt? <br />10 <br />No <br />9. <br />Verify sample date, time and sampler name <br />Pe <br />No <br />Sign and date the COC, place in a ziplock and put mi ame ice chest <br />assamples. <br />Sample Receipt Review completed by (initials): <br />Sample Receipt at SP: <br />1. Were samples received in a chilled condition? Temps: <br />Acceptable is above freezing to 6E C. Yaggree <br />ckages are received /one'me check for tests/H.T.'s/rushes/ <br />2. Shipping tracking numbers: 1/ <br />3. Do e number of bottles receivewith the CONo <br />4. Were samples received intact? (i.e. no broken bottles, leaks etc.) Qlb No <br />5. 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 />1. Were all requested analyses understood and acceptable? No <br />2 Did bottle labels correspond with the client's ID's? Ye No <br />3. Were all bottles requiring sample preservation properly preserved? Yes No FGL <br />[Exception: Oil & Grease, VOA and CM verified in labl <br />4. VOAs checked for Headspace? Yes No <br />5. Have rush or project due dates been checked and accepted? Yes No /A <br />6. Were all analyses within holding times at time of receipt? ®e No <br />Attach labels to the containers and include a copy of the COC fb ivery. <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: ' T <br />Initiated By: (3-17259) <br />Problem: Barbara Ratto <br />Resolution: <br />(Please use the back of this sheet for additional commen STK 19 3 9 0 21 <br />contacts) SRP -06/19/2019-16:50:29 <br />S <br />
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