Post on 03-Apr-2018
7/28/2019 IMS ChecklistsampleXYZ
1/5
Doc. No. :
Date of Effectivity:
IMS CHECKLIST FORM
XYZ Plant Page of
Department/Areas:Q.C. Laboratory
Audited by/ Date:
Activities/Areas:Sampling : Collection and preparation of samples, Distribution of Samples, Storage of samples for dailycomposite, Disposal of Excess Samples
Clause Requirement Y/N/NA Findings
4.2, 4.3.1, 4.3.3,4.3.2, 5.3,5.4.1, 7.1,
7.4, 8.3, 6.4, 7.5.5,8.2.3
4.4.3, 4.4.6, 4.4.7,4.4.2, 6.2.2, 7.1, 7.4,
8.3, 7.5.5, 8.2.3
4.5.1, 4.5.2, 8.2.3,7.5.5
4.5.3,4.5.3.1/4.5.3.2,8.5.1, 8.5.2
A1. Collection ofsample at different
sampling point areclearly defined in theprocedure as well as thepreparation of samplefor analysis.
-QESH Risks clearlyidentified
2. Samplers properly
trained on the procedureof sampling and aware
of the QESH Risks ofthe activity?
What about samplers
under Contractor?
3. Requiredperformance evaluation
of samplers to ensurethat sampling procedureis carried out correctly?
Verify if HIRADC wasconducted?
4. Create procedure of
sampling at differentsampling point.
Create HIRADC for thesampling of material atdifferent sampling
point.
Evaluate the samplersby letting them perform
the actual sampling vs.the procedure.
7/28/2019 IMS ChecklistsampleXYZ
2/5
Doc. No. :
Date of Effectivity:
IMS CHECKLIST FORM
XYZ Plant Page of
Department/Areas:Q.C. Laboratory
Audited by/ Date:
Activities/Areas:Sampling : Collection and preparation of samples, Distribution of Samples, Storage of samples for dailycomposite, Disposal of Excess Samples
Clause Requirement Y/N/NA Findings
4.2, 4.3.1, 4.3.3,4.3.2, 5.3,5.4.1, 7.1,
7.4, 8.3, 6.4, 7.5.5,8.2.3
4.4.3, 4.4.6, 4.4.7,4.4.2, 6.2.2, 7.1, 7.4,8.3, 7.5.5, 8.2.3
4.5.1, 4.5.2, 8.2.3,7.5.5
4.5.3,4.5.3.1/4.5.3.2,8.5.1, 8.5.2
B1. Samples foranalysis at different
section are properlylabeled and with propercontainers?
2. Proper labeling ofsample containers
done?
3. Visual Inspection of
sample containers withthe appropriate samples
inside.
4. Samples should beplaced in different
containers and properly
labeled.
7/28/2019 IMS ChecklistsampleXYZ
3/5
Doc. No. :
Date of Effectivity:
IMS CHECKLIST FORM
XYZ Plant Page of
Department/Areas:Q.C. Laboratory
Audited by/ Date:
Activities/Areas:Sampling : Collection and preparation of samples, Distribution of Samples, Storage of samples for dailycomposite, Disposal of Excess Samples
Clause Requirement Y/N/NA Findings
4.2, 4.3.1, 4.3.3,4.3.2, 5.3,5.4.1, 7.1,
7.4, 8.3, 6.4, 7.5.5,8.2.3
4.4.3, 4.4.6, 4.4.7,4.4.2, 6.2.2, 7.1, 7.4,
8.3, 7.5.5, 8.2.3
4.5.1, 4.5.2, 8.2.3,7.5.5
4.5.3,4.5.3.1/4.5.3.2,8.5.1, 8.5.2
C1. Proper labeling andstorage of samples for
daily composite
2. Daily compositesamples are well
segregated andcollected?
3.Packaging andstorage of dailycomposite samples
4. Composite samplesare collected,
segregated and storedproperly for future
analysis.
7/28/2019 IMS ChecklistsampleXYZ
4/5
Doc. No. :
Date of Effectivity:
IMS CHECKLIST FORM
XYZ Plant Page of
Department/Areas:Q.C. Laboratory
Audited by/ Date:
Activities/Areas:Sampling : Collection and preparation of samples, Distribution of Samples, Storage of samples for dailycomposite, Disposal of Excess Samples
Clause Requirement Y/N/NA Findings
4.2, 4.3.1, 4.3.3,4.3.2, 5.3,5.4.1, 7.1,
7.4, 8.3, 6.4, 7.5.5,8.2.3
4.4.3, 4.4.6, 4.4.7,4.4.2, 6.2.2, 7.1, 7.4,
8.3, 7.5.5, 8.2.3
4.5.1, 4.5.2, 8.2.3,7.5.5
4.5.3,4.5.3.1/4.5.3.2,8.5.1, 8.5.2
D1. -Proper disposal ofsamples are defined in
the procedure?-Environmental ImpactIdentified?-Volume of disposedwastes with regular
monitoring?
2. -Samplers aware ofthe procedure on proper
disposal of wastes?-Environmental Aspects
and Impact AssessmentIn Placed?-Record Monitoring ofWastes Disposal
3. Areas where theexcess samples are to be
disposed?- Records of wastesdisposal available?-EAIA
4. Disposal area should
be clearly defined in theprocedure.
Increase awareness of
the samplers of thedisposal area for the
excess
7/28/2019 IMS ChecklistsampleXYZ
5/5
Doc. No. :
Date of Effectivity:
IMS CHECKLIST FORM
XYZ Plant Page of
Department/Areas:Q.C. Laboratory
Audited by/ Date:
Activities/Areas:Sampling : Collection and preparation of samples, Distribution of Samples, Storage of samples for dailycomposite, Disposal of Excess Samples
Clause Requirement Y/N/NA Findings
4.2, 4.3.1, 4.3.3,4.3.2, 5.3,5.4.1, 7.1,
7.4, 8.3, 6.4, 7.5.5,8.2.3
4.4.3, 4.4.6, 4.4.7,4.4.2, 6.2.2, 7.1, 7.4,
8.3, 7.5.5, 8.2.3
4.5.1, 4.5.2, 8.2.3,7.5.5
4.5.3,4.5.3.1/4.5.3.2,8.5.1, 8.5.2
1. Collection of sampleat different sampling
point are clearly definedin the procedure as wellas the preparation ofsample for analysis.-QESH Risks clearly
identified
2. Samplers properlytrained on the procedure
of sampling and awareof the QESH Risks of
the activity?
What about samplersunder Contractor?
3. Requiredperformance evaluationof samplers to ensure
that sampling procedureis carried out correctly?
Verify if HIRADC was
conducted?
4. Create procedure ofsampling at different
sampling point.
Create HIRADC for the
sampling of material atdifferent sampling
point.
Evaluate the samplersby letting them performthe actual sampling vs.
the procedure.