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ARCHIVED REPORTS_XR0005624
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_XR0005624
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Last modified
11/19/2024 1:50:29 PM
Creation date
4/28/2020 2:13:34 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0005624
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 F3REC005 002 <br /> Revision Date 01/20/04 Page 1 of 1 <br /> • Stockton - Condition Upon Receipt (Attach to COC) <br /> Sample Receipt at STK: <br /> 1 Number of ice chests/packages received <br /> 2 Were samples received in a chilled condition? Temps <br /> Acceptable is above freezmg 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 are received at one time check for tests/H T 's/rnshes/Bacti's to <br /> prioritize further review Please notify Microbiology personnel unmediately of backres�, <br /> amples 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 ) es No <br /> 5 Were sample custody seals intact? /A Y-es No <br /> Sign and date the COC,place in a ziplock and put in the same ice chest as the samples <br /> Sample Receipt Review completed by(initials) j <br /> Sample Receipt at SP: <br /> 1 Were samples received in a chilled condition's Temps <br /> Acceptable is above freezing to 6° C If many packages are received at one time check for tests/H T's/rushesBacti's to <br /> prioritize further review Please notify Microbiology personnel immediately of bactifA <br /> 2 Do the number of bottles received agree with the COC? No N/A <br /> • 3 Were samples received intact? (i e no broken bottles, leaks etcNo <br /> 4 Were sample custody seals intact Yes No <br /> Sign and date the COC, obtain LEAS sample numbers, select methods/tests and print labels <br /> Sample Verification, Labeling and Distribution: - <br /> 1 Were all requested analyses understood and acceptable? es No <br /> 2 Did bottle labels correspond with the client's ID'sl es No <br /> 3 Were all bottles requiring sample preservation properly preserved? es No N/A FGL <br /> 4 Were all analyses within holding times at time of receipt? No <br /> 5 Have rush or project due dates been checked and accepted 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 /> 1 Person Contacted Phone Number <br /> Initiated By Date <br /> • Problem <br /> Resolution (3-14996) <br /> Ground Zero Ana I ys i s <br /> STK@431884 <br /> SRP-03/19/2004-12.14 55 <br />
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