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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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KENNEFICK
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1600 - Food Program
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PR0547668
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COMPLIANCE INFO_2025
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Entry Properties
Last modified
9/10/2025 2:47:06 PM
Creation date
9/10/2025 2:46:00 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
COMPLIANCE INFO
FileName_PostFix
2025
RECORD_ID
PR0547668
PE
1608 - CLASS A COTTAGE FOOD-DIRECT SALES
FACILITY_ID
FA0027138
FACILITY_NAME
MAMA'S TOUCH SPECIALTY COOKIES
STREET_NUMBER
21600
Direction
N
STREET_NAME
KENNEFICK
STREET_TYPE
RD
City
ACAMPO
Zip
95220
CURRENT_STATUS
Active, billable
QC Status
Approved
Scanner
SJGOV\ymoreno
Supplemental fields
Site Address
21600 N KENNEFICK RD ACAMPO 95220
Tags
EHD - Public
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1. <br />2. <br />N/A <br />7X <br />\/A <br />es <br />1. <br />2. <br />N/A <br />Yes N/A <br />OTOFGLNo <br />ilivery. <br />2. <br />— xiumber here(Please use the back of this sheet for additioni <br />contacts) <br />FGL Environmental <br />Revision Date: 10/09/14 <br />4. <br />5. <br />6. <br />3. <br />4. <br />5. <br />Person Contacted: <br />Initiated By: <br />Problem: <br />Resolution: <br />Yes <br />Yes <br />Yes <br />Yes <br />Yes <br />No <br />No <br />No <br />No <br />No <br />No <br />No <br />No <br />No <br />No <br />1. <br />2. <br />3. <br />3. <br />4. <br />5. <br />6. <br />7. <br />8. <br />9. <br />Doc ID: 3D0900002_SOP_12.DOC <br />Page 1 of 1 <br /> Acceptable is above freezing to 60 C^f at one time check for tests/H.T.’s/rushes/ <br />(3019350) <br />Do the number of bottles received agree with the COC? No <br />Were samples received intact? (i.e. no broken bottles, leaks etc.) No <br />Were sample custody seals intact? 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 />Were all requested analyses understood and acceptable? X^Yes No <br />Did bottle labels correspond with the client’s ID’s? cEWjf* No <br />Were all bottles requiring sample preservation properly preserved? Yes <br />(Exception: Oil & Grease, VOA and CrVI verified in lab| <br />VO As checked for Headspace? <br />Have rush or project due dates been checked and accepted? <br />Were all analyses within holding times at time of receipt? <br />Attach labels to the containers and include a copy of the COC for <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 />Inter-L^hftr<tory Condition Upon Receipt (Attach to COC) <br />Sample Receipt at: (^TKy CC CH VI <br />Number of ice chestsTpackages received: I Shipping tracking # <br />Were samples received in a chilled condition? Temps: fO. SI // / <br />Surface water SWTR bact samples: A sample 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 />Do the number of bottles received agree with the COC? <br />Were samples received intact? (i.e. no broken bottles, leaks etc.) <br />VO As checked for Headspace? <br />Were sample custody seals intact? <br />If required, was sample split for pH analysis? <br />Were all analyses within holding times at time of receipt? <br />Verify sample date, time and sampler name <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): d&i <br />Sample Receipt at SP: Q <br />Were samples received in a chilled condition? Temps: X / <br />Shipping tracking numbers: <br />es. <br />es
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