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COMPLIANCE INFO_2021
Environmental Health - Public
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JACK TONE
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1600 - Food Program
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PR0543586
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COMPLIANCE INFO_2021
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Entry Properties
Last modified
11/9/2021 2:25:20 PM
Creation date
10/7/2021 9:28:21 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
COMPLIANCE INFO
FileName_PostFix
2021
RECORD_ID
PR0543586
PE
1609
FACILITY_ID
FA0021857
FACILITY_NAME
RATTO FAMILY FARMS
STREET_NUMBER
14350
Direction
S
STREET_NAME
JACK TONE
STREET_TYPE
RD
City
MANTECA
Zip
95336
APN
20305018
CURRENT_STATUS
01
SITE_LOCATION
14350 S JACK TONE RD
P_LOCATION
04
P_DISTRICT
004
QC Status
Approved
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EHD - Public
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FGL Environmental Doc ID: 3DO900002_SOP_12-3.DOC <br /> Revision Date: 10/09/14 Page 1 of 1 <br /> Inter-L ory Condition Upon Receipt (Attach to COC) 4OF'IR7 <br /> Sample Receipt at: ST CC CH VI <br /> 1. Number of ice the s packages received: Ship&-q- <br /> ping tracking# <br /> 2. Were samples received in a chilled condition? Temps: &-q / / / / <br /> Surface water SWTR bact samples: A sample that has a temperature upon receipt of >I0°C,whether iced or not, <br /> should be flagged unless the time since sample collection has been less than two hours. <br /> 3. Do the number of bottles received agree with the COC? No N/A <br /> 4. Were samples received intact? (i.e. no broken bottles, leaks etc.) Ye No <br /> 5. VOAs checked for Headspace? es No <br /> 6. Were sample custody seals intact? Yes No <br /> 7. If required, was sample split for pH analysis? Yes No / <br /> 8. Were all analyses within holding times at time of receipt? No <br /> 9. Verify sample date,time and sampler name Yes No <br /> Sign and date the COC, place in a ziplock and put in th a ice chest as the samples. <br /> Sample Receipt Review completed by (initials): <br /> Sample Receipt at SP: <br /> 1. Were samples received in a chilled condition? Temps: 3/ <br /> Acceptable is above freezing to 6U C. If many packages are received at one time check for tests/H.T.'s/rushes/ <br /> 2. Shipping tracking numbers: <br /> 3�o�coo t�34a�i�� <br /> 3. Do the number of bottles received agree with the COC? No N/A <br /> 4. Were samples received intact? (i.e. no broken bottles, leaks etc.) No <br /> 5. Were sample custody seals intact? Yes No <br /> Sign and date the COC, obtain LIMS sample numbers, select methods/tests and print Labe s. <br /> Sample Verification, Labeling and Distribution: <br /> I. Were all requested analyses understood and acceptable? No <br /> e <br /> 2. Did bottle labels correspond with the client's ID's? No <br /> 3. Were all bottles requiring sample preservation properly preserved? Yes No FGL <br /> [Exception:Oil&Grease,VOA and CM verified in lab/ <br /> 4. VOAs checked for Headspace? Yes No <br /> 5. Have rush or project due dates been checked and accepted? Yes No <br /> 6. Were all analyses within holding times at time of receipt? 49?' No <br /> Attach labels to the containers and include a copy of the COC for lab delivery. <br /> Sample Receipt, Login and Verification completed by (initials): ` O� <br /> Discrepancy Documentation: <br /> Any items above which are "No" or do not meet specifications (i.e. temps) must be resolved. <br /> 1. Person Contacted: Phone Number: <br /> Initiated By: Date: <br /> Problem: <br /> Resolution: <br /> (3017259) <br /> 2. Person Contacted: Barbara Ratio <br /> Initiated By: STKPIUM <br /> Problem: <br /> Resolution: apb 06/28/2021 15:49:17 <br /> (Please use the back of this sheet for add: <br /> III 1111111 11 ler bene <br /> contacts) <br />
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