DEQp00021695

Regional Field Inspectors Check List for Field Parameters
lame of site to be Inspected: Q,., aDn 4- Date:_ 3 - a 1 - 03
field certification # (if applicable): 51 C 5 Inspector:1
JPDES #: A/C no 6 3 S 7 3 Region: e+j g /; J1 e.
Circle the parameter or parameters performed at this site.
tesidual Chlorine, Settleable SolidsDO, Conductivity emperatur
1. Instrumentation:
k. Does the facility have the equipment necessary to analyze field parameters as circled above?
I. A pH meter es No
t. A Residual Chlorine meter Yes No
3. DO meter Yes No
f. A Cone for settleable solids Yes No
5. A thermometer or meter that measures temperature. es No
3. Conductivity meter Yes No
111. Calibration/Analysis:
1. Is the pH meter calibrated with a 2 buffers and
checked with a third buffer each day of use?. es No
2. For Total Residual Chlorine, is a check standard
analyzed each day of use? Yes No
3. Is the air calibration of the DO meter performed
each day of use? Yes No
4. For Settleable Solids, is 1 liter of sample
settled for 1 hour? Yes No
5. Is the temperature measuring device calibrated
annually against a certified thermometer?es : No
6. For Conductivity, is a calibration standard
analyzed each day of use? Yes No

IV. Documentation:
1. is the date and time that the sample was collected documented?
Yes
No
2. Is the sample site, documented?
Yes
No
3. Is the sample collector documented?
Yes
No
4. Is the analysis date and time documented?
Yes
No
5. Did the analyst sign the documentation?
Yes
No
6. Is record of calibration documented?
Yes
No
7. For Settleable Solids, is sample volume and
1 hour time settling time documented?
Yes
No
8. For Temperature, is the annual calibration of
the measuring device documented?
Yes
No
Comments:
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Please submit a copy of this completed form to the Laboratory Certification Program.
DWQ Lab Certification
Chemistry Lab
Courier # 52-01-01
FIELD INSPECTOR CHECKLIST REV. 04/23/2002
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