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ARCHIVED REPORTS_XR0005613
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_XR0005613
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Last modified
11/19/2024 1:50:29 PM
Creation date
4/28/2020 2:10:31 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0005613
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
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EHD - Public
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1 <br /> 4GL Enviranrriental Doc ID F3REC005 002 <br /> Page 1 of 1 <br />' iRevislon Date 1M1102 <br /> Stockton - CorlditIOD Upon Receipt (Attach to COC) <br /> 1 <br /> Sample Receipt at STK <br /> l Number of ice chests/packages received <br />' <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 (ROT) 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/H T 'slnishes/Bacti's to <br /> pnoritize further review Please notify Microbiology personnel immediately of bacti samples received <br /> 3 Do the number of bottles received agree with the COC? ffe- No N/A <br /> 4 Were samples received intact? (I e no broken bottles, leaks etc } No <br /> 5 Were sample custody seals int?tac <br /> K Yes No <br /> Sign and date the COC, place in a ziplock and put in the same ice chest as rifles <br />' Sample Receipt Review completed by (initials) <br /> ample Receipt at SP <br /> Were samples received in a chilled condition? 'Temps <br /> Acceptable is above freezing to 6'C If many packages <br /> eceivr immeone tkrne diately of bane checksampfor r testreidT's/rushes/Bacti's to <br /> pnoritsze further review Please notify Microbiology personnel <br /> 2 Do the number of bottles received agree -with the COC? e No NIA <br /> 3 Were samples rece]Ved intact? (i e no broken bottles, leaks etc ) es Flo <br /> 4 Were sample custody seals intact? <br /> Yes No <br /> Sign and date the COC, obtain LIMS sample numbers, select methods/tests and pnnt labels <br /> 1 Sample Verification, Labeling and Distribution 6-� <br /> 1 Wete all requested analyses understood and acceptable? No <br /> 2 Did bottle labels correspond with the client's ID's? ,�e� No <br /> I1--03 {Vere all bottles requiring sample preservation properly preserved? Yes NoFGL <br /> 4 Were all analyses within holding times at time of receipt's No <br /> 5 Have rush or prosect due dates been checked and accepted / Yes No <br /> Attach labels to the containers and include a copy of the COC for lab delivery ; <br /> Sample Receipt, Login acid Verification completed by (initials) <br /> >]iscl epaacy Uocurn°n�atlar. (3-14996) <br /> r\_n, Mems abo�« which are "bio or oto nc)' rr ect speclficati Ground Zero Analysis <br /> STK 0 4 3 8 8 6 9 <br /> IV-12/27/2004-14 16.17 <br /> 1 <br />
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