Title Page

  • Reason for audit

  • Audit Number

  • Analyst

  • Conducted on

  • Prepared by

  • Location

QA, Aims and Replicate QC Analysis

  • Has the analyst successfully completed the analysis of 4 no bulk samples from the laboratory s stock of QC bulk samples ?

  • Has the analyst successfully completed the analysis of the AIMs samples? If results are known

  • Has the analyst successfully completed the required number of re analysis samples?

  • Has the analyst got a P401 (or equivalent) and relevant training file up to date?

Health and Safety

  • Sample handling in line with company procedures?

  • Risk Assessment s / COSHH for RI liquids available?

  • Risk assessments / COSHH for all other chemicals available (Acid , Acetone etc) ?

  • Cabinet cleaned between samples ?

  • Is the analyst aware of emergency procedures ?

  • Is the analyst aware of spillage procedures ?


  • Is the fume cabinet working correctly and are relevant safety checks and service details in date.Record the ID no and last Service date , date of last weekly check, record of flow rate checks and PAT test dates.

  • PLM microscope present ? Record ID no, service date and PAT test info

  • Stereo microscope present ? Record ID no , service date and PAT test info

  • Type H Vacuum Present ? Record ID no , service date and PAT test info

  • RI Liquids present ? Record all batch numbers and use by dates

  • Tools in good working condition ?

  • Petri dishes clean with no deep scratches that could harbour contamination ?

  • Hot plate / stirer in good condition ? Clean and electricity tested if applicable

  • Suitable lighting and seating for both fume cabinet and microscope ?

  • Is any additional equipment in use in the fume cabinet ?

  • Warning signs on door of laboratory ?

Analysis Procedure

  • Lab sample booking in file filled in correctly ?

  • Analyst wearing lab coat ?

  • Fume cabinet on ?

  • Sample placed into appropriate receptacle (Petri dish) ?

  • Sample inspected under stereo microscope ?

  • Sample preparation appropriate to material ?

  • Fibers mounted in correct RI liquid with cover slip fitted ?

  • Slide transferred to PLM ?

  • PLM microscope procedure followed (each step demonstrated to auditor) ?

  • Analysis sheet correctly filled in ?

Witnessed Bulk Analysis

  • Project No

  • Material

  • Sample examined under stereo microscope

  • Sample mounted (RI)

  • Morphology

  • Elongation

  • Pleochrism

  • Dispersion Staining

  • Fibre identified

  • Birefringence

  • Summary

  • Bulk Analyst

  • Auditor

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.