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FR-055/ 22.03.2017 /Rev01/13.03.2020 1 / 6 NATIONAL ACCREDITATION CENTER Dosya No (File number) i /............ Akreditasyon Başvuru Formu Accreditation Application Form (FR-055) ( Deney Laboratuarları İçin Akreditasyon Başvuru Formu) (Accreditation Application Form for Testing Laboratories) (ISO/IEC 17025) İlk akreditasyon (initial accreditation) Akreditasyon kapsamı genişletilmesi (extension of accreditation scope) Akreditasyon kapsamı değişikliği (the change of accreditation scope) Akreditasyon yenileme (the re-accreditation) İlgili APAC dökümanlarına göre “Onaylanmış Laboratuvar” olarak değerlendirilmek ve akredite edilmek istiyorum. Request accreditation and to be evaluated as a “notified laboratory” according related APAC documentation. Deney Laboratuvarının Adı / Tanımı: (Name-Identity of the testing laboratory:) …………………………………………………………….………………………………………..……....….…………..…………….…………………………………………………….…… …………………………………..……....….…………………..………......... Adres (Address ) :……………………………………………………………………………………………………………..……....…............... …….………………………………………………………….…………………………………………………………….……............ …….………………………………………………………….…………………………………………………………….……............ Şehir (State/City) : ………………………………… Posta Kodu(Postal Code): ……………………… Ülke (Country) : ……….………………................. Telefon (Phone Number ) : ………………………….......... Fax (Fax):……….………….................. E-posta(email): …………………………………... Web Site:…....................................................................................... Vergi Dairesi (Tax Office) : …………...…………………................. Vergi No (Tax Number-where applicable) :….......................................... Deney Laboratuvarı Yöneticisi (Name and Surname of Head of the testing laboratory): ..……………………………………………………….…….............................................................. Telefon (Phone Number ) : …………………………...... Fax (Fax): ……………............................... E-posta (email): …..............................….…. Cep Tel (Mobile phone number): ……….…………………………….................................................................................................................. Laboratuvar Personel Sayısı (Number of testing laboratory employee): ........................................................................................................ Dahili Kalibrasyon Yapılıyor mu (Does the testing laboratory carry out internal)? Evet/Yes: Hayır/No: Yapılan Dahili Kalibrasyonlar (Name of Carried out internal calibrations): .................................................................................................................................................................................................................. .................................................................................................................................................................................................................. ....
Transcript of NATIONAL ACCREDITATION CENTERnationalaccreditationcenter.org/wp-content/uploads/... · (ISO/IEC...
FR-055/ 22.03.2017 /Rev01/13.03.2020 1 / 6
NATIONAL ACCREDITATION CENTER
Dosya No (File number)i/............
Akreditasyon Başvuru Formu Accreditation Application Form
(FR-055)
( Deney Laboratuarları İçin Akreditasyon Başvuru Formu)
(Accreditation Application Form for Testing Laboratories)
(ISO/IEC 17025)
İlk akreditasyon (initial accreditation)
Akreditasyon kapsamı genişletilmesi (extension of accreditation scope)
Akreditasyon kapsamı değişikliği (the change of accreditation scope)
Akreditasyon yenileme (the re-accreditation)
İlgili APAC dökümanlarına göre “Onaylanmış Laboratuvar” olarak değerlendirilmek ve akredite edilmek istiyorum.
Request accreditation and to be evaluated as a “notified laboratory” according related APAC documentation.
Deney Laboratuvarının Adı / Tanımı: (Name-Identity of the testing laboratory:)
…………………………………………………………….………………………………………..……....….…………..…………….…………………………………………………….……
…………………………………..……....….…………………..……….........
Adres (Address ) :……………………………………………………………………………………………………………..……....…...............
…….………………………………………………………….…………………………………………………………….……............
…….………………………………………………………….…………………………………………………………….……............
Şehir (State/City) : ………………………………… Posta Kodu(Postal Code): ……………………… Ülke (Country) : ……….……………….................
Telefon (Phone Number ) : ………………………….......... Fax (Fax):……….…………..................
E-posta(email): …………………………………... Web Site:….......................................................................................
Vergi Dairesi (Tax Office) : …………...…………………................. Vergi No (Tax Number-where applicable) :…..........................................
Deney Laboratuvarı Yöneticisi (Name and Surname of Head of the testing laboratory): ..……………………………………………………….……..............................................................
Telefon (Phone Number ) : …………………………...... Fax (Fax): ……………............................... E-posta (email): …..............................….….
Cep Tel (Mobile phone number): ……….……………………………..................................................................................................................
Laboratuvar Personel Sayısı (Number of testing laboratory employee): ........................................................................................................
Dahili Kalibrasyon Yapılıyor mu (Does the testing laboratory carry out internal)? Evet/Yes: Hayır/No:
Yapılan Dahili Kalibrasyonlar (Name of Carried out internal calibrations):
..................................................................................................................................................................................................................
..................................................................................................................................................................................................................
....
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Deney Laboratuvarının Yasal Statüsü (Legal status of the testing laboratory) …………………………………………………….......
Deney Laboratuvarının Sahibi (Owner of the testing laboratory): ……………………………………………………………….............
Deney Laboratuvarı Sahibinin Adresi (Address of the owner of testing laboratory): ………………………………………………………………...............
……………...……………………………………………...……………………………………………………………………….........
Laboratuarın Yasal Olarak Yetkilendirilmiş Temsilcileri (legal Representatives of the Owners) :
…………………………………………………………………...............................................................................................................
………………………………………………………………………………………………………………………………………........
Deney Laboratuvarının Şubeleri var mı? (Does the testing laboratory operate at several sites?) Evet/Yes: Hayır/No:
Deney Laboratuvarının Şubesiii (Site of Test Laboratory):
Şube Deney Laboratuvarının Adı / Tanımı (Name-Identity of the site testing laboratory)
…………………………………………………………….………………………………………..……....….…………..…………....
Adres (Address ).........................................................……… …………………………………………………………………………………..
.………………...…....................................................Posta Kodu(Postal Code): …...................... Şehir (State/City) :...........................
Telefon (Phone Number ) : ………………….…………………………................... Fax (Fax): ……………………………..…………………...................................
E-posta(email): …………………………………............. Laboratuvar Personel Sayısı (Number of testing laboratory employee): ……………………
Deney Laboratuvarı Yöneticisi (Name and Surname of Head of the testing laboratory):
…………………………………………………………...………………………………………………………….....
İrtibat Kurulacak Kişi (Name and Surname of Contact Person):…………………………………… Telefon (Phone Number): …………………………......
.......................
Fax (Fax): ……………………….................. E-posta(email): ………………...................... Cep Tel (Mobile phone number): ….………………...………
Dahili Kalibrasyon Yapılıyor mu (Does the testing laboratory carry out internal)? Evet/Yes: Hayır/No:
Yapılan Dahili Kalibrasyonlar (Name of Carried out internal calibrations):
..................................................................................................................................................................................................................
..................................................................................................................................................................................................................
Akreditasyonu istenen deney kapsamlarını 3. Sayfada belirtiniz. (please give the information about the testing scopes for which accreditation
is requested at page 3)
.................................................................................................................................................................................................................
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Başvuran laboratuvar olarak NAC Akreditasyon Prosedürleri ile NAC kurallarını okuduğumuzu, anladığımızı ve aynı zamanda NAC
Hizmet Ücretleri Klavuzuna (K-001) uygun olarak tarafımıza fatura edilecek bedelleri ödeyeceğimizi taahhüt ederiz. (As the applicant testing laboratory, we hereby declare that the NAC Accreditation Procedures and NAC Rules are understood by us
and all costs that will be invoiced consistent with NAC Service Fees Guide (K-001) will be paid by our testing laboratory.)
(Resmi Kaşe)/( Official Stamp)
Yer (place) : ...................................
Tarih (Date): ..................................
Yetkili Adı Soyadı ve İmzası (Autorized Person’s Name-Surname-Signature):
....................................................................................
Önemli Hatırlatmalar (Reminder)
Başvuru formunun ekine, “FR-034 Akreditasyon Hizmetleri, Uygunluk Değerlendirme Kuruluşu Yetkili Bildirim
Formu” ile “FR-001 Akreditasyon Sözleşmesi” (2 Nüsha) doldurulup yetkili kişi tarafından imzalanarak eklenmesi
gerekmektedir. FR-034 “Conformity Assessment Body Representing Person Declaration for Accreditation Services Form” and FR-001
“Accreditation Contract” (2 copies) shall be filled, signed by authorized person and attached to this application form.
Başvuru Formunun ve eklerinin birlikte iletilmesinin ardından başvurunuz NAC Bilgi Sistemine kaydedilecektir. Bu işlemi takiben Kuruluşunuzun Yetkilisi tarafından denetim ile ilgili dokümanlarınız NAC Bilgi sistemine yüklenmelidir. After receiving the application form and annexes, your application will be uploaded to NAC Information System.
Following this process, applicant testing laboratory should upload requested documents to NAC Information System
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Akreditasyonu talep edilen deney metodları (Test methods subjected to accreditation)iii
Deney Alanı - Deneyi Yapılan Malzemeler/Ürünler ( Testing Fields-
Tested Materials/Products)iv
Deney Adı (Name of Test) Deney Metodu (Ulusal, uluslararası standartlar, işletme-içi
metodlar) ( Testing Method (national,
international standards, in-house methods)
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EK-A /(Annex A)
Deney Laboratuvarının Şubeleri /Sites of testing laboratory
Şube Deney Laboratuvarının Adı / Tanımı (Name-Identity of the site testing laboratory)
…………………………………………………………….………………………………………..……....….…………..…………....
Adres (Address ).........................................................……… …………………………………………………………………………………..
.………………...…....................................................Posta Kodu(Postal Code): …...................... Şehir (State/City) :...........................
Telefon (Phone Number): ………………….…………………………................... Fax (Fax): ……………………………..…………………...................................
E-posta(email): …………………………………............. Laboratuvar Personel Sayısı (Number of testing laboratory employee): ……………………
Deney Laboratuvarı Yöneticisi (Name and Surname of Head of the testing laboratory):
…………………………………………………………...………………………………………………………….....
İrtibat Kurulacak Kişi (Name and Surname of Contact Person):…………………………………… Telefon (Phone Number): …………………………......
.......................
Fax (Fax): ……………………….................. E-posta(email): ………………...................... Cep Tel (Mobile phone number): ….………………...………
Dahili Kalibrasyon Yapılıyor mu (Does the testing laboratory carry out internal)? Evet/Yes: Hayır/No:
Yapılan Dahili Kalibrasyonlar (Name of Carried out internal calibrations):
..................................................................................................................................................................................................................
..................................................................................................................................................................................................................
Şube Deney Laboratuvarının Adı / Tanımı (Name-Identity of the site testing laboratory)
…………………………………………………………….………………………………………..……....….…………..…………....
Adres (Address ).........................................................……… …………………………………………………………………………………..
.………………..…....................................................Posta Kodu(Postal Code): …...................... Şehir (State/City) :...........................
Telefon (Phone Number ) : ………………….…………………………................... Fax (Fax): ……………………………..…………………...................................
E-posta(email): …………………………………............. Laboratuvar Personel Sayısı (Number of testing laboratory employee): ……………………
Deney Laboratuvarı Yöneticisi (Name and Surname of Head of the testing laboratory): …………………………………………………………...………………………………………………………….....
İrtibat Kurulacak Kişi (Name and Surname of Contact Person):…………………………………… Telefon (Phone Number): …………………………...... .......................
Fax (Fax): ……………………….................. E-posta(email): ………………...................... Cep Tel (Mobile phone number): ….………………...………
Dahili Kalibrasyon Yapılıyor mu (Does the testing laboratory carry out internal)? Evet/Yes: Hayır/No:
Yapılan Dahili Kalibrasyonlar (Name of Carried out internal calibrations):
..................................................................................................................................................................................................................
..................................................................................................................................................................................................................
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EK-B /(Annex B)
Onaylanmış Deney Laboratuarı (Notified Testing Laboratory)
Önemli Not (Important notice): Bu bölüm doküman ve direktiflere göre Onaylanmış Laboratuvar olarak değerlendirilecek laboratuvarlar tarafından doldurulacaktır. (This
chapter will be filled as only notified laboratory according to documents and directives.)
i NAC tarafından doldurulacaktır./ filled by NAC.
ii Eğer şube sayısı birden fazla ise, lütfen EK-A’daki sayfayı kullanınız. (If there are one more sites, please use page which is given at Annex-A). iii Eğer yeterli sayıda boşluk yoksa lütfen ek için yeni sayfa kullanınız. (If there is insufficient space, please use a new page for this Annex.) iv Mümkünse, NAC K-019, K-020, K-021 numaralı dokümanları kullanınız. (Please use NAC guidance documents for scope statement K-019, K-020, K-021 etc.)
Komisyon Kararı (Decision of Commission) Ürün Ailesi, Ürün / Kullanım Amacı
(Product Family, Product/Intended use) Şartname/Standartlar
(Technical specification/standarts)
