Aud Check 03022011

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Audi t Check Sheet AUDI T- 1Revi sed 2/ 03/ 11

1. Dat e( s) of I nspect i on:

2. CE I nspect or( s) : Rodger s Cof f i ng ( 601) 634- 3156Zach Wi l son ( 601) 634- 3255

MTC Di r ect or : Al f r ed B. Cr awl ey ( 601) 634- 3123

3. Gener al Laborat ory I nf ormat i on:

a. Poi nt of Cont act( s) :

b. Busi ness Name:

c. Owner ( s) :

d. St r eet Addr ess:

e. Ci t y, St at e, Zi p Code:

f . Phone Number :

g. Year s i n Busi ness:

h. Empl oyees:( 1) Prof essi onal :( 2) Techni cal :( 3) Cl er i cal :

i . Ful l - t i me Labor at or y Per sonnel :

j . Test i ng Ar ea ( f t 2) :

k. Type of Bui l di ng:

l . Of f si t e/ Por t abl e Labor at or y:

4. Speci f i c Labor at or y I nf or mat i on:

a. Type of ser vi ces of f er ed:( 1) Aggr egat e: ___( 2) Bi t umi nous: ___( 3) Concret e: ___( 4) Masonr y: ___( 5) Rock: ___(6) Soi l : ___

b. Prof i ci ency Sampl e Progr ams:( 1) Aggr egat e: ___( 2) Bi t umi nous: ___

( 3) Concret e: ___( 4) Masonr y: ___(5) Soi l : ___

ADDI TI ONAL COMMENTS:

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Audi t Check Sheet AUDI T- 2c. Cur r ent Ref er ence Mat er i al :

( 1) ASTM St andar ds: ___( 2) AASHTO Standar ds: ___( 3) CE CRD Handbook: ___( 4) CE Engi neer Manual s: __ _( 5) CE Rock Test i ng Handbook: ___( 6) Cont r act Speci f i cat i ons: ___( 7) Mi l i t ary Speci f i cat i ons: ___( 8) Feder al Speci f i cat i ons: ___

5. Exi t Br i ef i ng At t endees:(1) __________________(2) __________________(3) __________________(4) __________________(5) __________________(6) __________________


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Audi t Check Sheet AUDI T- 3PERSONNEL QUALI FI CATI ONS

7. 1. Engi neer orSci ent i st i n Char ge

Exper t i se / Year sExper i ence (5 yr s mi n. )

Educat i on Regi st r at i on /St at es

Geot echni cal / Const r

7. 2. Super vi si ng LabTechni ci an


Educat i on Cert i f i cat i ons


7. 3. Super vi si ng Fi el dTechni ci an


Educat i on Cert i f i cat i ons


TECHNI CAL STAFF

7. 4. Labor at or y & Fi el dTechni ci ans

Exper t i se/YearsExper i ence

Curr ent ACIFi el d/ LabCer t i f i cat i on

Cur r ent NI CETLevelCer t i f i cat i on

Curr entNucl earCer t i f i cat i on

MT/MT/

MT/

MT/

MT/

MT/

MT/

MT/

MT/

MT/

MT/MT/

MT/

MT/

MT/

MT/

ACCREDI TATI ONS

AASHTO A2LA CMEC NVLAP

Curr ent Date Accr ed.

Expi r at i on Dat e

I NSPECTI ONS

Aut hor i t y Date of I nsp. Aggregate Bi t umi nous Concr ete Rock Soi l

AMRL

CCRL

USACE


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Audi t Check Sheet AUDI T- 48.0 QUALITY SYSTEM CRITERIA

( ASTM C 1077, D 3666, D 3740, E 329)Note: A "D" i ndi cat es a def i ci ency exi st s and "s" denot es sat i sf act or y

8. 1. 1. Qual i t y Manual ( QM) :a. Does t he l abor at or y mai nt ai n a QM? ___b. Does each document i n QM i ndi cat e i t s pr epar at i on or r evi si on dat e? ___c. I s t he QM avai l abl e f or use by the l abor at or y st af f ? ___

8. 1. 2. Qual i t y Management :a. Who i s r esponsi bl e f or det er mi ni ng i f qual i t y system i mpl ement at i onar e bei ng conduct ed accor di ng t o t he QM? Name: ___________________________ ___b. Does t hi s i ndi vi dual have access t o t op management ? ___

8. 1. 3. Laboratory Procedur e Manual :a. Does t he l aborat ory have a l aborat ory pr ocedur e manual out l i ni ng t hemet hods f or each cust omar y test pr ocedur e or ser vi ce pr ovi ded? ___b. Does each pr ocedur e i ncl ude speci f i c r ef er ences t o such st andar ds al ongwi t h except i ons t o t hem and/ or speci al i nst r uct i ons ( r equi r ement f or f or ms,cal cul at i on pr ogr ams, checki ng and/ or r evi ew, et c. ) ? ___

8. 1. 4. Equi pment Cal i br at i on and Ver i f i cat i on:

a. Does t he l abor at or y cal i br at e/ ver i f y al l si gni f i cant t est i ng equi pmentwi t hi n t he speci f i ed i nt er val s l i st ed i n t he QM? ___b. I s newl y acqui r ed equi pment wi t hout manuf act ur er s cer t i f i cat i oncal i br at ed bef or e bei ng pl aced i nt o ser vi ce? ___c. Does the l abor at or y have det ai l ed wr i t t en pr ocedur es f or al l i n- housecal i br at i on and ver i f i cat i on act i vi t i es? ___d. Do t hese pr ocedur es i ndi cat e t he equi pment r equi r ed t o perf orm t hecal i br at i on? ___

8. 1. 5. Equi pment Cal i br at i on and Ver i f i cat i on Recor ds:Does t he l abor at or y mai nt ai n cal i br at i on and ver i f i cat i on r ecor dswhi ch i ncl ude t he f ol l owi ng i nf or mat i on:

8. 1. 5. 1. Det ai l ed resul t s of t he cal i br at i on per f or med (di mensi ons, mass,f or ce, t i me, et c. ) ? ___

8. 1. 5. 2. Descr i pt i on of t he equi pment cal i br at ed/ ver i f i ed i ncl udi ng model andser i al number ? ___

8. 1. 5. 3. Dat e t he cal i br at i on/ ver i f i cat i on was per f or med? ___8. 1. 5. 4. I dent i f i cat i on of t he per son per f or mi ng t he cal i br at i on/ ver i f i cat i on? ___8. 1. 5. 5. I dent i f i cat i on of t he cal i br at i on/ ver i f i cat i on pr ocedur e used? ___8. 1. 5. 6. The previ ous and next due dat es of cal i brat i on/ ver i f i cat i on? __ _8. 1. 5. 7. I dent i f i cat i on of any i n- house cal i br at i on devi ce used? ___

8. 1. 6. I nspect i on of Faci l i t i es :a. Does t he l abor at or y have i t s f aci l i t y i nspect ed at i nt er val s of notmore t han 3 years by a qual i f i ed nat i onal aut hor i t y ( AMRL and/ or CCRL) ? __ _b. Does t he l aborat or y submi t t o t he qual i f i ed nat i onal aut hor i t y awr i t t en repor t document i ng how any def i ci enci es wer e cor r ect ed wi t hi n

30 days of r ecei pt of t he eval uat i on r epor t ? ___

8. 1. 7. Prof i ci ency Sampl e Test i ng:a. Does t he l abor at or y par t i ci pat e i n a f or mal pr of i ci ency sampl e pr ogr am( AMRL or CCRL) , i n- house progr am, or i ndependent t hi r d par t y pr ogr am? __ _

8. 1. 8. Exter nal Audi t Recor ds:a. Does t he l aborat ory mai nt ai n r ecor ds of any ext er nal audi t s anddocument at i on descr i bi ng how t he def i ci enci es wer e cor r ect ed? ___


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Audi t Check Sheet AUDI T- 58. 1. 9. Prof i ci ency Sampl e Records:

a. Does the l abor at or y r et ai n r esul t s of par t i ci pat i on i n pr of i ci encysampl e pr ogr ams i ncl udi ng dat a sheet s, summary r epor t s, and document at i ondescri bi ng st eps t aken t o det er mi ne the cause of poor r esul t s andcor r ect i ve act i ons t aken? ___

8. 1. 10. Test Methods and Procedur es:a. Does t he l aboratory mai nt ai n copi es of st andard and non- st andardpr ocedur es f or t est i ng per f or med? ___

b. Ar e t hese pr ocedur es cur r ent ? ___c. Ar e t he pr ocedur es r eadi l y accessi bl e t o empl oyees per f ormi ng t he work? ___

8. 1. 11. Test Recor ds:a. Does t he l abor at or y mai nt ai n t est r epor t s whi ch cl ear l y pr esent t hef ol l owi ng i nf or mat i on ( f r om Tabl e 2 Test Repor t Requi r ement s) :

( A) Name and addr ess of t he t est i ng l abor at or y? ___( B) I dent i f i cat i on of t he r epor t and t he dat e i ssued? ___( C) Name and addr ess of t he cl i ent ? ___( D) Pr oj ect i dent i f i cat i on? ___( E) Descr i pt i on and i dent i f i cat i on of t he t est sampl e? ___( F) Dat e of r ecei pt of t he test sampl e? ___( G) Dat e t est was per f or med? ___

( H)

I dent i f i cat i on of t he st andar d test met hod used and anynot at i on of devi at i ons f r om t he st andar d? ___( I ) Test r esul t s and other per t i nent dat a r equi r ed by t he st andar d

t est met hod? ___( J ) I dent i f i cat i on of any t est r esul t s obt ai ned f r om t est s

per f or med by a subcont r act or ? ___( K) The name of t he person( s) accept i ng t echni cal r esponsi bi l i t y

f or t he t est r epor t ? ___( L) Sampl e and f i el d i dent i f i cat i on/ l ocat i on i nf or mat i on? __ _

8. 1. 12. Recor ds Ret ent i on:a. Does t he l abor at or y r et ai n t he f ol l owi ng r ecor ds i n a secur e l ocat i onf or a mi ni mum of 3 year s per t ai ni ng t o:

( 1) Test i ng? ___

( 2) Equi pment cal i br at i on and ver i f i cat i on? ___( 3) Test r epor t s? ___( 4) I nt er nal qual i t y syst em r evi ews? ___( 5) Pr of i ci ency sampl e t est i ng? ___( 6) Test t echni ci an t r ai ni ng and eval uat i on? ___( 7) Per sonnel ? ___


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Audi t Check Sheet AUDI T- 69.0 QUALITY MANUAL (QM) REQUIREMENTS( ASTM C 1077, D 3666, D 3740, E 329)

Note: A "D" i ndi cat es a def i ci ency exi st s and "s" denot es sat i sf act or y

9. 1. 1. Or gani zat i on and Or gani zat i onal Pol i ci es:9. 1. 1. 1. Legal name and addr ess of t he l abor at or y, or t hat of mai n of f i ce

or company, i f di f f er ent ? ___9. 1. 1. 2. Ownershi p and management st r uct ur e of t he l aboratory i ncl udi ng names,

af f i l i at i ons and posi t i ons of pr i nci pal of f i cer s and di r ect or s? ___

9. 1. 1. 3. Or gani zat i on char t showi ng r el evant i nt er nal or gani zat i onalcomponent s? ___

9. 1. 1. 4. Li st of t he appl i cabl e dat es of qual i f i cat i ons, accredi t at i on, andr ecogni t i on by ot her s? ___

9. 1. 2. St af f :9. 1. 2. 1. Out l i ne/ char t showi ng oper at i onal per sonnel posi t i ons & t hei r l i nes of

aut hor i t y & r esponsi bi l i t y? ___9. 1. 2. 2. Posi t i on Descri pt i ons: ( Not e: A r ef er ence t o wher e posi t i on

descr i pt i ons are f ound i s acceptabl e i f t hey ar e not i n QM) ___( 1) Posi t i on descri pt i ons f or each t echni cal oper at i onal posi t i on shown

on t he l abor at or y' s or gani zat i on char t ? ___( 2) I dent i f y t he posi t i on? ___

( 3) Descr i be t he dut i es associ at ed wi t h t he posi t i on? ___( 4) Descr i be t he requi r ed ski l l s, educat i on and exper i ence? ___( 5) I ndi cat e t he super vi si on exer ci sed and r ecei ved? ___

9. 1. 2. 3. Bi ogr aphi cal Sket ches: ( Note: A r ef er ence t o wher e bi ogr aphi calsket ches ar e f ound i s accept abl e i f t hey ar e not i n QM) ___

( 1) Br i ef bi ogr aphi cal sket ches f or super vi sor y st af f i nvol ved i n t est i ngar eas cover ed by scope of qual i t y sys t em eval uat i on? ___

( 2) I ndi cat e educat i on and wor k exper i ence? ___( 3) I ndi cat e l i cense and cer t i f i cat i ons? ___( 4) I ndi cat e cur r ent posi t i on? ___

9. 1. 2. 4. Met hods of Tr ai ni ng:( 1) Descr i be the met hods used t o ensur e that al l l aborat ory t echni cal

st af f ar e t r ai ned and qual i f i ed to per f or m t est s? ___( 2) I ndi cat e what posi t i on( s) or empl oyee( s) i s r esponsi bl e f or t he

t r ai ni ng pr ogr am and mai nt enance of r ecor ds? ___9. 1. 2. 5. Methods t o Eval uate Staf f Competency:

( 1) Descr i be t he methods used t o eval uate st af f competency t o ensuret hat each t est cover ed by t he scope of qual i t y syst em eval uat i on i sper f or med i n accor dance wi t h st andar d pr ocedur es? ___

( 2) I ndi cat e f r equency of eval uat i ons? ___( 3) I ndi cat e what posi t i on( s) or empl oyee( s) i s r esponsi bl e f or eval uat i ng

st af f compet ency and mai nt enance of r ecor ds? ___9. 1. 2. 6. Sampl e f orm( s) used t o r ecord r esul t s of t r ai ni ng and compet ency

eval uat i on act i vi t i es? ___( 1) I ncl ude a f i el d f or ent er i ng name of t r ai nee? ___( 2) I ncl ude a f i el d f or ent er i ng name of eval uat or ? ___( 3) I ndi cat e t est met hod( s) eval uat ed? ___

( 4) I ncl ude a f i el d f or i ndi cat i ng dat e act i vi t i es t ook pl ace? __ _( 5) Pr ovi de a f i el d f or r ecor di ng r esul t s of t r ai ni ng or eval uat i onact i vi t y? ___


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Audi t Check Sheet AUDI T- 79. 1. 3. 1. I nvent or y: ( Not e: A r ef er ence t o wher e t he i nvent ory i s f ound i s

accept abl e i f i t i s not i n QM) ___a. I nvent or y of maj or sampl i ng, t est i ng, cal i br at i on and ver i f i cat i onequi pment associ ated wi t h test methods cover ed by scope of qual i t y syst emeval uat i on? ___b. The f ol l owi ng i t ems shoul d be i ncl uded f or each pi ece of maj or equi pment :

( 1) Name of equi pment ? ___( 2) Manuf act ur er ? ___( 3) Model and ser i al number ?** ___

( **Note: An i dent i f i cat i on number assi gned by the l aborat ory or ot heruni que i dent i f yi ng i nf ormat i on may be subst i t ut ed f or t he model andser i al number i f t hi s i s t he pr act i ce nor mal l y f ol l owed by the l abor at or y.

9. 1. 3. 2. Equi pment Cal i br at i on and Ver i f i cat i on:9. 1. 3. 2( 1) . Li st ( s) gi vi ng gener al descri pt i on of equi pment f or per f or mi ng t est s

cover ed by scope of qual i t y syst em eval uat i on whi ch r equi r ecal i br at i on/ ver i f i cat i on? ___

a. Does the i nf or mat i on f or each i t em l i st ed i ncl ude:( 1) I nt er val of cal i br at i on/ ver i f i cat i on? ___( 2) Ref erence t o cal i brat i on/ ver i f i cat i on procedur e used? ___( 3) Locat i on of cal i br at i on/ ver i f i cat i on r ecor ds? ___

9. 1. 3. 2( 2) . Document descr i bi ng l aborat ory' s method f or ensur i ng t hatcal i br at i on/ ver i f i cat i on pr ocedur es ar e per f or med f or al l r equi r ed

equi pment at speci f i ed i nt er val s? ___a. Does the document i ncl ude:

( 1) Name( s) of i ndi vi dual ( s) r esponsi bl e f or ensur i ng t hatcal i brat i on/ ver i f i cat i on act i vi t i es ar e car r i ed out ? ___( 2) Procedures f or handl i ng equi pment t hat i s new, r emoved f r omser vi ce, out of cal i br at i on, or def ect i ve? ___

9. 1. 3. 2( 3) . I n- house equi pment cal i br at i on/ ver i f i cat i on pr ocedur es, when t heycannot be r ef erenced i n appl i cabl e st andards, or has r ef erence t ot hei r l ocat i on i n the l abor at or y? ___

9. 1. 3. 2( 4) . Cer t i f i cat es or ot her document s t hat est abl i sh t r aceabi l i t y ofi n- house equi pment or r ef er ence st andar ds used f or cal i br at i on/ver i f i cat i on or has ref er ence t o t hei r l ocat i on i n t he l abor at or y? ___

9. 1. 4. Test Recor ds and Repor t s: ( Not e: Pri nt out s showi ng t ypi cal t est r ecor dsar e accept abl e i f t he l abor at or y uses el ect r oni c medi a f or st or age)9. 1. 4. 1. Descr i be met hods used by the l aborat ory to pr oduce t est r ecords and t o

pr epar e, check and amend t est r epor t s? ___9. 1. 4. 2. Cont ai n t ypi cal t est r epor t f or ms whi ch i l l ust r at e t he manner i n whi ch

t est r esul t s and suppor t i ng i nf or mat i on ar e document ed? ___

9. 1. 5. Sampl e Management :a. Cont ai n a document descr i bi ng pr ocedur es( s) f or sampl e i dent i f i cat i on,st or age, r et ent i on, & di sposal ? ___

9. 1. 6. Di agnosti c and Corr ect i ve Act i on:9. 1. 6. 1. Descri pt i on of par t i ci pat i on i n pr of i ci ency sampl e and on- si t e

i nspect i on pr ogr ams? ___( 1) Met hods t o i dent i f y poor r esul t s? ___( 2) Procedur es f ol l owed when poor r esul t s and def i ci enci es occur ? ___

9. 1. 6. 2. Out l i ne t he met hod( s) used i n r espondi ng t o external t echni calcompl ai nt s? ___


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Audi t Check Sheet AUDI T- 8

9. 1. 7. I nt er nal Qual i t y Syst em Revi ew:( 1) Descr i pt i on of t he scope of qual i t y sys t em r evi ews? ___( 2) I ndi cat e f r equency of r evi ews? ___( 3) I dent i f y i ndi vi dual ( s) r esponsi bl e f or conduct i ng r evi ews? ___( 4) Descr i be di st r i but i on of r epor t s t o management ? ___( 5) I ndi cate l ocat i on of r ecor ds showi ng r esul t s of r evi ews? __ _

9. 1. 8. Subcont r act i ng:a. A r ef er ence t o wher e t he pol i ci es are f ound i s accept abl e i f t hey ar enot i n t he QM ___b. Descri pt i on of pol i ci es whi ch t he l abor at or y f ol l ows rel at i ve t osubcont r act i ng or a st atement t hat t he l aboratory does not engage i n suchact i vi t i es? ___

( 1) Procedur es f ol l owed by t he l aborat ory i n sel ect i ng compet entsubcont r act or s? ___( 2) Procedur es f ol l owed by t he l aborat ory when r eport i ng r esul t s oft est i ng per f or med by subcont r act or s? ___


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Audi t Check Sheet AUDI T- 910.0 RECORDS AND REPORTING REQUIREMENTS

( ASTM C 1077, D 3666, D 3740, E 329)Note: A "D" i ndi cat es a def i ci ency exi st s and "s" denot es sat i sf act or y

10. 1. System of Recor ds:a. Does t he l aborat ory mai nt ai n a syst emof r ecor ds t hat per mi t sver i f i cat i on of any i ssued r epor t ? ___b. Ar e r epor t s and r ecor ds ret ai ned f or at l east t hree years? ___c. Do t he t est r ecor ds i ncl ude t he name of t he per son per f ormi ng t he

t est s? ___10. 2. Mai nt enance of Recor ds:10. 2. 1 Det ai l ed resul t s ( i . e. wor ksheet s) of al l r equi r ed equi pment

cal i br at i on and ver i f i cat i on? ___10. 2. 2. Resul t s of i nt er nal audi t s? ___10. 2. 3. Resul t s of any on- t he- j ob t r ai ni ng per f or med i ncl udi ng:

( 1) Name of per son? ___( 2) Dat e of t r ai ni ng? ___( 3) By whom? ___( 4) Type of t r ai ni ng? ___

10. 2. 4. Resul t s of any act i vi t i es perf ormed t o ensur e cont i nued compet ence i nper f ormi ng st andard t est methods i ncl udi ng:( 1) Name of per son? ___

( 2) Dat e of compet ency check? ___( 3) By whom? ___( 4) Type of act i vi t y? ___

10. 2. 5. Resul t s of audi t s and i nspect i ons? ___( 1) Cer t i f i cat i ons of l aboratory per sonnel wi t h appl i cabl e dates? __ _

10. 2. 6. Recor ds of ver i f i cat i on of compet ency of any ext ernal or g. used? __ _10. 2. 7. Recor ds or r esumes t hat document each per son' s:

( 1) Qual i f i cat i ons? ___( 2) Wor k exper i ence? ___( 3) Tr ai ni ng hi st or y? ___

10. 3. Repor t s:10. 3. 1. Name and addr ess of t he l abor at or y? ___10. 3. 2. Dat e t he r epor t was i ssued and dat e t he t est was per f or med? ___

10. 3. 3. Name of t he cl i ent ? ___10. 3. 4. I dent i f i cat i on of t he r epor t , pr oj ect, name and t i t l e of t he per sont echni cal l y r esponsi bl e f or t he r epor t , and st andar d t est met hod( s) ? ___

10. 3. 5. Speci f i c i dent i f i cat i on and descri pt i on of t he t est speci men i ncl udi ngf i el d i dent i f i cat i on and det ai l ed l ocat i on ( i . e. , hor i zont al and ver t i calcoor di nat es of t he sampl e sour ce) ? ___

10. 3. 6. Dat e the test sampl e was r ecei ved by t he l abor at or y? ___10. 3. 7. St andard t est met hod( s) used wi t h a notat i on of al l known devi at i ons

f r omt he ref er enced method( s) or r equi r ement s of t he met hod( s) , or both,not per f or med by t he l abor at or y? ___

10. 3. 8. I dent i f i cat i on of t est r esul t s or other dat a, or bot h, obt ai ned f r omsubcont r act or ( s) ? ___

10. 3. 9. Resul t s and ot her per t i nent data r equi r ed by t he t est method used? __ _10. 4. Accur at el y and cl ear l y pr esent t he speci f i ed t est r esul t s and al l

per t i nent dat a? ___10. 5. Cl ear l y r ef er ence t he r epor t bei ng amended f or cor r ect i ons or addi t i ons? ___

Addi t i onal Comment s:

Aud Check 03022011

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Transcript of Aud Check 03022011