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ARCHIVED REPORTS_XR0005650
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_XR0005650
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Last modified
11/19/2024 1:50:30 PM
Creation date
4/28/2020 2:16:44 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0005650
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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' FG L Environmental Doc ID. F3REC005.002 <br /> Revision Date 10/11/02 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 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 are received at one time check for tests/H T 's/rushes/Bacti's to <br /> prioritize further review Please notify Microbiology personnel immediately of bacti samples received <br />' 3 Do the number of bottles received agree with the COC' Yes No N/A <br /> 4 Were samples received intact9 (i a no broken bottles, leaks etc ) No <br /> 5 Were sample custody seals iAtact? r Yes No <br /> 1 <br /> Sign and date the COC, place in a ziplock and put in the same ice chest as e samples <br /> Sample Receipt Review completed by(initials) <br />' Sample Receipt at SP: <br /> 1 Were samples received in a chilled condition? Temps I I 1 I <br />' Acceptable is above freezing to 6° C If many packages are received atone time check for tests/H T's/rushesBacti's to <br /> prioritize further review Please notify Microbiology personnel immediately of bacti samples received <br /> 2 Do the number of bottles received agree with the COC? �� No N/A <br /> 3 Were samples received intact? (i a no broken bottles, leaks etc ) No <br /> 4 Were sample custody seals intact9 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` s No <br /> 2 Did battle labels correspond with the client's ID's9 e No <br /> I3 Were all bottles requiring sample preservation properly preserved9 Yes No FGL <br /> 4 Were all analyses within holding times at time of receipts No <br /> 1 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 delivery ; <br /> ISample Receipt, Login and Verification completed by(initials) <br /> Discrepancy Documentation <br /> Any items above which are "No" or do not meet specs <br /> I Person Contacted (3-14996) <br /> Initiated By_ Ground Zero Analysis <br /> Problem c mK 043 C G O C <br /> Resolution IV-109/17/2004--0:9J 20V28 <br />
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