Environmental Method Witness (OPIEF) Form
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TNI/ DoD-ELAP & ISO/IEC 17025 Method Review Matrix TNI/ DoD QSM 5.0 Section → Parameter / Test Name or Technology Method(s) (From Scope) Acid Digestion EPA 3050B Alkaline Digestion EPA 3060A Depth of Assessment *See codes Laboratory Name: Assessment Date(s): 5.2 5.3; 5.5 5.4 5.4.6 5.6 5.7; 5.8 5.9 4.12 5.10 Name(s) of Personnel Interviewed Accommodation / Environment; Equipment & Ref. Materials Procedure / Operating Instructions Measurement Uncertainty Verification Traceability; Verification / Calibration Sampling; Handling / Prep. Quality Checks Records Report / Certificate As per SOP Thermometer Balance Pipettor As per SOP MB LCS/D MS/D Hardcopy and Electronic Records OK As per SOP Thermometer Balance Analytical Balance Pipettor As per SOP MB LCS/D MS/D Hardcopy and Electronic Records OK As per SOP Thermometer Balance Pipettor Turbidimeter As per SOP MB LCS/D MS/D Hardcopy and Electronic Records OK As per SOP Thermometer Balance Pipettor As per SOP MB LCS/D MS/D Hardcopy and Electronic Records OK Digestion Tubes Various Glassware Centrifuge Pipettors Block Digester Thermometer Filtration Apparatus CRM pH meter Various Glassware Hot Plate Thermometer Drying Oven Filtration Apparatus Balance Analytical Balance CRM Digestion Tubes Various Glassware Centrifuge Pipettors Turbidimeter Block Digester Thermometer Filtration Apparatus CRM Digestion Tubes Various Glassware Centrifuge Pipettors Block Digester Cr+6 Digestion EPA 3005A Digestion EPA 3010A ACLASS Form 67 Page 1 Environmental Method Witness Form January 14, 2014 TNI/ DoD-ELAP & ISO/IEC 17025 Method Review Matrix TNI/ DoD QSM 5.0 Section → Parameter / Test Name or Technology Method(s) (From Scope) Digestion EPA 3020A Organic Lead CA LUFT Mercury EPA 7470A Mercury EPA 7471A ACLASS Form 67 Depth of Assessment *See codes Laboratory Name: Assessment Date(s): 5.2 5.3; 5.5 5.4 5.4.6 5.6 5.7; 5.8 5.9 4.12 5.10 Name(s) of Personnel Interviewed Accommodation / Environment; Equipment & Ref. Materials Procedure / Operating Instructions Measurement Uncertainty Verification Traceability; Verification / Calibration Sampling; Handling / Prep. Quality Checks Records Report / Certificate As per SOP Thermometer Balance Pipettor As per SOP MB LCS/D MS/D Hardcopy and Electronic Records OK As per SOP 4 pt. Cal ICV/ICB CCV/CCB Balance Pipettor As per SOP MB LCS/S MS/MSD PS/D Hardcopy and Electronic Records OK As per SOP Min 5 pt. Cal ICV CCV CB Pipettor Thermometer As per SOP MB LCS/D MS/D LLOQ Ck/ CRDL Ck PDS Hardcopy and Electronic Records OK As per SOP Min 5 pt. Cal ICV CCV CB Pipettor Thermometer Analytical Balance As per SOP MB LCS/D MS/D LLOQ Ck/ CRDL Ck PDS Hardcopy and Electronic Records OK Thermometer Filtration Apparatus CRM Digestion Tubes Various Glassware Centrifuge Pipettors Block Digester Thermometer Filtration Apparatus CRM AAS Software Various Glassware Shaker Pipettors CRM AAS Software Various Glassware Pipettors Block Digester Thermometer Filtration Apparatus CRM AAS Software Various Glassware Pipettors Block Digester Thermometer Analytical Page 2 Environmental Method Witness Form January 14, 2014 TNI/ DoD-ELAP & ISO/IEC 17025 Method Review Matrix TNI/ DoD QSM 5.0 Section → Parameter / Test Name or Technology Method(s) (From Scope) Mercury EPA 7471B Mercury EPA 1631E Metals EPA 6010B ACLASS Form 67 Depth of Assessment *See codes Laboratory Name: Assessment Date(s): 5.2 5.3; 5.5 5.4 5.4.6 5.6 5.7; 5.8 5.9 4.12 5.10 Name(s) of Personnel Interviewed Accommodation / Environment; Equipment & Ref. Materials Procedure / Operating Instructions Measurement Uncertainty Verification Traceability; Verification / Calibration Sampling; Handling / Prep. Quality Checks Records Report / Certificate As per SOP Min 5 pt. Cal ICV CCV CB Pipettor Thermometer Analytical Balance As per SOP MB LCS/D MS/D LLOQ Ck/ CRDL Ck PDS Hardcopy and Electronic Records OK As per SOP Min 5 pt. Cal ICV CCV CCB Thermometer Balance Pipettor As per SOP Hardcopy and Electronic Records OK As per SOP One pt. Cal ICV/ICB CCV/CCB Balance Pipettor As per SOP MB System Blank QCS LCS/D MS/D OPR Bottle Blanks Reagent Blanks LDR LLCCV ICS A ICS AB MB LCS/S MS/MSD Dilution Test PDS/D Hardcopy and Electronic Records OK Balance Filtration Apparatus CRM AAS Software Various Glassware Pipettors Block Digester Thermometer Analytical Balance CRM Filtration Apparatus CRM Clean Room CVAFS Software Various Glassware Thermometer Balance Pipettors CRM ICPAES Software Various Glassware Pipettors CRM Page 3 Environmental Method Witness Form January 14, 2014 TNI/ DoD-ELAP & ISO/IEC 17025 Method Review Matrix TNI/ DoD QSM 5.0 Section → Assessment Date(s): 5.2 5.3; 5.5 5.4 5.4.6 5.6 5.7; 5.8 5.9 4.12 5.10 Name(s) of Personnel Interviewed Accommodation / Environment; Equipment & Ref. Materials Procedure / Operating Instructions Measurement Uncertainty Verification Traceability; Verification / Calibration Sampling; Handling / Prep. Quality Checks Records Report / Certificate LDR LLCCV ICS A ICS AB MB LCS/S MS/MSD Dilution Test PDS/D ICS A ICS AB LDR Tune IS MB LCS/S MS/MSD CRDL PDS ICS A ICS AB LLCCV Dil Test LDR Tune IS MB LCS/S MS/MSD CRDL PDS ICS A ICS AB LLCCV Dil Test LDR Tune IS Hardcopy and Electronic Records OK Hardcopy and Electronic Records OK Hardcopy and Electronic Records OK Hardcopy and Electronic Records OK Parameter / Test Name or Technology Method(s) (From Scope) Metals EPA 6010C ICPAES Software Various Glassware Pipettors CRM As per SOP One pt. Cal ICV/ICB CCV/CCB Balance Pipettor As per SOP Metals EPA 1640 Clean Room ICP-MS Software Various Glassware Balance Pipettor Digestion Tubes CRM As per SOP Multi pt. Cal based on range ICV/ICB CCV/CCB Balance Pipettor As per SOP Metals EPA 6020 ICP-MS Software Various Glassware Balance Pipettor Digestion Tubes CRM As per SOP Mass Cal ICV/ICB CCV/CCB Balance Pipettor As per SOP Metals EPA 6020A ICP-MS Software Various Glassware Balance Pipettor Digestion Tubes As per SOP Mass Cal ICV/ICB CCV/CCB Balance Pipettor As per SOP ACLASS Form 67 Depth of Assessment *See codes Laboratory Name: Page 4 Environmental Method Witness Form January 14, 2014 TNI/ DoD-ELAP & ISO/IEC 17025 Method Review Matrix TNI/ DoD QSM 5.0 Section → Parameter / Test Name or Technology Method(s) (From Scope) Depth of Assessment *See codes Laboratory Name: Assessment Date(s): 5.2 5.3; 5.5 5.4 5.4.6 5.6 5.7; 5.8 5.9 4.12 5.10 Name(s) of Personnel Interviewed Accommodation / Environment; Equipment & Ref. Materials Procedure / Operating Instructions Measurement Uncertainty Verification Traceability; Verification / Calibration Sampling; Handling / Prep. Quality Checks Records Report / Certificate Hardcopy and Electronic Records Hardcopy Records OK CRM Hardness by Calc. SM 2340B Continuous Liquid-Liquid Extraction EPA 3520C Micro Extraction EPA 3511 Pressurized Fluid Extraction (PFE) EPA 3545A ACLASS Form 67 See Determinative technique: _____________ Continuous liquid-liquid extractor Various glassware Filtration Apparatus KD Apparatus Balance Syringes Thermometer Waterbath Various glassware Balance Syringes Centrifuge CRM Pressurized Fluid Extraction Equipment Drying Oven Balance Various Glassware KD apparatus Concentrator Waterbath Thermometer Hot plate Page 5 MB LCS/S MS/MSD CRDL PDS As per SOP Balance Syringes Thermometer As per SOP MB LCS/D MS/D IS Surrogate As per SOP Balance Syringes As per SOP MB LCS/D MS/D IS Surrogate Hardcopy and Electronic Records OK As per SOP Thermometer Balance Syringes As per SOP MB LCS/D Surrogates MS/D IS Hardcopy and Electronic Records OK Environmental Method Witness Form January 14, 2014 OK TNI/ DoD-ELAP & ISO/IEC 17025 Method Review Matrix TNI/ DoD QSM 5.0 Section → Parameter / Test Name or Technology Method(s) (From Scope) Depth of Assessment *See codes Laboratory Name: Assessment Date(s): 5.2 5.3; 5.5 5.4 5.4.6 5.6 5.7; 5.8 5.9 4.12 5.10 Name(s) of Personnel Interviewed Accommodation / Environment; Equipment & Ref. Materials Procedure / Operating Instructions Measurement Uncertainty Verification Traceability; Verification / Calibration Sampling; Handling / Prep. Quality Checks Records Report / Certificate As per SOP Thermometer Analytical Balance Syringes As per SOP MB LCS/D Surrogates MS/D IS Hardcopy and Electronic Records OK As per SOP Thermometer Analytical Balance Syringes As per SOP MB LCS/D Surrogates MS/D IS Hardcopy and Electronic Records OK As per SOP Thermometer Balance Syringes As per SOP MB LCS/D Surrogates MS/D IS Hardcopy and Electronic Records OK Shaker Syringes CRM Purge and Trap EPA 5030C Purge and Trap EPA 5035A Ultrasonic Extraction EPA 3550 C ACLASS Form 67 Purge and Trap Various Glassware Thermometer Analytical Balance Drying Oven Syringes CRM Purge and Trap Various Glassware Thermometer Analytical Balance Drying Oven Syringes CRM Ultrasonic Extraction Equipment Grinding Apparatus Various Glassware Filtration apparatus KD apparatus Concentrator Waterbath Thermometer Drying Oven Balance Hot plate Shaker Syringes Page 6 Environmental Method Witness Form January 14, 2014 TNI/ DoD-ELAP & ISO/IEC 17025 Method Review Matrix TNI/ DoD QSM 5.0 Section → Parameter / Test Name or Technology Method(s) (From Scope) Depth of Assessment *See codes Laboratory Name: Assessment Date(s): 5.2 5.3; 5.5 5.4 5.4.6 5.6 5.7; 5.8 5.9 4.12 5.10 Name(s) of Personnel Interviewed Accommodation / Environment; Equipment & Ref. Materials Procedure / Operating Instructions Measurement Uncertainty Verification Traceability; Verification / Calibration Sampling; Handling / Prep. Quality Checks Records Report / Certificate As per SOP Thermometer Balance Syringes As per SOP MB LCS/D Surrogates MS/D IS Hardcopy and Electronic Records OK As per SOP Balance Analytical Balance Thermometer Pipettors As per SOP MB LCS/D MS/D Reverse Surrogate Hardcopy and Electronic Records OK As per SOP Thermometer Balance Syringes As per SOP MB LCS/D Surrogates MS/D IS Hardcopy and Electronic Records OK CRM Separatory Funnel Extraction EPA 3510 C Silica Gel Cleanup EPA 3630 C Soxhlet Extraction EPA 3540 C ACLASS Form 67 Separatory Funnels Various Glassware Filtration apparatus KD apparatus Concentrator Waterbath Thermometer Balance Hot plate Shaker Syringes CRM Various Glassware Pipettors Filtration Apparatus Shaker Ultrasonic Bath Centrifuge Thermometer Hot Plate Oven(s) Balance Analytical Balance CRM Soxhlet Apparatus Various Glassware Filtration apparatus KD apparatus Page 7 Environmental Method Witness Form January 14, 2014 TNI/ DoD-ELAP & ISO/IEC 17025 Method Review Matrix TNI/ DoD QSM 5.0 Section → Parameter / Test Name or Technology Method(s) (From Scope) Sulfur Cleanup EPA 3660 A Sulfuric Acid Cleanup EPA 3665 A ACLASS Form 67 Depth of Assessment *See codes Laboratory Name: Assessment Date(s): 5.2 5.3; 5.5 5.4 5.4.6 5.6 5.7; 5.8 5.9 4.12 5.10 Name(s) of Personnel Interviewed Accommodation / Environment; Equipment & Ref. Materials Procedure / Operating Instructions Measurement Uncertainty Verification Traceability; Verification / Calibration Sampling; Handling / Prep. Quality Checks Records Report / Certificate As per SOP Balance Analytical Balance Thermometer Pipettors As per SOP MB LCS/D MS/D Reverse Surrogate Hardcopy and Electronic Records OK As per SOP Balance Analytical Balance Thermometer Pipettors As per SOP MB LCS/D MS/D Reverse Surrogate Hardcopy and Electronic Records OK Concentrator Waterbath Thermometer Drying Oven Balance Hot plate Shaker Syringes CRM Various Glassware Pipettors Filtration Apparatus Shaker Ultrasonic Bath Centrifuge Thermometer Hot Plate Oven(s) Balance Analytical Balance CRM Various Glassware Pipettors Filtration Apparatus Shaker Ultrasonic Bath Centrifuge Thermometer Hot Plate Oven(s) Balance Analytical Balance CRM Page 8 Environmental Method Witness Form January 14, 2014 TNI/ DoD-ELAP & ISO/IEC 17025 Method Review Matrix TNI/ DoD QSM 5.0 Section → Parameter / Test Name or Technology Method(s) (From Scope) Gel Permeation Cleanup (GPC) EPA 3640 A Waste Dilution EPA 3580 A Petroleum Hydrocarbons NWTPH EPH ACLASS Form 67 Depth of Assessment *See codes Laboratory Name: Assessment Date(s): 5.2 5.3; 5.5 5.4 5.4.6 5.6 5.7; 5.8 5.9 4.12 5.10 Name(s) of Personnel Interviewed Accommodation / Environment; Equipment & Ref. Materials Procedure / Operating Instructions Measurement Uncertainty Verification Traceability; Verification / Calibration Sampling; Handling / Prep. Quality Checks Records Report / Certificate As per SOP Balance Analytical Balance Thermometer Pipettors As per SOP MB LCS/D MS/D Reverse Surrogate Hardcopy and Electronic Records OK As per SOP Balance Syringes As per SOP MB LCS/D Surrogates MS/D IS Hardcopy and Electronic Records OK As per SOP 5 pt. Cal ICV CCV Analytical Balance Syringes As per SOP Surrogate BFB MS/D LCS/D MB Hardcopy and Electronic Records OK Various Glassware Pipettors Filtration Apparatus Shaker Ultrasonic Bath Centrifuge Thermometer Hot Plate Oven(s) Balance Analytical Balance CRM Various Glassware Filtration apparatus Balance Syringes CRM P&T GC Software Column Analytical Balance Syringes Purging vessels Vials Shakers Extraction Heater Separatory Funnels CRM Page 9 Environmental Method Witness Form January 14, 2014 TNI/ DoD-ELAP & ISO/IEC 17025 Method Review Matrix TNI/ DoD QSM 5.0 Section → Parameter / Test Name or Technology Method(s) (From Scope) Petroleum Hydrocarbons NWTPH-Gx Petroleum Hydrocarbons OK DEQ GRO Petroleum Hydrocarbons NWTPH VPH Petroleum Hydrocarbons NWTPH VPH GC/MS ACLASS Form 67 Depth of Assessment *See codes Laboratory Name: Assessment Date(s): 5.2 5.3; 5.5 5.4 5.4.6 5.6 5.7; 5.8 5.9 4.12 5.10 Name(s) of Personnel Interviewed Accommodation / Environment; Equipment & Ref. Materials Procedure / Operating Instructions Measurement Uncertainty Verification Traceability; Verification / Calibration Sampling; Handling / Prep. Quality Checks Records Report / Certificate As per SOP 5 pt. Cal ICV CCV Analytical Balance Syringes As per SOP Surrogate BFB MS/D LCS/D MB Hardcopy and Electronic Records OK As per SOP 5 pt. Cal ICV CCV Analytical Balance Syringes As per SOP Surrogate IS MS/D LCS/D MB Hardcopy and Electronic Records OK As per SOP 5 pt. Cal ICV CCV Syringes As per SOP Dup LCS/D MB Hardcopy and Electronic Records OK As per SOP Min 6 pt. Cal ICV CCV Syringes As per SOP Tune IS LCS/D MS/D MB Surrogate MS/D Hardcopy and Electronic Records OK P&T GC Software Column Analytical Balance Syringes Purging vessels Vials Shakers Extraction Heater Separatory Funnels CRM P&T GC FID Software Column Analytical Balance Syringes Purging vessels Vials CRM GC FID Software Column P&T Syringes Vials CRM GCMS Software Column Microsyringes CRM Page 10 Environmental Method Witness Form January 14, 2014 TNI/ DoD-ELAP & ISO/IEC 17025 Method Review Matrix TNI/ DoD QSM 5.0 Section → Parameter / Test Name or Technology Method(s) (From Scope) Air Gases ASTM D2820 (M) Air Hydrocarbons EPA TO-3M Dissolved Gases RSK-175 (M) Hydrogen Sulfide EPA 16 (M) Air VOCs EPA TO-15 (M) Air VOCs EPA TO-15 ACLASS Form 67 Depth of Assessment *See codes Laboratory Name: Assessment Date(s): 5.2 5.3; 5.5 5.4 5.4.6 5.6 5.7; 5.8 5.9 4.12 5.10 Name(s) of Personnel Interviewed Accommodation / Environment; Equipment & Ref. Materials Procedure / Operating Instructions Measurement Uncertainty Verification Traceability; Verification / Calibration Sampling; Handling / Prep. Quality Checks Records Report / Certificate As per SOP Min 5 pt. Cal ICV CCV Analytical Balance Syringes As per SOP Hardcopy and Electronic Records OK As per SOP 7 pt. Cal ICV CCV Analytical Balance Syringes As per SOP DUP (when requested) LCS/D MB IS Surrogate Surrogate IS DUP LCS/D MB Hardcopy and Electronic Records OK As per SOP 5 pt. Cal ICV CCV Syringes As per SOP Dup LCS/D MB Hardcopy and Electronic Records OK As per SOP 6 pt. Cal ICV CCV Syringes As per SOP MB LCS Dup Hardcopy and Electronic Records OK As per SOP Min. 5 pt. Cal ICV CCV Syringes As per SOP Tune IS LCS/D MB Surrogate Hardcopy and Electronic Records OK As per SOP Min. 5 pt. Cal ICV CCV Syringes As per SOP Tune IS LCS/D MB Surrogate Hardcopy and Electronic Records OK GC FID Software Column Analytical Balance Syringes CRM GC FID Software Column Analytical Balance Syringes CRM GC FID Software Column Shaker Syringes Vials CRM GC FDP Software Column Microsyringes CRM GCMS Software Column Cryogenic Concentrator Microsyringes CRM GCMS Software Column Cryogenic Concentrator Microsyringes Page 11 Environmental Method Witness Form January 14, 2014 TNI/ DoD-ELAP & ISO/IEC 17025 Method Review Matrix TNI/ DoD QSM 5.0 Section → Parameter / Test Name or Technology Method(s) (From Scope) Depth of Assessment *See codes Laboratory Name: Assessment Date(s): 5.2 5.3; 5.5 5.4 5.4.6 5.6 5.7; 5.8 5.9 4.12 5.10 Name(s) of Personnel Interviewed Accommodation / Environment; Equipment & Ref. Materials Procedure / Operating Instructions Measurement Uncertainty Verification Traceability; Verification / Calibration Sampling; Handling / Prep. Quality Checks Records Report / Certificate GC/MS Software Column Syringes Thermal Desorption System CRM GC TCD Software Columns Syringes CRM As per SOP Min 5 pt. Cal ICV CCV Syringes As per SOP Tune Surrogate IS MS/D LCS/D MB Hardcopy and Electronic Records OK As per SOP Min 5 pt. Cal CCV Syringes As per SOP MB LCS/D Hardcopy and Electronic Records OK P&T GC/MS Software Column Analytical Balance Syringes Purging vessels Vials CRM GC/MS Software Column Syringes CRM As per SOP Min 5 pt. Cal ICV CCV Analytical Balance Syringes As per SOP Tune Surrogate IS MS/D LCS/D MB Hardcopy and Electronic Records OK As per SOP Min 5 pt. Cal ICV CCV Syringes As per SOP Hardcopy and Electronic Records OK GC/MS Software Column Syringes CRM As per SOP Min 5 pt. Cal ICV CCV Syringes As per SOP Tune Surrogate MS/D LCS/D MB SPCC Tune Surrogate MS/D LCS/D MB Hardcopy and Electronic Records OK CRM Sorbent Tube VOCs EPA TO-17 Fixed Gases Volatiles ASTM D1946 And ASTM D1946 (M) EPA 524.2 Volatiles EPA 8260B Volatiles EPA 8260C ACLASS Form 67 Page 12 Environmental Method Witness Form January 14, 2014 TNI/ DoD-ELAP & ISO/IEC 17025 Method Review Matrix TNI/ DoD QSM 5.0 Section → Parameter / Test Name or Technology Method(s) (From Scope) EDB and DBCP EPA 504.1 Pesticides EPA 8081A Pesticides EPA 8081B PCBs EPA 8082 PCBs EPA 8082A ACLASS Form 67 Depth of Assessment *See codes Laboratory Name: Assessment Date(s): 5.2 5.3; 5.5 5.4 5.4.6 5.6 5.7; 5.8 5.9 4.12 5.10 Name(s) of Personnel Interviewed Accommodation / Environment; Equipment & Ref. Materials Procedure / Operating Instructions Measurement Uncertainty Verification Traceability; Verification / Calibration Sampling; Handling / Prep. Quality Checks Records Report / Certificate As per SOP 5 pt. Cal ICV CCV Balance Syringes As per SOP MS/D LCS/D MB Hardcopy and Electronic Records OK As per SOP Min. 5 pt. Cal ICV CCV Balance Syringes As per SOP Degradati on Test Surrogate MS/D LCS/D MB Hardcopy and Electronic Records OK As per SOP Min. 5 pt. Cal ICV CCV Balance Syringes As per SOP Degradati on Test Surrogate MS/D LCS/D MB Hardcopy and Electronic Records OK As per SOP Min. 5 pt. Cal ICV CCV Balance Syringes As per SOP Surrogate MS/D LCS/D MB Hardcopy and Electronic Records OK As per SOP Min. 5 pt. Cal ICV CCV Balance Syringes As per SOP Surrogate MS/D LCS/D MB Hardcopy and Electronic Records OK GC ECD Software Column Guard Column Balance Syringes Vials CRM GC ECD Software Guard Column Balance Syringes Vials CRM GC ECD Software Guard Column Balance Syringes Vials CRM GC ECD Software Guard Column Balance Syringes Vials CRM GC ECD Software Guard Column Balance Syringes Page 13 Environmental Method Witness Form January 14, 2014 TNI/ DoD-ELAP & ISO/IEC 17025 Method Review Matrix TNI/ DoD QSM 5.0 Section → Parameter / Test Name or Technology Method(s) (From Scope) Herbicides EPA 8151A Petroleum Hydrocarbons NWTPH-Dx Petroleum Hydrocarbons EPA 8015B ACLASS Form 67 Depth of Assessment *See codes Laboratory Name: Assessment Date(s): 5.2 5.3; 5.5 5.4 5.4.6 5.6 5.7; 5.8 5.9 4.12 5.10 Name(s) of Personnel Interviewed Accommodation / Environment; Equipment & Ref. Materials Procedure / Operating Instructions Measurement Uncertainty Verification Traceability; Verification / Calibration Sampling; Handling / Prep. Quality Checks Records Report / Certificate As per SOP Min. 5 pt. Cal ICV CCV Balance Syringes As per SOP Surrogate MS/D LCS/D MB Hardcopy and Electronic Records OK As per SOP 5 pt. Cal ICV CCV Analytical Balance Syringes As per SOP Surrogate MS/D LCS/D MB Hardcopy and Electronic Records OK As per SOP 5 pt. Cal ICV CCV Analytical Balance Syringes As per SOP Surrogate IS MS/D LCS/D MB Hardcopy and Electronic Records OK Vials CRM GC ECD Software Guard Column Balance Syringes Vials CRM P&T GC Software Column Analytical Balance Syringes Purging vessels Turbo Vap Dry Vap Vials Shakers Extraction Heater Separatory Funnels CRM P&T GC FID Software Column Analytical Balance Syringes Purging vessels Vials CRM Page 14 Environmental Method Witness Form January 14, 2014 TNI/ DoD-ELAP & ISO/IEC 17025 Method Review Matrix TNI/ DoD QSM 5.0 Section → Parameter / Test Name or Technology Method(s) (From Scope) SVOCs 8270C(M) Isotope Dilution NDMA Aqueous Only No Soil LOD/LOQ EPA 1625C (M) Base Neutrals & Acids EPA 8270C PCB Congeners EPA 8270C SIM PCB Congeners Base Neutrals & Acids EPA 8270D Organotins Organotins by Krone et al OPP EPA 8141 A ACLASS Form 67 Depth of Assessment *See codes Laboratory Name: Assessment Date(s): 5.2 5.3; 5.5 5.4 5.4.6 5.6 5.7; 5.8 5.9 4.12 5.10 Name(s) of Personnel Interviewed Accommodation / Environment; Equipment & Ref. Materials Procedure / Operating Instructions Measurement Uncertainty Verification Traceability; Verification / Calibration Sampling; Handling / Prep. Quality Checks Records Report / Certificate As per SOP 5 pt. Cal ICV CCV Syringes As per SOP Hardcopy and Electronic Records OK As per SOP Min 5 pt. Cal ICV CCV Syringes As per SOP Hardcopy and Electronic Records OK As per SOP Min 5 pt. Cal ICV CCV Syringes As per SOP Hardcopy and Electronic Records OK As per SOP Min 5 pt. Cal ICV CCV Syringes As per SOP Hardcopy and Electronic Records OK As per SOP Min 5 pt. Cal ICV CCV Syringes As per SOP Hardcopy and Electronic Records OK As per SOP Min 5 pt. Cal ICV CCV Syringes Analytical Balance As per SOP Tune IS LCS/D MB Surrogate MS/D Tune Surrogate MS/D LCS/D MB Tune Surrogate MS/D LCS/D MB Tune Surrogate MS/D LCS/D MB Tune Surrogate MS/D LCS/D MB Tune Surrogate IS MS/D LCS/D MB Hardcopy and Electronic Records OK As per SOP Min 5 pt. Cal CCV Syringes As per SOP MB LCS/D MS/D Surrogate Hardcopy and Electronic Records OK GCMS Software Guard Column Column Microsyringes CRM GC/MS Software Column Syringes CRM GC/MS Software Column Syringes CRM GC/MS Software Column Syringes CRM GC/MS Software Column Syringes CRM GC/MS Software Column Syringes PFE Analytical Balance Shaker CRM GC NPD Software Guard Column Syringes Page 15 Environmental Method Witness Form January 14, 2014 TNI/ DoD-ELAP & ISO/IEC 17025 Method Review Matrix TNI/ DoD QSM 5.0 Section → Parameter / Test Name or Technology Method(s) (From Scope) Depth of Assessment *See codes Laboratory Name: Assessment Date(s): 5.2 5.3; 5.5 5.4 5.4.6 5.6 5.7; 5.8 5.9 4.12 5.10 Name(s) of Personnel Interviewed Accommodation / Environment; Equipment & Ref. Materials Procedure / Operating Instructions Measurement Uncertainty Verification Traceability; Verification / Calibration Sampling; Handling / Prep. Quality Checks Records Report / Certificate CRM Multi-Incremental Sampling (MIS) (Without grinding) ASTM D 6323-98 Sieve Various Glassware Balance As per SOP Sieve Balance As per SOP Blank Hardcopy and Electronic Records OK Hexavalent Chromium (CrVI) EPA 7196A As per SOP 6 pt. Cal ICV CCV CCB Balance Analytical Balance Thermometer As per SOP MB LCS/D MS/D Hardcopy and Electronic Records OK Cyanide SM 4500-CN E As per SOP 6 pt. Cal ICV CCV CCB Balance Analytical Balance Pipettor Thermometer As per SOP MB LCS/D MS/D Hardcopy and Electronic Records OK Cyanide EPA 9010C/9014 UV-VIS spectrophotomet er Software Various glassware Balance Drying oven Analytical Balance Pipettor CRM UV-VIS spectrophotomet er Software Various glassware Balance Drying oven Analytical Balance Distillation Apparatus Pipettor CRM UV-VIS spectrophotomet er Software As per SOP 6 pt. Cal ICV CCV CCB As per SOP MB LCS/D MS/D Hardcopy and Electronic Records OK ACLASS Form 67 Page 16 Environmental Method Witness Form January 14, 2014 TNI/ DoD-ELAP & ISO/IEC 17025 Method Review Matrix TNI/ DoD QSM 5.0 Section → Parameter / Test Name or Technology Method(s) (From Scope) Cyanide SM 4500 CN C/G Cyanide SM 4500-CN I ACLASS Form 67 Depth of Assessment *See codes Laboratory Name: Assessment Date(s): 5.2 5.3; 5.5 5.4 5.4.6 5.6 5.7; 5.8 5.9 4.12 5.10 Name(s) of Personnel Interviewed Accommodation / Environment; Equipment & Ref. Materials Procedure / Operating Instructions Measurement Uncertainty Verification Traceability; Verification / Calibration Sampling; Handling / Prep. Quality Checks Records Report / Certificate Various glassware Balance Drying oven Analytical Balance Distillation Apparatus Pipettor CRM UV-VIS spectrophotomet er Software Various glassware Balance Drying oven Analytical Balance Distillation Apparatus Pipettor CRM Spectrophotome ter. Reflux distillation apparatus Hot plate stirrer/heating mantle pH meter Vacuum source Various Glassware Balance Analytical Balance Page 17 Balance Analytical Balance Pipettor Thermometer As per SOP 6 pt. Cal ICV CCV CCB Balance Analytical Balance Pipettor Thermometer As per SOP MB LCS/D MS/D Hardcopy and Electronic Records OK As per SOP 6 pt. Cal ICV CCV CCB Balance Analytical Balance Pipettor As per SOP MB LCS/D MS/D Hardcopy and Electronic Records OK Environmental Method Witness Form January 14, 2014 TNI/ DoD-ELAP & ISO/IEC 17025 Method Review Matrix TNI/ DoD QSM 5.0 Section → Parameter / Test Name or Technology Method(s) (From Scope) Depth of Assessment *See codes Laboratory Name: Assessment Date(s): 5.2 5.3; 5.5 5.4 5.4.6 5.6 5.7; 5.8 5.9 4.12 5.10 Name(s) of Personnel Interviewed Accommodation / Environment; Equipment & Ref. Materials Procedure / Operating Instructions Measurement Uncertainty Verification Traceability; Verification / Calibration Sampling; Handling / Prep. Quality Checks Records Report / Certificate As per SOP 3 pt. Cal ICV CCV CCB Analytical Balance Pipettor Thermometer As per SOP MB LCS/D MS/D Hardcopy and Electronic Records OK As per SOP 5 pt. Cal ICV CCV CCB Balance Analytical Balance Pipettor Thermometer As per SOP MB LCS/D MS/D Hardcopy and Electronic Records OK As per SOP 3 pt. Cal ICV CCV CCB Balance Analytical Balance Pipettor As per SOP MB LCS/D MS/D Hardcopy and Electronic Records OK CRM Phosphorus, Total Phosphate and Orthophosphate SM 4500 P B/E Potassium Permanganate SM 4500KMnO4 B Nitrite SM 4500NO2 B ACLASS Form 67 UV-VIS spectrophotomet er Software Various glassware Ultrasonic Bath Centrifuge Analytical Balance Separatory Funnels Waterbath Filtration Apparatus Pipettor CRM UV-VIS spectrophotomet er Software Various glassware Balance Analytical Balance Pipettor CRM UV-VIS spectrophotomet er Software Various glassware Balance Page 18 Environmental Method Witness Form January 14, 2014 TNI/ DoD-ELAP & ISO/IEC 17025 Method Review Matrix TNI/ DoD QSM 5.0 Section → Parameter / Test Name or Technology Method(s) (From Scope) Nitrate SM 4500NO3 E Nitrate/Nitrite SM 4500NO3 E/SM 4500-NO2 B ACLASS Form 67 Depth of Assessment *See codes Laboratory Name: Assessment Date(s): 5.2 5.3; 5.5 5.4 5.4.6 5.6 5.7; 5.8 5.9 4.12 5.10 Name(s) of Personnel Interviewed Accommodation / Environment; Equipment & Ref. Materials Procedure / Operating Instructions Measurement Uncertainty Verification Traceability; Verification / Calibration Sampling; Handling / Prep. Quality Checks Records Report / Certificate Analytical Balance Vacuum Filtration Apparatus Pipettor Sonicator bath CRM UV-VIS spectrophotomet er Software Various glassware Drying oven Analytical Balance Sonicator Bath Vacuum Filtration Apparatus Pipettor CRM UV-VIS spectrophotomet er Software Various glassware Drying oven Analytical Balance Sonicator Bath Vacuum Filtration Apparatus Pipettor CRM Page 19 Thermometer As per SOP 5 pt. Cal ICV CCV CCB Analytical Balance Pipettor Thermometer As per SOP MB LCS/D MS/D Hardcopy and Electronic Records OK As per SOP 5 pt. Cal ICV CCV CCB Analytical Balance Pipettor Thermometer As per SOP MB LCS/D MS/D Hardcopy and Electronic Records OK Environmental Method Witness Form January 14, 2014 TNI/ DoD-ELAP & ISO/IEC 17025 Method Review Matrix TNI/ DoD QSM 5.0 Section → Parameter / Test Name or Technology Method(s) (From Scope) MBAS SM 5540C Ferrous Iron (Fe+2) SM3500 Fe-B ACLASS Form 67 Depth of Assessment *See codes Laboratory Name: Assessment Date(s): 5.2 5.3; 5.5 5.4 5.4.6 5.6 5.7; 5.8 5.9 4.12 5.10 Name(s) of Personnel Interviewed Accommodation / Environment; Equipment & Ref. Materials Procedure / Operating Instructions Measurement Uncertainty Verification Traceability; Verification / Calibration Sampling; Handling / Prep. Quality Checks Records Report / Certificate As per SOP 5 pt. Cal ICV CCV CCB Balance Analytical Balance Pipettor Thermometer As per SOP MB LCS/D MS/D Hardcopy and Electronic Records OK As per SOP 6 pt. Cal ICV CCV CCB Balance Analytical Balance Pipettor Thermometer As per SOP MB LCS/D MS/D Hardcopy and Electronic Records OK UV-VIS spectrophotomet er Software Various glassware Balance Drying oven Analytical Balance Centrifuge Syringe Filtration Apparatus Filtration Apparatus Pipettor Separatory Funnels CRM UV-VIS spectrophotomet er Software Various glassware Balance Drying oven Analytical Balance Centrifuge Syringe Filtration Apparatus Filtration Apparatus Pipettor CRM Page 20 Environmental Method Witness Form January 14, 2014 TNI/ DoD-ELAP & ISO/IEC 17025 Method Review Matrix TNI/ DoD QSM 5.0 Section → Parameter / Test Name or Technology Method(s) (From Scope) Ammonia EPA 350.1 Ammonia SM 4500NH3 B/C (M) Chemical Oxygen Demand (COD) SM 5220D Organic Carbon EPA 9060 ACLASS Form 67 Depth of Assessment *See codes Laboratory Name: Assessment Date(s): 5.2 5.3; 5.5 5.4 5.4.6 5.6 5.7; 5.8 5.9 4.12 5.10 Name(s) of Personnel Interviewed Accommodation / Environment; Equipment & Ref. Materials Procedure / Operating Instructions Measurement Uncertainty Verification Traceability; Verification / Calibration Sampling; Handling / Prep. Quality Checks Records Report / Certificate As per SOP 6 pt. Cal ICV ICB CCV CCB Thermometer Balances pH Meter As per SOP MB LCS/D MS/D Hardcopy and Electronic Records OK As per SOP 6 pt. Cal ICV ICB CCV CCB Thermometer Balances pH Meter As per SOP MB LCS/D MS/D Hardcopy and Electronic Records OK As per SOP 6 pt. Cal ICV CCV CCB Balances As per SOP MB LCS/D MS/D Hardcopy and Electronic Records OK As per SOP 5 pt. Cal ICV CCV CCB Balance As per SOP Replicate Injections MB LCS/D MS/D Hardcopy and Electronic Records OK Flow Analyzer pH Meter Balance Analytical Balance Drying Oven Distillation Apparatus Various glassware CRM Flow Analyzer pH Meter Balance Analytical Balance Drying Oven Distillation Apparatus Various glassware CRM Hot Block Digester Spectrophotome ter Software Various glassware Balance Analytical Balance CRM TOC Analyzer Analytical Balance Drying Oven Various glassware Page 21 Environmental Method Witness Form January 14, 2014 TNI/ DoD-ELAP & ISO/IEC 17025 Method Review Matrix TNI/ DoD QSM 5.0 Section → Parameter / Test Name or Technology Method(s) (From Scope) Depth of Assessment *See codes Laboratory Name: Assessment Date(s): 5.2 5.3; 5.5 5.4 5.4.6 5.6 5.7; 5.8 5.9 4.12 5.10 Name(s) of Personnel Interviewed Accommodation / Environment; Equipment & Ref. Materials Procedure / Operating Instructions Measurement Uncertainty Verification Traceability; Verification / Calibration Sampling; Handling / Prep. Quality Checks Records Report / Certificate As per SOP 5 pt. Cal ICV CCV CCB Balance As per SOP Replicate Injections MB LCS/D MS/D Hardcopy and Electronic Records OK As per SOP 5 pt. Cal ICV CCV CCB Balance As per SOP Replicate Injections MB LCS/D MS/D Hardcopy and Electronic Records OK As per SOP Standard Titrant Balance Pipettor As per SOP MB LCS Dup Hardcopy and Electronic Records OK Pipettors Total and Dissolved Organic Carbon SM 5310 B Total and Dissolved Organic Carbon SM 5310 D SW 846 Sec 7.3 Reactive Sulfide/CN ACLASS Form 67 TOC Analyzer Analytical Balance Drying Oven Various glassware Pipettors TOC Analyzer Analytical Balance Drying Oven Various glassware Pipettors Various Glassware Pipettors Balance Titration Apparatus pH meter Burette CRM UV Vis Spectrophotome ter Distillation Assembly Various Glassware Pipettors pH meter Analytical Balance Page 22 Environmental Method Witness Form January 14, 2014 TNI/ DoD-ELAP & ISO/IEC 17025 Method Review Matrix TNI/ DoD QSM 5.0 Section → Parameter / Test Name or Technology Method(s) (From Scope) PM 10 40 CFR 50 Appendix J % Moisture ASTM D2216 (M) Oil and Grease EPA 1664A ACLASS Form 67 Depth of Assessment *See codes Laboratory Name: Assessment Date(s): 5.2 5.3; 5.5 5.4 5.4.6 5.6 5.7; 5.8 5.9 4.12 5.10 Name(s) of Personnel Interviewed Accommodation / Environment; Equipment & Ref. Materials Procedure / Operating Instructions Measurement Uncertainty Verification Traceability; Verification / Calibration Sampling; Handling / Prep. Quality Checks Records Report / Certificate As per SOP Balance Thermometer Pipettor As per SOP MB Dup LCS/D Hardcopy and Electronic Records OK As per SOP Balance Thermometer Pipettor As per SOP MB Dup Hardcopy and Electronic Records OK As per SOP Balance Analytical Balance Thermometer Pipettors As per SOP MB LCS/D MS/D (When enough sample for aqueous) Hardcopy and Electronic Records OK Balance Weigh Dish Thermometer Drying oven Furnace Desiccator Forceps Blender Pipets Balance Weigh Dish Thermometer Drying oven Furnace Desiccator Forceps Blender Pipets Separatory Funnels Various Glassware Pipettors Filtration Apparatus Shaker Ultrasonic Bath Centrifuge Thermometer Hot Plate Oven(s) Balance Analytical Balance CRM Page 23 Environmental Method Witness Form January 14, 2014 TNI/ DoD-ELAP & ISO/IEC 17025 Method Review Matrix TNI/ DoD QSM 5.0 Section → Parameter / Test Name or Technology Method(s) (From Scope) Ash Free Dry Weight SM 10300C (M) Solids, Total SM 2540 B Solids, Total Suspended SM 2540 D Solids, Volatile Suspended SM 2540 E/EPA 160.4 ACLASS Form 67 Depth of Assessment *See codes Laboratory Name: Assessment Date(s): 5.2 5.3; 5.5 5.4 5.4.6 5.6 5.7; 5.8 5.9 4.12 5.10 Name(s) of Personnel Interviewed Accommodation / Environment; Equipment & Ref. Materials Procedure / Operating Instructions Measurement Uncertainty Verification Traceability; Verification / Calibration Sampling; Handling / Prep. Quality Checks Records Report / Certificate As per SOP Balance Analytical Balance Thermometer As per SOP MB DUP Hardcopy and Electronic Records OK As per SOP Balance Thermometer Pipettor As per SOP MB Dup Hardcopy and Electronic Records OK As per SOP Balance Thermometer Pipettor As per SOP MB Dup LCS/D Hardcopy and Electronic Records OK As per SOP Balance Analytical Balance As per SOP MB Dup Hardcopy and Electronic Records OK Various glassware Homogenizer Vacuum filtration apparatus Drying Oven Muffle Furnace Thermometer Analytical Balance Balance Balance Weigh Dish Thermometer Drying oven Furnace Desiccator Forceps Blender Pipets Balance Weigh Dish Thermometer Drying oven Furnace Desiccator Forceps Blender Pipets Muffle Furnace Desiccator Forceps Balance Analytical Balance Evaporating Dish Page 24 Environmental Method Witness Form January 14, 2014 TNI/ DoD-ELAP & ISO/IEC 17025 Method Review Matrix TNI/ DoD QSM 5.0 Section → Parameter / Test Name or Technology Method(s) (From Scope) Solids, Total Dissolved SM 2540 C Oil & Grease SM 5520 B Explosives EPA 8330A Perchlorate EPA 331.0 ACLASS Form 67 Depth of Assessment *See codes Laboratory Name: Assessment Date(s): 5.2 5.3; 5.5 5.4 5.4.6 5.6 5.7; 5.8 5.9 4.12 5.10 Name(s) of Personnel Interviewed Accommodation / Environment; Equipment & Ref. Materials Procedure / Operating Instructions Measurement Uncertainty Verification Traceability; Verification / Calibration Sampling; Handling / Prep. Quality Checks Records Report / Certificate As per SOP Balance Thermometer Pipettor As per SOP MB Dup Hardcopy and Electronic Records OK As per SOP Balance Thermometer Pipettor As per SOP MB Solvent Blank Dup Hardcopy and Electronic Records OK As per SOP 5 pt. Cal ICV CCV Balance Syringes As per SOP Surrogate MB LCS/LCS D MS/MSD Hardcopy and Electronic Records OK As per SOP 6 pt. Cal ICV CCC Balance Syringes Cond. Meter As per SOP IS MB LCS/LCS D MS/MSD Hardcopy and Electronic Records OK Balance Weigh Dish Thermometer Drying oven Furnace Desiccator Forceps Blender Pipets Separatory Funnel Thermometer Drying oven Desiccator Forceps Blender Pipets Shaker Sonicator CRM HPLC HPLC Columns Pump Software Syringes Autopipettes Analytical Balance Various Glassware Ultrasonic Bath Oven CRM LC/ESI/MS/MS HPLC Column Pump Software Syringes Autopipettes Page 25 Environmental Method Witness Form January 14, 2014 TNI/ DoD-ELAP & ISO/IEC 17025 Method Review Matrix TNI/ DoD QSM 5.0 Section → Parameter / Test Name or Technology Method(s) (From Scope) Perchlorate EPA 6850 Hexavalent Chromium (CrVI) EPA 218.6 ACLASS Form 67 Depth of Assessment *See codes Laboratory Name: Assessment Date(s): 5.2 5.3; 5.5 5.4 5.4.6 5.6 5.7; 5.8 5.9 4.12 5.10 Name(s) of Personnel Interviewed Accommodation / Environment; Equipment & Ref. Materials Procedure / Operating Instructions Measurement Uncertainty Verification Traceability; Verification / Calibration Sampling; Handling / Prep. Quality Checks Records Report / Certificate As per SOP 6 pt. Cal ICV CCC Balance Syringes Cond. Meter As per SOP IS MB LCS/LCS D MS/MSD Quarterly IPC Hardcopy and Electronic Records OK As per SOP 10 pt. Cal ICV ICB CCV CCB Balance Analytical Balance Pipettor As per SOP MB LCS/D MS/D Hardcopy and Electronic Records OK Analytical Balance Conductivity Meter Various Glassware Pretreatment Cartridges CRM LC/ESI/MS/MS HPLC Column Pump Software Syringes Autopipettes Analytical Balance Conductivity Meter Various Glassware Ultrasonic Bath Pretreatment Cartridges CRM IC Software Column Guard Column Analytical Balance Balance Pipettors pH meter Various Glassware CRM Page 26 Environmental Method Witness Form January 14, 2014 TNI/ DoD-ELAP & ISO/IEC 17025 Method Review Matrix TNI/ DoD QSM 5.0 Section → Parameter / Test Name or Technology Method(s) (From Scope) Anions EPA 300.0 Hexavalent Chromium (CrVI) EPA 7199 Anions EPA 9056A ACLASS Form 67 Depth of Assessment *See codes Laboratory Name: Assessment Date(s): 5.2 5.3; 5.5 5.4 5.4.6 5.6 5.7; 5.8 5.9 4.12 5.10 Name(s) of Personnel Interviewed Accommodation / Environment; Equipment & Ref. Materials Procedure / Operating Instructions Measurement Uncertainty Verification Traceability; Verification / Calibration Sampling; Handling / Prep. Quality Checks Records Report / Certificate As per SOP 7 pt. Cal ICV ICB CCV CCB LLOQ Ck Balance Pipettor Thermometer As per SOP MB LCS/D MS/D Hardcopy and Electronic Records OK As per SOP 7 pt. Cal CB ICV CCV CCB Balances Pipettes As per SOP MB LCS/D MS/D Hardcopy and Electronic Records OK As per SOP 7 pt. Cal ICV ICB CCV FINAL CCB LLOQ Ck Balance Pipettor Thermometer As per SOP MB LCS/D MS/D Hardcopy and Electronic Records OK IC Software Column Guard Column Balance Pipettors Various Glassware Drying Oven Thermometer Desiccator CRM IC Guard Column Separator Column Detector Software Analytical Balance Balance Pipettes Various Glassware pH meter CRM IC Software Column Guard Column Balance Pipettors Various Glassware Drying Oven Thermometer Desiccator CRM Page 27 Environmental Method Witness Form January 14, 2014 TNI/ DoD-ELAP & ISO/IEC 17025 Method Review Matrix TNI/ DoD QSM 5.0 Section → Parameter / Test Name or Technology Method(s) (From Scope) Perchlorate EPA 314.0 Particle Size Laser ASTM D4464 (M) Leaching SPLP EPA 1312 ACLASS Form 67 Depth of Assessment *See codes Laboratory Name: Assessment Date(s): 5.2 5.3; 5.5 5.4 5.4.6 5.6 5.7; 5.8 5.9 4.12 5.10 Name(s) of Personnel Interviewed Accommodation / Environment; Equipment & Ref. Materials Procedure / Operating Instructions Measurement Uncertainty Verification Traceability; Verification / Calibration Sampling; Handling / Prep. Quality Checks Records Report / Certificate As per SOP Min 3 pt. Cal ICV CCV CCB Analytical Balance Syringes Pipettor As per SOP MB LCS/D MS/D Hardcopy and Electronic Records OK As per SOP IPV DPV As per SOP DPV Dup Hardcopy and Electronic Records OK As per SOP Balance Pipettors pH meter Thermometer Rotatory Agitator Timer As per SOP MB LCS/D Post spiked for determinat ive technique MS/D Post spiked for determinat ive technique Hardcopy and Electronic Records OK IC Guard Column Separator Column Anion Suppressor Detector Software Analytical Balance Balance Syringes Pipettes Various Glassware CRM Particle size analyzer Sieves Spatula Beakers Jars Particle CRM Rotatory Agitator ZHE Device Filtration System Syringe Filtration Apparatus Vacuum Filtration Apparatus Various Glassware pH meter Thermometer Hot Plate Page 28 Environmental Method Witness Form January 14, 2014 TNI/ DoD-ELAP & ISO/IEC 17025 Method Review Matrix TNI/ DoD QSM 5.0 Section → Parameter / Test Name or Technology Method(s) (From Scope) Leaching STLC CA Title 22, Chapter 11, Article 5, Appendix II Leaching TCLP EPA 1311 ACLASS Form 67 Depth of Assessment *See codes Laboratory Name: Assessment Date(s): 5.2 5.3; 5.5 5.4 5.4.6 5.6 5.7; 5.8 5.9 4.12 5.10 Name(s) of Personnel Interviewed Accommodation / Environment; Equipment & Ref. Materials Procedure / Operating Instructions Measurement Uncertainty Verification Traceability; Verification / Calibration Sampling; Handling / Prep. Quality Checks Records Report / Certificate As per SOP Balance Pipettors pH meter Thermometer Rotatory Agitator Timer As per SOP MB LCS/D Post spiked for determinat ive technique MS/D Post spiked for determinat ive technique Hardcopy and Electronic Records OK As per SOP Balance Pipettors pH meter Thermometer Rotatory Agitator Timer As per SOP MB LCS/D Post spiked for determinat ive technique MS/D Post spiked for determinat ive technique Hardcopy and Electronic Records OK Balance Pipettors Drying Oven Sieve Timer Rotatory Agitator Filtration System Syringe Filtration Apparatus Vacuum Filtration Apparatus Various Glassware pH meter Thermometer Hot Plate Balance Pipettors Drying Oven Sieve Timer Rotatory Agitator ZHE Device Filtration System Vacuum Filtration Apparatus Various Glassware pH meter Thermometer Hot Plate Balance Page 29 Environmental Method Witness Form January 14, 2014 TNI/ DoD-ELAP & ISO/IEC 17025 Method Review Matrix TNI/ DoD QSM 5.0 Section → Parameter / Test Name or Technology Method(s) (From Scope) Flashpoint EPA 1010 Ignitability EPA 1030 pH EPA 9040C pH EPA 9045D pH SM 4500 H+ B ACLASS Form 67 Depth of Assessment *See codes Laboratory Name: Assessment Date(s): 5.2 5.3; 5.5 5.4 5.4.6 5.6 5.7; 5.8 5.9 4.12 5.10 Name(s) of Personnel Interviewed Accommodation / Environment; Equipment & Ref. Materials Procedure / Operating Instructions Measurement Uncertainty Verification Traceability; Verification / Calibration Sampling; Handling / Prep. Quality Checks Records Report / Certificate As per SOP Thermometer As per SOP P-Xylene Std Dup OK As per SOP Thermocouple Thermometer Anemometer Timer Ruler As per SOP Replicates Hardcopy and Electronic Records Hardcopy and Electronic Records As per SOP 3 pt. Cal Cal Ck As per SOP Cal Ck Dup Hardcopy and Electronic Records OK As per SOP 3 pt. Cal Cal Ck As per SOP Cal Ck Dup Hardcopy and Electronic Records OK As per SOP 3 pt. Cal Cal Ck As per SOP Cal Ck Dup Hardcopy and Electronic Records OK Pipettors Drying Oven Sieve Timer Flash Point Tester Thermometer P-Xylene Std Tile Powder Train Mold Ruler Thermocouple and Probe Thermometer Anemometer Timer pH meter pH/reference probe Various glassware CRM pH meter pH/reference probe Various glassware Analytical Balance Ultrasonic Bath Centrifuge CRM pH meter pH/reference probe Various glassware Buffers Page 30 Environmental Method Witness Form January 14, 2014 OK TNI/ DoD-ELAP & ISO/IEC 17025 Method Review Matrix TNI/ DoD QSM 5.0 Section → Parameter / Test Name or Technology Method(s) (From Scope) Turbidity SM 2130 B Specific Conductance SM 2510 B Salinity SM 2520B Fluoride SM 4500-F B/C ACLASS Form 67 Depth of Assessment *See codes Laboratory Name: Assessment Date(s): 5.2 5.3; 5.5 5.4 5.4.6 5.6 5.7; 5.8 5.9 4.12 5.10 Name(s) of Personnel Interviewed Accommodation / Environment; Equipment & Ref. Materials Procedure / Operating Instructions Measurement Uncertainty Verification Traceability; Verification / Calibration Sampling; Handling / Prep. Quality Checks Records Report / Certificate As per SOP 3 pt. Cal Daily Check w/2ndry Std As per SOP LCS Dup Hardcopy and Electronic Records OK As per SOP 3 pt. Cal Cal Ck As per SOP Cal Ck Dup Hardcopy and Electronic Records OK As per SOP 3 pt. Cal Cal Ck As per SOP Cal Ck Dup Hardcopy and Electronic Records OK As per SOP 3 pt. Cal ICV CCV Thermometer Pipettor Balance As per SOP MB LCS/D MS/D Hardcopy and Electronic Records OK Turbidimeter Sample cuvettes Wipes Various Glassware CRM Conductivity Meter Conductivity Cell Vials Centrifuge Balance Ultrasonic Bath Various Glassware Salinity Meter Conductivity Meter Conductivity Cell Vials Centrifuge Balance Ultrasonic Bath Various Glassware IS Meter ISE Pipettors Balance Analytical Balance Distillation Apparatus Various glassware CRM Page 31 Environmental Method Witness Form January 14, 2014 TNI/ DoD-ELAP & ISO/IEC 17025 Method Review Matrix TNI/ DoD QSM 5.0 Section → Parameter / Test Name or Technology Method(s) (From Scope) Ammonia SM 4500NH3 F Dissolved Oxygen SM 4500-O G Biochemical Oxygen Demand (BOD) SM 5210B Alkalinity SM 2320B ACLASS Form 67 Depth of Assessment *See codes Laboratory Name: Assessment Date(s): 5.2 5.3; 5.5 5.4 5.4.6 5.6 5.7; 5.8 5.9 4.12 5.10 Name(s) of Personnel Interviewed Accommodation / Environment; Equipment & Ref. Materials Procedure / Operating Instructions Measurement Uncertainty Verification Traceability; Verification / Calibration Sampling; Handling / Prep. Quality Checks Records Report / Certificate IS Meter ISE Pipettors Balance Analytical Balance Distillation Apparatus Various glassware CRM DO Meter DO Probe BOD Bottle As per SOP 5 pt. Cal CCV Thermometer Pipettor As per SOP MB LCS/D MS/D Hardcopy and Electronic Records OK As per SOP DO Cal As per SOP Dup OK DO Meter DO Probe BOD Bottle Incubators pH Meter Various glassware Burette pH meter Various glassware Balance Analytical Balance Hot plate Stirrer Oven Pipettors Std Titrant As per SOP DO Cal pH Cal Thermometer As per SOP As per SOP Standardization Balance Pipettors pH Meter Thermometer As per SOP Seed Control Duplicate Dilution Water Test GGA MB LCS/D Dup Electronic Records No record of calibration kept. Hardcopy and Electronic Records Hardcopy and Electronic Records OK Page 32 Environmental Method Witness Form January 14, 2014 OK TNI/ DoD-ELAP & ISO/IEC 17025 Method Review Matrix TNI/ DoD QSM 5.0 Section → Parameter / Test Name or Technology Method(s) (From Scope) Hardness SM 2340C Chloride SM 4500Cl¯ C TKN 351.3 Ammonia SM 4500NH3 B/C ACLASS Form 67 Depth of Assessment *See codes Laboratory Name: Assessment Date(s): 5.2 5.3; 5.5 5.4 5.4.6 5.6 5.7; 5.8 5.9 4.12 5.10 Name(s) of Personnel Interviewed Accommodation / Environment; Equipment & Ref. Materials Procedure / Operating Instructions Measurement Uncertainty Verification Traceability; Verification / Calibration Sampling; Handling / Prep. Quality Checks Records Report / Certificate As per SOP Standardization Balance Pipettors pH Meter As per SOP MB Dup Hardcopy and Electronic Records OK As per SOP Standardization Pipettors pH Meter As per SOP Dup Hardcopy and Electronic Records OK As per SOP Standardization Pipettors Balances As per SOP MB LCS Dup Hardcopy and Electronic Records OK As per SOP Standardization Pipettors Balances As per SOP MB LCS?D Dup Hardcopy and Electronic Records OK Burette pH meter Various glassware Balance Analytical Balance Hot plate Stirrer Pipettors Std Titrant Burette pH meter Various glassware Stirrer Pipettors Std Titrant Digestion Distillation Apparatus pH Meter Burette Pipettor Various Glassware Analytical Balance Balance Std Titrant Distillation Apparatus pH Meter Burette Pipettor Various Glassware Analytical Balance Page 33 Environmental Method Witness Form January 14, 2014 TNI/ DoD-ELAP & ISO/IEC 17025 Method Review Matrix TNI/ DoD QSM 5.0 Section → Parameter / Test Name or Technology Method(s) (From Scope) Depth of Assessment *See codes Laboratory Name: Assessment Date(s): 5.2 5.3; 5.5 5.4 5.4.6 5.6 5.7; 5.8 5.9 4.12 5.10 Name(s) of Personnel Interviewed Accommodation / Environment; Equipment & Ref. Materials Procedure / Operating Instructions Measurement Uncertainty Verification Traceability; Verification / Calibration Sampling; Handling / Prep. Quality Checks Records Report / Certificate As per SOP Standardization Balance Pipettors pH Meter Thermometer As per SOP MB LCS/D Dup Hardcopy and Electronic Records OK Balance Std Titrant Carbon Dioxide SM 4500CO2D ACLASS Form 67 Burette pH meter Various glassware Balance Analytical Balance Hot plate Stirrer Oven Pipettors Std Titrant Page 34 Environmental Method Witness Form January 14, 2014 TNI/ DoD-ELAP & ISO/IEC 17025 Method Review Matrix TNI/ DoD QSM 5.0 Section → Parameter / Test Name or Technology Method(s) (From Scope) Depth of Assessment *See codes Laboratory Name: Assessment Date(s): 5.2 5.3; 5.5 5.4 5.4.6 5.6 5.7; 5.8 5.9 4.12 5.10 Name(s) of Personnel Interviewed Accommodation / Environment; Equipment & Ref. Materials Procedure / Operating Instructions Measurement Uncertainty Verification Traceability; Verification / Calibration Sampling; Handling / Prep. Quality Checks Records Report / Certificate ASSESSOR NAME: DATE COMPLETED: NOTES: _______________________________ *O = Observed Test; P = Procedure Reviewed; I = Interviewed Personnel; E = Equipment Inspected; F = Field (On-Site); NR = Not Running ACLASS Form 67 Page 35 Environmental Method Witness Form January 14, 2014 INSTRUCTIONS FOR COMPLETION OF SCOPE/METHOD ASSESSMENT REVIEW Compare scope with table. Add and Delete as appropriate to match proposed scope of accreditation. When completing table based upon review, highlight all changes/additions in yellow. When adding new methods, send a copy to the Environmental Program Manager for revision. Please complete table for each parameter/test/technology and the corresponding method(s) in the following categories: Parameter, Test Name or Technology: For calibration labs, list parameter and tool (dimensional-calipers, force, etc.); For testing labs list Test category and name (Chemical, Biological, etc.) and GC-MS or Salmonella Depth of Assessment: Record the extent to which the parameter/test was assessed as follows: o O = Observed Calibration or Test o I = Interviewed Person(nel) o P = Procedure Reviewed o E = Equipment Inspected o F = Field (On-Site) Calibration and/or Test You may have a combination of the above (e.g. O/I/P, I/P, I/E, O/I/E/F) You must verify, at a minimum, that the laboratory has the equipment, method, and trained personnel to perform each calibration/test on the proposed Scope of Accreditation. Personnel Interviewed: List name(s) of personnel with prospective competence for the method. Environmental Conditions,: Indicate whether the environment/facility/equipment was suitable for the methods listed, and any environmental monitoring devices (which may also require traceability).. Standards/Equipment//Reference Materials: all reference standards and equipment utilized, trying to list all those mentioned on the proposed scope of accreditation, Procedure/Operating Instructions: Indicate the specific laboratory internal procedures or instructions for performing the calibration or test, and whether they were acceptable. Be sure to note the same methods as noted on the proposed scope of accreditation. ACLASS Form 67 Page 36 Environmental Method Witness Form January 14, 2014 Measurement Uncertainty: Indicate whether uncertainty analysis is required for the method; if required, indicate if laboratory analysis is acceptable. May indicate to be verified later (TBV) Verification/Calibration: Indicate whether the calibration or verification data for the relevant equipment is acceptable, and any objective evidence observed. Sampling; Handling/Preparation of Items: Indicate all protective gear used for the methods, whether the laboratory performs any sampling for the listed methods, and indicate if those activities, as well as any handling or preparation performed, are acceptable. Quality Checks: Indicate what quality checks are in place and whether they are acceptable. Records: Indicate whether the appropriate records are maintained for the listed methods, and what records were reviewed. Note all handwritten. Logbooks, or forms utilized. Many may have differing record retention times. Report/Certificate: Indicate whether the results for the listed methods are appropriately reported in accordance with 17025 and any requirements of the methods. Note if reports issue out of a database, electronic or templates. ACLASS Form 67 Page 37 Environmental Method Witness Form January 14, 2014
