State Water Resources Control Board Environmental Laboratory Accreditation Program P.O. Box 100, Floor 24 850 Marina Bay Parkway, Build. P 500 N Central Ave, Suite 500 Sacramento, CA 95812-0100 Richmond, CA 94804-6403 Glendale, CA 91203-3920 TEL 916-341-5175 TEL 510-620-3155 TEL 818-551-2047 FAX 510-620-3165 FAX 818-551-2052 CHECKLIST FOR LABORATORY ON-SITE INSPECTION LABORATORY INFORMATION Laboratory Name ELAP Reference No Certificate No Expiration Date Telephone No FAX No Laboratory Director Contact Person and Title DEPARTMENT INFORMATION Inspector Name/s Signature of Inspector/s Date Inspection Type: -certification Inspection Initial Certification Inspection Renewal Certification Inspection -certification Inspection -up Inspection LABORATORY CONFIRMATION OF INSPECTION This is to confirm that an on-site inspection was conducted on this date/s at the laboratory. Signature does not necessarily constitute agreement with the findings of the inspector. Signature of Contact Person Date
LABORATORY FORM FIELD OF TESTING, LIST LABORATORY REFERENCE ID NO INSPECTOR DATE 1. APPLICATION REVIEW/INFORMATION VERIFICATION The name of laboratory, mailing and facility addresses, telephone and FAX numbers, laboratory director and contact person are correct All Fields of Testing and methods within Field of Testing are correct. Personnel qualifications for all signatory personnel are correct All instruments as listed on the application are in the laboratory and are in proper working condition Are there any proposed changes in any of the above in the near future? (If so, written notification by the laboratory to ELAP is required) manual (QAM) acceptable M adhered to, reflect actual lab practices and accessible to all Personnel QAM reviewed and/or revised at least annually. Include a signatory page with review date NOTE: Auditors review the additional methods or fields of testing during the site visit (SV). Any method added after the SV can be done as an Amendment to application. Discuss the process. COMMENTS: 2. FACILITIES Laboratory Environment: Laboratory Water: ionized; -line monitoring
Utilities: COMMENTS: 3. BASIC LABORATORY INSTRUMENTATION/EQUIPMENT ph Meter: buffers 3 units apart (3 rd buffer second source). (Buffer used only once and not past expiration date) sensitivity Analytical Reagents: received and opened Conductivity Meter: 0.01 M KCl solution Analytical Balance: stable and level base Verification should be performed, each day balance is used annually with ASTM Type 1 class 1 or 2 weights Type 1 class 1 or 2 weights in good condition with no fingerprints or corrosion; recertification of weights recommended every 5 years clean Top Loader Balance Drying Ovens: -105 0 C for gravimetric analyses o C ± 2 o C for gravimetric analyses monitored and records maintained eter can be read without opening door or in sand bath Refrigerators and Freezers: y. Temperature range C_. s of responsible person and acceptable temperature range are recorded Water Baths: o to 100 o C temperatures meters calibrated against Standard thermometer, monitored and records maintained
Certified Thermometer: Date: Working thermometers verified against certified thermometer at least annually OR when exposed to temperature extremes n exposed to temperature extremes Glassware: Desiccator: Desiccant maintained Turbidimeter: secondary standards of appropriate range before each use -referenced against primary standards on quarterly basis ±15% NOTE: Ratio turbidimeters are not approved!. Other Equipment: COMMENTS: 4. REFERENCE MATERIALS STANDARD METHODS, Edition. (For Drinking Water and Wastewater analyses) EPA - "Methods For Chemical Analysis of Water and Wastes" (For Drinking Water and Wastewater analyses) EPA - "Handbook for Analytical Quality Control in Water and Wastewater Laboratories (For all analyses) EPA - "Methods for the Determination of Organic Compounds in Drinking Water" (500's Series) (For Drinking Water organic analyses) EPA-SW-846 3rd Edition (For Hazardous Waste analyses) PAM Manuals, Volumes I & II (For pesticide residue testing) rganic substances in environmental samples 5. SAMPLE RECEIVING/STORAGE. Collection personnel/sampling instructions acceptable (only if laboratory collects samples) Written procedures available to sample custodian for sample receiving and storage Adequate receiving area for samples Instructions for preservatives, containers and holding times available in sample receiving area Appropriate containers, preservatives and holding times Unique sample identifier on containers and in permanent log Log records shall include: Preservatives
Adequate system for tracking sample/holding times in the laboratory Adequate storage facilities for samples Samples stored so as to minimize contamination Chain of custody protocol and forms (when required) Storage area security COMMENTS: 6. * SAFETY (NOT ENFORCEABLE) Safety Equipment: Distillations, Solvent Extractions and Acid Digestions: Chemical Storage Shelvings and Gas Cylinders: es have guards to prevent tip overs Solvents and Acids Storage: Hazardous Wastes: -proof refrigerators COMMENTS: 7. RECORDS/DATA RETENTION Complete retention of data (results, chromatograms, raw data) Raw data maintained on worksheets and/or permanently bound lab books (ink only, no correction fluid) Adequate system of data review before final results were submitted Documentation of corrective action: Date, analyst, samples affected, problem and resolution COMMENTS: 8. Additional Records Reviewed, SOPs available E Standards & Reagents not expired F Samples analyzed within holding times G Preservation & storage of samples, standards & reagents according to method
COMMENTS: 9. STANDARD OPERATING PROCEDURES (S.O.P'S) Each Type of Test COMMENTS: 10. NOTIFICATION AND REPORTING PROCEDURES Identification of the laboratory by name and Environmental Laboratory Accreditation Program certificate number For each sample for which data is to be reported, the following data elements shall be provided: Sample identification including any sample identification numbers assigned by the laboratory Date and time of sample collection. Date and time of sample receive by the laboratory. Date and time of sample analysis. Name of analytical method. Analytical values including units of measure. Limits of detection. Date of report. Original signature by a Signatory Person NOTE: In any arrangements between laboratories involving the transfer of samples, or portions of samples, the laboratory issuing the combined report shall include an original report as issued by the other laboratory. COMMENTS: 11. FOLLOW-UP OF PREVIOUS DEFICIENCIES (for labs previously visited by ELAP only) Implementation of corrective actions as addressed in the previous deficiency response letter Non-compliances, list: 1. 2. 3. 4. COMMENTS: