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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: 4/07/04 Page: I of I <br /> Santa Paula - Condition Upon Receipt (Attach to COC) <br /> . Sample Receipt. <br /> 1 Number of ice chests/packages received <br /> Note as OTC if received over the counter unpackaged <br /> 2 Were samples received in a chilled condition? Temps I I I I <br /> Acceptable is above freezing to 6°C Also acceptable is received on ice(R(5) 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 are received at one time check for tests/1-1 T 's/ushes/Bacti's to <br /> prioritize further review Please notify Microbiology personnel immediately ofPbOliam�Ics received <br /> 3 Do the number of bottles received agree with the COC? No N/A <br /> 4 Were samples received intact? (i a no broken bottles, leaks etc } ` No <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 /> I1 Were all requested analyses understood and acceptable? a No <br /> 2 Did bottle labels correspond with the client's ID's? Yes No <br /> 3 Were aII bottles requiring Sample preservation properly preserved? Yes No N/A FGL <br /> 4 Were all analyses within holding times at time of receipt? Y No <br />� . 5 Have rush or project due dates been checked and accepted? /A es No <br /> Attach labels to the containers and include a copy of the COC for lab delive <br /> Sample Receipt, Login and Venfication 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 /> 1 Person Contacted Phone Number <br /> Initiated By Date <br /> Problem <br /> Resolution <br />' 2 Person Contacted <br /> Phone Number <br /> Initiated By Date <br /> Problem <br /> IResolution (3-14996) <br /> Ground Zero Ana j yS i S <br /> STK0531973 <br /> SRP-03/21/2005-14 33 21 )er here <br />
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