ACCREDITATION SCOPE PROPOSAL – ISO/IEC 17025 - TESTING
Source standard:NIT-DICLA-016 / Page:1
LABORATORY CORPORATE NAME/ DESIGNATION

SIGNATORIES AUTHORIZED TO APPROVE TESTING REPORTS

DATE

/

ANNEX

to ACCREDITATION APPLICATION/ EXTENSION / to RAV:(FOR DICLA/ ASSESSOR USE)
PURPOSE (use separate files/sheets for each case)
ACCREDITATION / EXTENSION / UPDATE / REDUCTION / SUSPENSION
ACCREDITATION No. / FACILITY TYPE
Fill out if already accredited. / PERMANENT FACILITY
ACTIVITY AREA/ PRODUCT / TESTING CLASS/ TESTING DESCRIPTION / STANDARD AND /OR PROCEDURE
Attention!Use this part of the form only for tests carried out at the permanent facilities of the laboratory.There are two pages in the form for this.Add more lines in the table, if required.
There are other parts of the form for client facilities and mobile facilities.
Please, delete the pages that are not used and erase the filling instructions.
ACTIVITY AREA (FORMAT:CAPITALIZED, BOLD-FACED, UNDERSCORE, ARIAL 10)
SEE LIST OF ACTIVITY AREAS IN NIT-DICLA-016. / TESTING CLASS (FORMAT:CAPITALIZED, BOLD-FACED, UNDERSCORE, ARIAL 10)
REFER TO THE LIST OF TESTING CLASSES IN NIT-DICLA-016.
PRODUCT
(FORMAT:CAPITALIZED, ARIAL 10)
(REFER TO THE INSTRUCTIONS IN NIT-DICLA-016 AND IN THE SPECIFIC DOCUMENT FOR THE ACTIVITY AREA AND USE THE STANDARDIZED DESCRIPTIONS OF THE PRODUCT.) / Testing Description
(FORMAT:Arial 10.Refer to the instructions in NIT-DICLA-016 and in the specific document for the Activity Area and use the standardized descriptions for the test.)
Use one line for each test.Write the range or level of quantification, as applicable, below the description of the test.
For the cases of determination of more than one analyte or property with the same method, write each analyte or property and its respective range or level of quantification in one separated line of the table.) / Standard and /or procedure
(FORMAT:Arial 10.Write one standard or procedure in each line.Mention year of the standard or revision of the procedure.)
ACCREDITATION No. / FACILITY TYPE
Fill out if already accredited. / CLIENT FACILITY
ACTIVITY AREA/ PRODUCT / TESTING CLASS/ TESTING DESCRIPTION / STANDARD AND /OR PROCEDURE
Warning!Use this part of the form only for tests carried out at client facilities.There are two pages in the form for this.Add more lines in the table, if required.
There are other parts of the form for permanent facilities and mobile facilities.
Please, delete the pages that are not used and erase the filling instructions.
ACTIVITY AREA (FORMAT:CAPITALIZED, BOLD-FACED, UNDERSCORE, ARIAL 10)
SEE LIST OF ACTIVITY AREAS IN NIT-DICLA-016. / TESTING CLASS (FORMAT:CAPITALIZED, BOLD-FACED, UNDERSCORE, ARIAL 10)
REFER TO THE LIST OF TESTING CLASSES IN NIT-DICLA-016.
PRODUCT
(FORMAT:CAPITALIZED, ARIAL 10)
(REFER TO THE INSTRUCTIONS IN NIT-DICLA-016 AND IN THE SPECIFIC DOCUMENT FOR THE ACTIVITY AREA AND USE THE STANDARDIZED DESCRIPTIONS OF THE PRODUCT.) / Testing Description
(FORMAT:Arial 10.Refer to the instructions in NIT-DICLA-016 and in the specific document for the Activity Area and use the standardized descriptions for the test.)
Use one line for each test.Write the range or level of quantification, as applicable, below the description of the test.
For the cases of determination of more than one analyte or property with the same method, write each analyte or property and its respective range or level of quantification in one separated line of the table.) / Standard and /or procedure
(FORMAT:Arial 10.Write one standard or procedure in each line.Mention year of the standard or revision of the procedure.)
ACCREDITATION NO. / FACILITY TYPE
Fill out if already accredited. / MOBILE FACILITY
ACTIVITY AREA/ PRODUCT / TESTING CLASS/ TESTING DESCRIPTION / STANDARD AND /OR PROCEDURE
Warning!Use this part of the form only for tests carried out at mobile facilities.There are two pages in the form for this.Add more lines in the table, if required.
There are other parts of the form for permanent facilities and client facilities.
Please, delete the pages that are not used and erase the filling instructions.
ACTIVITY AREA (FORMAT:CAPITALIZED, BOLD-FACED, UNDERSCORE, ARIAL 10)
SEE LIST OF ACTIVITY AREAS IN NIT-DICLA-016. / TESTING CLASS (FORMAT:CAPITALIZED, BOLD-FACED, UNDERSCORE, ARIAL 10)
REFER TO THE LIST OF TESTING CLASSES IN NIT-DICLA-016.
PRODUCT
(FORMAT:CAPITALIZED, ARIAL 10)
(REFER TO THE INSTRUCTIONS IN NIT-DICLA-016 AND IN THE SPECIFIC DOCUMENT FOR THE ACTIVITY AREA AND USE THE STANDARDIZED DESCRIPTIONS OF THE PRODUCT.) / Testing Description
(FORMAT:Arial 10.Refer to the instructions in NIT-DICLA-016 and in the specific document for the Activity Area and use the standardized descriptions for the test.)
Use one line for each test.Write the range or level of quantification, as applicable, below the description of the test.
For the cases of determination of more than one analyte or property with the same method, write each analyte or property and its respective range or level of quantification in one separated line of the table.) / Standard and /or procedure
(FORMAT:Arial 10.Write one standard or procedure in each line.Mention year of the standard or revision of the procedure.)

FOR-CGCRE-012 – Rev. 08 - Appr. MAR/13 - Page 02/06