NC0003719_Field Parameter Checklist_20200624

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: ,�, �,� (' ;; L �--� ," L
NPDES #:
Regional. Plant Inspector:-{tl(->1,;*(. �L "• ,
Regional Inspector Contact #: � q3 3 33 �
Field Lab Certification #:.3 ',
Region:
Lab Contact: (Col-(,fej-l-ew.
Date:
I. Check the parameter(s) performed of this site for reporting purposes.
[§otal Residual Chlorine (TRC) [Temperature (TEMP) ❑ Specific Conductivity (SC)
P�H 2Dissolved 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? glesF-1 No
Are standards, reagents and consumables used within manufacturer expiration dates? [,'Yes ❑ No
[TRC gel standard is exempt.]
Date of sample collection*
Time of sample collection*
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✓
✓'
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4 r
Sample collector's initials or signature_.__
Date of sample anal sis*
Time of sample analysis*
-
Analyst initials or signature
✓
-'✓
4� ,
Sample site (i.e., facility name, location, ID, etc.)
Instrument ID
V/
°�
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N/A
Parameter
Data qualifiers, when required
*Date and time of sample collection and analysis may be the same Tor rn sau or on -site rneasuicinC[ILa.
Total Residual Chlorine meter make and model: jC
Is a check standard analyzed each dayof use? (Circle one: or liquid standard) des ❑ No
What is the assi ned/observed value of the daily check standard?
Is a 5-point calibration verification performed? Note date of last verification: I0 9-R- I es ❑ No
Alternatively, does the lab construct a linear regression, using 5 standards, to calculate ['Yes El No
results? Note date of last calibration curve constructed:
True values: pg/L ❑ mg/L 90 4 ` S
Obtained values. pg/L ❑ mg/L C_ 5 a
What program are samples analyzed on? g
Are results reported in proper units? Check one: [g /L ❑ m /L Yes ❑ No
Are results reported between the facility's permit limit and the compliance limit of 50 pg/L? es ❑ No
If value is less than the low standard, report as "<x", where x=low standard conc.
Are samples analyzed within 15 minutes of collection? Yes ❑ No
pH meter make and model:
Is the pH meter calibrated with at least 2 buffers per mfg's instructions each day of use? 0-Yes ❑ No
Note buffers used: `74-- C
Is the pH meter calibration checked with an additional buffer each day of use? -'Yes ❑ No
Note check buffer used:
Does the check buffer read within ±0.1 S.U. of the known value? [] Yes ❑ No
Are the following items documented:
Meter calibration? es ❑ No
Check buffer readin (s)? [2-Yes ❑ No
Are samples analyzed within 15 minutes of collection? ['Yes ❑ No
Are sample results reported to 0.1 pH units? Yes ❑ No

m e—reerenceV. Teatmethod.
_
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 ❑ Yes ❑ No
traceable or NIST certified thermometer?
Are temperature corrections even if zeroposted on the instrument/thermometer? ❑ Yes ❑ No
Are samples measured in situ or on -site? [REQUIRED - there is no holding time for ❑ Yes ❑ No
temperature]
Are sample results reported in degrees C? R Yes R No
DO meter make and model: Y3:T,.;.,,_
Is the air calibration of the DO meter performed each day of use? es ❑ No
Are the following items documented:
Meter calibration? [2'Yes ❑ No
Are samples analyzed within 15 minutes of collection? s ❑ No
Are results reported in mg/L? Yes F1 No
Conductivity meter make and model:
Is the meter calibrated daily according to the manufacturer's instructions? Note standard ❑ Yes ❑ No
used (this is generally a one -point calibration):
Is a daily check standard analyzed? Note value: ❑ Yes ❑ No
Are the following items documented:
Meter calibration? ❑ Yes ❑ No
Are samples analyzed within 28 days of collection? ❑ Yes ❑ No
Are results reported in pmhos/cm (some meters displav equivalent uS/cm units)? I-1 Yes I-1 No
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?
1-1 Yes
R
No
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(,ncdenr.gov.
Revision 09/11/2015