NC0074390_Checklist for Field Parameters_20181210

Regional Inspectors' Checklist for Field Parameters
[This checklist is to be completed during regional plant inspections for Field Laboratories, denoted by certification numbers in the 5000s.]
Facility Name: 40soi, (a.(,;r tt,, 4) r f
Regional Plant Inspector: //31 /e. 4.)A/lr_._,
NPDES #: /I/(_c"y.)7Yj9--
Regional Inspector Contact #: ci/o -433-.33d..?
Field Lab Certification #:
Region: F aC)
Lab Contact: ,bo,t;t ( 6-eak ta9od
Date: /a -/O•-/ 8
I. Check the parameter(s) performed at this site for reporting purposes.
Wotal Residual Chlorine (TRC) ❑ Temperature (TEMP) ❑ Specific Conductivity (SC)
0 pH ❑ Dissolved Oxygen (DO) ❑ Settleable Residue (SETT)
II. General Laboratory (note any exceptions in section XI
Are instruments, meters, probes, photometric cells, etc. maintained in good condition?
F'es
❑ No
Are standards, reagents and consumables used within manufacturer expiration dates?
[TRC gel standard is exempt.]
Y'Yes
❑ No
Are the following' items documented (V where applicable):
Item
TRC
pH
TEMP
DO . --
_ SC
SETT
Date of sample collection*
,%
1/`
Time of sample collection*
L,r
17-
Sample collector's initials or signature
/
✓
Date of sample analysis*
r/
t/
Time of sample analysis*
v. '
1/
•
Analyst initials or signature
t,.r'
r/
Sample site (i.e., facility name, location, ID, etc.)
t/
i/
Instrument ID
vV
t/
N/A
Parameter
1.-'.-,
,-,
Data qualifiers, when required
✓
*Date and time of sample collection and analysis may be the same for in situ or on -site measurements.
III. Total Residual Chlorine - reference method: •
Total Residual Chlorine meter make and model: I-ja.c(n' S ecfroj>rp r 74)17
Is a check standard analyzed each day of use? (Circle one:,ge or liquid standard)
11:`Yes
❑ No
What is the assigned/observed value of the daily check standard? lb)
Is a 5-point calibration verification performed? Note date of last verification: 574141/7
1--'Yes
❑ No
Alternatively, does the lab construct alinear regression, using 5 standards, to calculate
results? Note date of last calibration curve constructed:
❑ Yes
❑ No
True values: ❑ pg/L ❑ mg/L ::).J 30 S 0 D-OO :.fWO
Obtained values: M'pg/L ❑ mg/L 2.1 i 3 o 5 9-9-0 I417
What program are samples analyzed on?
Are results reported in proper units? Check one: 2 pg/L ❑ mg/L
PiYes
❑ No
Are results reported between the facility's permit limit and the compliance limit of 50 pg/L?
If value is less than the low standard, report as "<x", where x=low standard conc.
!!'Yes
❑ No
Are samples analyzed within 15 minutes of collection?
v Yes
❑ No
IV. pH - reference method: - .
pH meter make and model: 0f-t'oo _. ;_ .4-(l/
Is the pH meter calibrated with at least 2 buffers per mfg's instructions each day of use?
Note buffers used: L1 ri- l L
[1-Yes
❑ No
Is the pH meter calibration checked with an additional buffer each day of use?
Note check buffer used: 7 •
E'Yes
❑ No
Does the check buffer read within ±0.1 S.U. of the known value?
Hes
❑ No
Are the following items documented:
Meter calibration?
M' ' es
❑ No
Check_buffer reading(s)?
E-Yes
❑ No
Are samples analyzed within 15 minutes of collection?
Y s
❑ No
Are sample results reported to 0.1 pH units?
❑'Yes
❑ No

V. - Temperature — reference method:
What instrument(s) is used to measure temperature? Check all that apply: ❑ pH meter
❑ DO meter ❑ Conductivity meter ❑ Digital thermometer ❑ Glass thermometer
Is the instrument/thermometer calibration checked at least annually against a NIST
traceable or NIST certified thermometer?
❑ Yes ❑ No
Are temperature corrections (even if zero) posted on the instrument/thermometer?
❑ Yes ❑-No'.
Are samples measured in situ or on -site? [REQUIRED - there is no holding time for
temperture]
❑ Yes ❑ No;'
-`%
Are sample results reported in degrees C?
❑ Yes ❑ No
VI. • Dissolved Oxygen - reference method:
DO meter make and model:
Is the air calibration of the DO meter performed each day of use?
❑ Yes ❑ No
Are the following items documented:
Meter calibration?
❑ Yes ❑ No
Are samples analyzed within 15 minutes of collection?
❑ Yes ❑ No
Are -results reported in mg/L?
❑ Yes ❑ No
VII. Conductivity - reference method:
Conductivity meter make and model:
Is the meter calibrated daily according to the manufacturer's instructions? Note standard
used (this is generally a one -point calibration):
❑ Yes ❑ No
Is a daily check standard analyzed? Note value:
❑ Yes ❑ No
Are the followingitems documented: -
Meter calibration?
❑ Yes ❑ No
Are samples analyzed within 28 days of collection?
❑ Yes ❑ No
Are results reported in pmhos/cm (some meters display equivalent pS/cm units)?
❑ Yes ❑ No
VIII. Settleable Residue - reference method:
Does the laboratory have an Imhoff Cone in good condition?
❑ Yes ❑ No
Is the sample settled for 1 hour?
❑ Yes No
Is the sample agitated after 45 minutes?
❑ Yes ❑ No
Are the following items documented:
Volume of sample analyzed? Note volume analyzed:
❑ Yes ❑ No
Date and time of sample analysis (settling start time)?
❑ Yes ❑ No
Time of agitation after 45 minutes of settling?
❑ Yes ❑ No
Sample analysis completion (settling end time)?
❑ Yes ❑ No
Are samples analyzed within 48 hours of, collection?
❑ Yes ❑ No
Are results reported in ml/L?
❑ Yes ❑ No
IX. . Was a paper trail (comparing contract lab and on -site data to DMRs)
performed? If so, list months reviewed: 'I'7 ;;o/g.
, E 'es ❑ No,
X. Is follow-up by the Laboratory Certificationprogram recommended?,
❑ Yes ENO
XI. Additional comments:
Please submit a copy of this completed form to the Laboratory Certification program at:
DWR Lab Certification, Water Sciences Section, 1623 Mail Service Center, Raleigh NC, 27699-1623
Electronic copies may be emailed to linda:chavis(c�ncdenr.gov.
Revision 09/11/2015