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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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Entry Properties
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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Doc ID ;3PICC05 002 <br /> GL Environmetita] page of I <br />' ;Revision Date 10/11/02 <br /> Stockton - CarldItIOD Upon Receipt (A tach to COQ - <br />' le Receipt at STK <br /> ,�amp P <br /> 1 Number of ice chests/packages received — <br />' I I <br /> 2 Were samples received in a chilled condition? Temps l <br /> Also acceptable is receivod on ice (ROI) for the same day of sampling or <br /> Acceptable is above freezing to b° C <br /> of receipt Client contact for temperature fail lies <br /> received at room temperature (RRT) if sampled vvithin one hour <br />' must be documented below If many packages are received at one tune check for tests/H T 's/rushesBacti's to <br /> priontize further review Please notify Microbiology personnel irrifnediately of bacti samples received <br /> 1 3 Do the number of bottles received agree with the COC? No N/A <br /> q Were samples received intact? (i e no broken bottles, leaks etc ) es leo <br /> 5 Were sample custody seals lhtact'? <br /> /A T Yes Na <br /> Sign and date the COC, place in a ziplock and put in the same ice chest as sles <br />' Sample Receipt Review completed by (initials) <br /> Sample Receipt at SP d ? Te / / / <br /> Were samples received in a chilled conitionmps/ <br /> 10 Acceptable is above freezing to 6' C ifmany packages es are received at one time cYteck for tests/i3 T's/rushcs/Bactr s to ; <br /> prtontizc further review Please notify Microbiology p <br /> ? <br /> ersonnei irrurtedtately of bacti samples No NIA <br /> 2 Do the number of bottles received agxee with the COC <br />' N <br /> 3 Were samples received intact? (i e no broken bottles, leaks etc o <br /> } <br /> d� Yes No <br /> 4 Were sample custody seals intact <br /> Sign and date the COC, obtain LEVIS sample numbers, select methods/tests and print labels <br /> Sample V�xificatiou, Labeling and Distribution <br /> ] Wete all requested analyses understood and acceptable? `j No <br /> No <br /> 2 Did bottle labels correspond with the client's ID's? <br /> le reservation properly preserved? Yes No � FOL <br /> 3 bVere all bottles requiring camp p <br />' <br /> 4 Were. all anayses <br /> 1 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 F_eceipt, Login and Veriilcalton completed by (initi�ls> <br /> (3-14996) <br /> Discs epaacy Doc1irnen attoi; Ground Zero Analysis <br /> �1iv items above whicri are "bio ur CIL) not rnect sped Tical S TKO 4 3 8 8 7 2 <br /> I 1 l 13 t t i E ' r��_��� - <br /> IV-12/27/2004-14 19 57 <br />
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