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COMPLIANCE INFO_2025
Environmental Health - Public
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EHD Program Facility Records by Street Name
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1600 - Food Program
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PR2500323
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COMPLIANCE INFO_2025
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Entry Properties
Last modified
3/12/2026 1:07:55 PM
Creation date
4/21/2025 9:46:35 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
COMPLIANCE INFO
FileName_PostFix
2025
RECORD_ID
PR2500323
PE
1608 - CLASS A COTTAGE FOOD-DIRECT SALES
FACILITY_ID
FA0003310
FACILITY_NAME
MRS CUPCAKES TIMELESS TREATS
STREET_NUMBER
2221
Direction
W
STREET_NAME
CANAL
STREET_TYPE
BLVD
City
TRACY
Zip
95304
CURRENT_STATUS
Active, billable
QC Status
Approved
Scanner
SJGOV\ymoreno
Supplemental fields
Site Address
2221 W CANAL BLVD TRACY 95304
Tags
EHD - Public
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FGL)Environmental Doc ID: 3D0900002_SOP—I4.DOC <br /> Revision Date: 10/10/23 page I of 1 <br /> Inter-Laboratory Co ndit�" 41pon Receipt (Attach to COP 0 30" <br /> Sample Receipt at: CC CH STK VI <br /> 1. Number of ice chests/packages receive . Shipping tracking #(s): <br /> 2. Temp IR Gun ID #:� 5 <br /> 3. Were samples received on is . Yes o Temps:� <br /> Surface water SWTR bact samples: ple that has a temperature upon receipt of >10'C,whether iced or not, <br /> should be flagged unless the time since sample collection has been less than two hours. <br /> 4. Do the number of bottles received agree with the COC? No NIA <br /> 5. Were samples received intact? (i.e. no broken bottles, leaks etc. Yes No <br /> 6. VOAs checked for Headspace? No NIA <br /> 7. Were all analyses within holding times at time of receipt? No <br /> 8. Verify sample date, time and sampler name Yes No <br /> Sign and date the COC, place in a ziplock and put in the same ice the pies. <br /> Sample Receipt Review completed by (initials): <br /> Sample Receipt at SP: <br /> I. Number of ice chests/packages received: Shipping tracking #(s): <br /> 2. Temp IR Gun ID #:w1 <br /> 3. Were samples received on ice? es No Temps: I I 1 I <br /> Acceptable is above freezing to 6°C. If many packages are received at one time check for tests/H.f.wrushes/ <br /> 4. Do the number of bottles received agree with the COC? e No N/A <br /> 5. Were samples received intact? (i.e. no broken bottles, leaks etc.) es No <br /> Sign and date the COC, obtain LIMS sample numbers, select methods/tests and print labels. <br /> Sample Verifications,Labeling and Distribution: <br /> 1. Were all requested analyses understood and acceptable? No <br /> 2. Did bottle labels correspond with the client's ID's? No <br /> 3. Were all bottles requiring sample preservation properly preserved? Tes No N% FGL <br /> [Exception:Oil&Grcese,VOA,and CrV]verified in labl <br /> 4. VOAs checked for Headspace? Yes No <br /> 5. Have rush or project due dates been checked and accepted? Yes No Ok <br /> 6. Were all analyses within holding times at time of receipt? YK No <br /> Attach labels to the containers and include a copy of the COC for lab deli ery. <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.e. temps) must be resolved. <br /> 1. Person Contacted: Phone Number: <br /> Initiated By: Date: <br /> Problem: <br /> Resolution: <br /> 2. Person Contacted: (3019566) <br /> Initiated By:Problem: Lein <br /> {� <br /> �� Villa <br /> Resolution: STK2531392 <br /> iv 02/03/2025 07:14:16 <br /> {Please use the back of this sheet for additional comments or ce..._.. _ 1Il 10111f 1101if ill <br /> STK2.171I42 <br />
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