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ARCHIVED REPORTS_XR0005609
Environmental Health - Public
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EHD Program Facility Records by Street Name
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N
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99 (STATE ROUTE 99)
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8200
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3500 - Local Oversight Program
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PR0545621
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ARCHIVED REPORTS_XR0005609
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Last modified
11/19/2024 1:50:29 PM
Creation date
4/28/2020 2:07:56 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0005609
RECORD_ID
PR0545621
PE
3528
FACILITY_ID
FA0003977
FACILITY_NAME
SPEEDY FOOD #2*
STREET_NUMBER
8200
Direction
N
STREET_NAME
STATE ROUTE 99
City
STOCKTON
Zip
95212
CURRENT_STATUS
02
SITE_LOCATION
8200 N HWY 99
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\sballwahn
Tags
EHD - Public
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' FGL Environmental Doc ID. F2REC005.009 <br /> Revision Date: 4107/04 page: l of I <br />' Santa Paula - Condition Upon Receipt (Attach to COC) <br /> Sample Receipt. <br /> I 1 Number of ice chests/packages received <br /> Note as OTC if received over tiie counter unpackaged <br /> 2 Were samples received in a chilled condition? Temps <br />' Acceptable is above freezing to 6°C Also acceptable is received on ice(ROI) for the same day of sampling or <br /> received at room temperature(RRT) if sampled within one hour of receipt Client contact for temperature failures <br /> must be documented below If many packages arc received at one time check for tests/14 T 's/rvshes/Bacti's to <br />' pnoritize further review Please notify Microbiology personnel immediately of bacm les received <br /> 3 Do the number of bottles received agree with the COC9 No N/A <br />' 4 Were samples received intact? (t a no broken bottles, leaks etc ) No <br /> (� <br /> 5 Were sample custody seals intact? N/ 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 /> II Were all requested analyses understood and acceptable? Y No <br /> 2 Did bottle labels correspond with the client's ID's9 Yes No <br />' 3 Were all bottles requiring bample preservation properly preserved? Ye No N! FGL <br /> 4 Were all analyses within holding times at time of receipt? No <br /> 5 Have rusts or project due dates been checked and accepted? N/A Yes No <br /> Attach labels to the containers and include a copy of the COC for lab deli <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 a temps) must be resolved <br /> I Person Contacted Phone Number <br /> Initiated By Date <br /> Problem <br /> Resolution <br /> 2 Person Contacted Phone Number <br /> Initiated By Date <br /> IProblem <br /> Resolution (3`14995) <br /> I �rQd Zero AnaY s is <br /> LJ <br /> 531 g69 <br /> SRP-03/21/�0p5�14• <br /> 39 03 number here <br />
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