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COMPLIANCE INFO_2018
Environmental Health - Public
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1600 - Food Program
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COMPLIANCE INFO_2018
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Entry Properties
Last modified
12/29/2020 3:30:08 PM
Creation date
2/15/2019 9:14:10 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
COMPLIANCE INFO
FileName_PostFix
2018
RECORD_ID
PR0542133
PE
1608
FACILITY_ID
FA0024197
FACILITY_NAME
KNEAD PATISSERIE
STREET_NUMBER
5303
Direction
E
STREET_NAME
WOODBRIDGE
STREET_TYPE
RD
City
ACAMPO
Zip
95220
CURRENT_STATUS
01
SITE_LOCATION
5303 E WOODBRIDGE RD
P_LOCATION
99
QC Status
Approved
Scanner
JCastaneda
Tags
EHD - Public
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FGL Environmental Doc ID: 3DO900002_SOP_12-7.1010C <br /> Revision Date: 10/09/14 Page 1 of 1 <br /> Inter-Laboratory Condition Upon Receipt (Attach to COC) / 35577 <br /> Sample Receipt at- CC CH V1 <br /> 1. Number of is packages received: Shipping tracking # <br /> 2. Were samples received in a chilled condition? Temps: / / <br /> Surface water SWTR bact samples:A sample that has a temperature upon receipt of >1 C, whether iced or not, <br /> should be flagged unless the time since sample collection has been less than two hours. <br /> 3. Do the number of bottles received agree with the COC? e No N/A <br /> 4. Were samples received intact? (i.e. no broken bottles, leaks etc Y No <br /> 5. VOAs checked for Headspace? Y No N/A <br /> 6. Were sample custody seals intact? Yes No� <br /> 7. If required, was sample split for pH analysis? Yes N8 <br /> I 8. Were all analyses within holding times at time of receipt? No <br /> 9. Verify sample date, time and sampler nameFesamples. <br /> No <br /> Sign and date the COC, place in a ziplock and put ' the same ice the <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 6iA C. if many packages are received at one time check for tests/H.T.'s/rushes/ <br /> 2. Shipping tracking numbers: 1540 <br /> �C r0 LaD 33 -f 9z4CUL �C4� <br /> 4�U <br /> 3. Do the number of bottles received agree with the COC? es No N/A <br /> 4, Were samples received intact? (i.e. no broken bottles, leaks etc.) Yes No N/ <br /> 5. Were sample custody seals intact? <br /> Sign and date the COC, obtain LIMS sample numbers, select methods/tests and print labels. <br /> Sample Verification, Labeling and Distribution: <br /> I. Were all requested analyses understood and acceptable? No <br /> 2. Did bottle labels correspond with the client's ID's? e No <br /> 3. Were all bottles requiring sample preservation properly preserved? Yes No N/ FGL <br /> JException:Oil&Grease,VOA and CrVI verified in lab) No N/A <br /> 4. VOAs checked for Headspace? <br /> 5. Have rush or project due dates been checked and accepted? Yeses No <br /> 6. 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 lab deti)#y- <br /> Sample Receipt, Login and Verification completed by (initials): ��JJ <br /> Discrepancy Documentation: <br /> Any items above which are"No" or do not meet specifications Phone Number: <br /> Date: be resolved. <br /> I. Person Contacted: Date: <br /> Initiated By: <br /> Problem: <br /> Resolution: <br /> M.,...,. XT... � .• <br /> 2. Person Contacted: (3-17968I <br /> Initiated By: ,Jake DesvoigneS <br /> Problem: <br /> Resolution: STK 18 3 5 5 7 7 <br /> ;re � <br /> (Please use the back of this sheet for additional comrr. <br /> -04/30/2018-16:45:57 <br /> contacts) __ _ <br />
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