(At minimum this should include 4 years of PT activities. Additional sheets may be used for further years)
# Proficiency Test Discipline
Year Year Year Year Source or Type
(3 rd party/Inter laboratory)
Enter the calibration or test discipline
1 Sub discipline to be tested
2
3
4
5
6
7
8
9
10
11
12
13
14
15
This plan defines the specific calibration or test disciplines or sub disciplines for which PT will be performed during the four year period indicated. This plan includes representative sub disciplines from each calibration or test discipline for which the organization is accredited. Please refer to PL-1 regarding PJLA policy on PT. *Where third party proficiency testing or Inter laboratory comparisons are not feasible, then the organization must include other means of evaluating such as intra laboratory or repeatability studies. When these are indicated, the organization must submit their reasoning for doing so and their procedure.*
PJLA Approval: _________________________________________
Signature/Date
Form #
LF-81
Issued: 6/07
Revised: 8/14
Rev 1.1
Page 1 of 2

#
(At minimum this should include 4 years of PT activities. Additional sheets may be used for further years)
Year Year Year Year
Proficiency Test Discipline Source or Type
2014 2015 2016 2017
Dimensional
1 Outside Micrometer

3 rd
Party
(Integrity PT)
Mechanical
2
Indirect Verification of Rockwell Hardness
Tester
Chemical

Inter laboratory comparison
3 pH Meters

3 rd Party
(American PT)
Electrical
4 Electrical Simulation of thermocouple output 
Inter laboratory comparison
Year Year Year Year
# Proficiency Test Discipline Source or Type
2014 2015 2016 2017
Environmental Testing
1
3 rd Part (PJLA
EPA 3050B test for Lead (Pb) in Paint Chips. sponsored PT)
Mechanical Testing
2 US Steel Retention Test (Four Gram Method) 
Inter laboratory comparison
Chemical Testing
3
ASTM D1121 test for Reserve Alkalinity of
Oils and Greases

3 rd
Party
(Chemical PT,
Inc.)
Biological Testing
4
PCR test for Specified Microorganism
(Salmonella)

Inter laboratory comparison
Note: PJLA lists approved PT providers on our website. However, the names of PT providers on this form are fictitious in order to avoid showing preference to any specific PT provider. The names of the calibration and testing organizations listed are also fictitious for the same reason. * Where third party proficiency testing or
Inter laboratory comparisons are not feasible, then the organization must include other means of evaluating such as intra laboratory or repeatability studies. When these are indicated the organization must submit their reasoning for doing so and their procedure. *
Form #
LF-81
Issued: 6/07
Revised: 8/14
Rev 1.1
Page 2 of 2