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INSPECTION REPORT ROUTING SHEET
To be attached to all inspection reports in-house only.
Laboratory Cert. #: 5276
Laboratory Name: Pinewood Manor Rest Home
Inspection Type: Field Maintenance
Inspector Name(s): Todd Crawford
Inspection Date: August 18, 2010
Date Report Completed: August 20, 2010
Date Forwarded to Reviewer: August 20, 2010
Reviewed by: Chet Whiting
Date Review Completed: August 23, 2010
Cover Letter to use: Insp. Initial X Insp. Reg. Insp. No Finding Insp. CP
Unit Supervisor: Dana Satterwhite
Date Received: August 23, 2010
Date Forwarded to Alberta: August 24, 2010
Date Mailed: August 24, 2010
_____________________________________________________________________
On-Site Inspection Report
LABORATORY NAME: Pinewood Manor Rest Home
NPDES PERMIT #: WQ0002096
ADDRESS: 240 S. Early Station Rd
Ahoskie, NC 27910
CERTIFICATE #: 5276
DATE OF INSPECTION: August 18, 2010
TYPE OF INSPECTION: Field Maintenance
AUDITOR(S): Todd Crawford
LOCAL PERSON(S) CONTACTED: Stewart White
I. INTRODUCTION:
This laboratory was inspected to verify its compliance with the requirements of 15A NCAC 2H .0800 for
the analysis of environmental samples.
II. GENERAL COMMENTS:
This inspection was conducted off-site from the Pinewood Manor Rest Home. All equipment necessary
to perform the certified parameters were present and appeared well maintained.
A description of current field lab policies and technical assistance documents for the analysis of the
facility’s currently certified parameters were provided at the time of the inspection.
Finding A is a new policy that has been implemented by our program since the last inspection.
III. FINDINGS, REQUIREMENTS, COMMENTS AND RECOMMENDATIONS:
Documentation
A. Finding: The laboratory needs to increase the documentation of purchased materials and
reagents, as well as, documentation of standards and reagents prepared in the laboratory.
Requirement: All chemicals, reagents, standards and consumables used by the laboratory
must have the following information documented: Date Received, Date Opened (in use),
Vendor, Lot Number, and Expiration Date. A system (e.g., traceable identifiers) must be in
place that links standard/reagent preparation information to analytical batches in which the
solutions are used. Documentation of solution preparation must include the analyst’s initials,
date of preparation, the volume or weight of standard(s) used, the solvent and final volume of
the solution. This information as well as the vendor, manufacturer, lot number, and expiration
date must be retained for chemicals, reagents, standards and consumables used for a period
of five years. Consumable materials such as pH buffers and lots of pre-made standards are
included in this requirement. Ref: Quality Assurance Policies for Field Laboratories.
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#5276 Pinewood Manor Rest Home
IV. PAPER TRAIL INVESTIGATION:
No paper trail performed.
V. CONCLUSIONS:
Correcting the above-cited finding will help this lab to produce quality data and meet certification
requirements. The inspector would like to thank the staff for its honesty and assistance during the
inspection and subsequent data discovery and review process. Please respond to all findings.
Report prepared by: Todd Crawford Date: August 20, 2010
Report reviewed by: Chet Whiting Date: August 23, 2010