Intergovernmental Data Quality Task Force

Workbook for

Uniform Federal Policy for Quality Assurance Project Plans

Evaluating, Assessing, and Documenting Environmental Data Collection and
Use Programs

Part 2A: UFP-QAPP Workbook

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Final

Version 1

March 2005

***This page intentionally left blank.***

**TABLE OF CONTENTS**

INTRODUCTION

QAPP Worksheet #1. Title and Approval Page 1

QAPP Worksheet #2. QAPP Identifying Information 2

QAPP Worksheet #3. Distribution List 6

QAPP Worksheet #4. Project Personnel Sign-Off Sheet 7

QAPP Worksheet #5. Project Organizational Chart 8

QAPP Worksheet #6. Communication Pathways 9

QAPP Worksheet #7. Personnel Responsibilities and Qualifications Table
10

QAPP Worksheet #8. Special Personnel Training Requirements Table 11

QAPP Worksheet #9. Project Scoping Session Participants Sheet 12

QAPP Worksheet #10. Problem Definition 13

QAPP Worksheet #11. Project Quality Objectives/Systematic Planning
Process Statements 14

QAPP Worksheet #12. Measurement Performance Criteria Table 15

QAPP Worksheet #13. Secondary Data Criteria and Limitations Table 16

QAPP Worksheet #14. Summary of Project Tasks 17

QAPP Worksheet #15. Reference Limits and Evaluation Table 18

QAPP Worksheet #16. Project Schedule/Timeline Table 19

QAPP Worksheet #17. Sampling Design and Rationale 20

QAPP Worksheet #18. Sampling Locations and Methods/SOP Requirements
Table 21

QAPP Worksheet #19. Analytical SOP Requirements Table 22

QAPP Worksheet #20. Field Quality Control Sample Summary Table 23

QAPP Worksheet #21. Project Sampling SOP Reference Table 24

QAPP Worksheet #22. Field Equipment Calibration, Maintenance, Testing,
and Inspection

Table 25

QAPP Worksheet #23. Analytical SOP Reference Table 26

QAPP Worksheet #24. Analytical Instrument Calibration Table 27

QAPP Worksheet #25. Analytical Instrument and Equipment Maintenance,
Testing, and

Inspection Table 28

QAPP Worksheet #26 Sample Handling System 29

QAPP Worksheet #27. Sample Custody Requirements 30

QAPP Worksheet #28. QC Samples Table 31

QAPP Worksheet #29. Project Documents and Records Table 32

QAPP Worksheet #30. Analytical Services Table 33

QAPP Worksheet #31. Planned Project Assessment Table 34

QAPP Worksheet #32. Assessment Findings and Response Actions 35

QAPP Worksheet #33. QA Management Reports Table 36

QAPP Worksheet #34. Sampling and Analysis Verification (Step I) Process
Table 37

QAPP Worksheet #35. Sampling and Analysis Validation (Steps IIa and IIb)
Process Table 38

QAPP Worksheet #36. Sampling and Analysis Validation (Steps IIa and IIb)
Summary Table 39

QAPP Worksheet #37. Data Usability Assessment 40

**WORKBOOK FOR UNIFORM FEDERAL POLICY FOR QUALITY ASSURANCE**

**PROJECT PLANS**

**INTRODUCTION**

This *Workbook for Uniform Federal Policy for Quality Assurance Project
Plans* is Part 2A of the *Uniform Federal Policy for Quality Assurance
Project Plans* (UFP-QAPP). It provides examples of worksheets to assist
with the preparation of QAPPs in accordance with Part 1 of the UFP-QAPP
(the UFP-QAPP Manual) and Section 6 (Part B) of *Quality Systems for
Environmental Data and Technology Programs - Requirements with guidance
for use*, ANSI/ASQ E4 (February 2004). This Workbook may be used by the
lead organization and its contractors to assist with the preparation of
QAPPs for environmental data gathering activities.

Each worksheet addresses specific requirements of the UFP-QAPP. Both the
UFP-QAPP Manual and the Workbook are intended to be comprehensive and
are not intended to be program-specific. Since the content and level of
detail in a specific QAPP will vary by program, by the work being
performed, and by the intended use of the data, specific worksheets may
not be applicable to all projects.

The ultimate success of an environmental program or project depends on
the quality of the environmental data collected and used in
decision-making, and this may depend significantly on the adequacy of
the QAPP and its effective implementation. It is recommended that the
individual worksheets included in this Workbook be taken to the project
scoping and planning sessions. The use of the worksheets will aid in
identifying the critical project information that will ensure that the
right type, quality, and quantity of data are collected to meet all of
the project's quality objectives. Though the format of each worksheet is
not mandatory, the information required on the worksheets must still be
presented in the QAPP, as appropriate to the project. In addition, QAPP
preparers are encouraged to develop additional tables, as appropriate to
the project. Sufficient written discussion in text format should
accompany all tables. Certain sections, by their nature, will require
more written discussion than others. In particular, Section 3.1.1 should
provide an in-depth explanation of the sampling design rationale, and
Section 5.2 should describe the procedures and criteria that will be
used for data review.

**QAPP Worksheet #1**

**(UFP-QAPP Manual Section 2.1)**

**Title and Approval Page**

**Site Name/Project Name: Title:**

**Site Location: Revision Number:**

**Revision Date:**

> **Page \_\_\_ of \_\_\_**

[\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_]{.underline}

Document Title

[\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_]{.underline}

Lead Organization

[\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_]{.underline}

Preparer's Name and Organizational Affiliation

[\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_]{.underline}

Preparer's Address, Telephone Number, and E-mail Address

[\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_]{.underline}

Preparation Date (Day/Month/Year)

Investigative Organization's Project
Manager:\_[\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_]{.underline}

Signature

[\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_]{.underline}\_\_
Printed Name/Organization/Date

Printed Name/Organization/Date

Investigative Organization's Project QA
Officer:\_[\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_]{.underline}

Signature

> [\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_]{.underline}\_\_\_
> Printed Name/Organization/Date

Lead Organization's Project
Manager:\_[\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_]{.underline}

Signature

> [\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_]{.underline}\_\_\_
> Printed Name/Organization/Date

Approval
Signatures:\_[\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_]{.underline}

Signature

> [\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_]{.underline}

Printed Name/Title/Date

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Approval Authority

Other Approval
Signatures:\_[\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_]{.underline}

Signature

> [\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_]{.underline}

#  Printed Name/Title/Date

**Document Control Number:**

**QAPP Worksheet #2**

**(UFP-QAPP Manual Section 2.2.4)**

**QAPP Identifying Information**

**Site Name/Project Name: Title:**

**Site Location: Revision Number:**

**Site Number/Code: Revision Date:**

**Operable Unit: Page \_\_\_ of \_\_\_**

**Contractor Name:**

**Contractor Number:**

**Contract Title:**

**Work Assignment Number:**

1\. Identify guidance used to prepare QAPP:

[\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_]{.underline}

2\. Identify regulatory
program:\_[\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_]{.underline}

3\. Identify approval
entity:\_[\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_]{.underline}

4\. Indicate whether the QAPP is a generic or a project-specific QAPP.
(circle one)

5\. List dates of scoping sessions that were
held:\_[\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_]{.underline}

> \_[\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_]{.underline}\_[\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_]{.underline}

6\. List dates and titles of QAPP documents written for previous site
work, if applicable:

Title Approval Date

[\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_]{.underline}\_\_\_\_\_\_\_\_\_\_\_
[\_\_\_\_\_\_\_\_\_\_\_\_\_]{.underline}

[\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_]{.underline}\_\_\_\_\_\_\_\_\_\_\_
[\_\_\_\_\_\_\_\_\_\_\_\_\_]{.underline}

[\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_]{.underline}\_\_\_\_\_\_\_\_\_\_\_
[\_\_\_\_\_\_\_\_\_\_\_\_\_]{.underline}

[\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_]{.underline}\_\_\_\_\_\_\_\_\_\_\_
[\_\_\_\_\_\_\_\_\_\_\_\_\_]{.underline}

7\. List organizational partners (stakeholders) and connection with lead
organization:\_\_\_\_\_\_\_\_\_\_

\_\_\_[\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_]{.underline}

\_\_\_[\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_]{.underline}

8\. List data
users:[\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_]{.underline}
\_\_[\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_]{.underline}\_\_[\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_]{.underline}

9\. If any required QAPP elements and required information are not
applicable to the project, then circle the omitted QAPP elements and
required information on the attached table. Provide an explanation for
their exclusion below:

\_\_\_[\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_]{.underline}

> \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
>
> \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Identify where each required QAPP element is located in the QAPP
(provide section, worksheet, table, or figure number) or other project
planning documents (provide complete document title, date, section
number, page numbers, and location of the information in the document).
Circle QAPP elements and required information that are not applicable to
the project. Provide an explanation in the QAPP.

+--------------------------------+-------------------+----------------+
| **Required QAPP Element(s) and | **Required        | **Crosswalk to |
| Corresponding QAPP             | Information**     | Related        |
| Section(s)**                   |                   | Documents**    |
+================================+===================+================+
| ## Pro                         |                   |                |
| ject Management and Objectives |                   |                |
+--------------------------------+-------------------+----------------+
| 2.1 Title and Approval Page    | \- Title and      |                |
|                                | Approval Page     |                |
+--------------------------------+-------------------+----------------+
| 2.2 Document Format and Table  | \- Table of       |                |
| of Contents                    | Contents          |                |
|                                |                   |                |
| 2.2.1 Document Control Format  | \- QAPP           |                |
|                                | Identifying       |                |
| 2.2.2 Document Control         | Information       |                |
| Numbering System               |                   |                |
|                                |                   |                |
| 2.2.3 Table of Contents        |                   |                |
|                                |                   |                |
| 2.2.4 QAPP Identifying         |                   |                |
| Information                    |                   |                |
+--------------------------------+-------------------+----------------+
| 2.3 Distribution List and      | \- Distribution   |                |
| Project Personnel Sign-Off     | List              |                |
| Sheet                          |                   |                |
|                                | \- Project        |                |
| 2.3.1 Distribution List        | Personnel         |                |
|                                | Sign-Off Sheet    |                |
| 2.3.2 Project Personnel        |                   |                |
| Sign-Off Sheet                 |                   |                |
+--------------------------------+-------------------+----------------+
| 2.4 Project Organization       | \- Project        |                |
|                                | Organizational    |                |
| 2.4.1 Project Organizational   | Chart             |                |
| Chart                          |                   |                |
|                                | \- Communication  |                |
| 2.4.2 Communication Pathways   | Pathways          |                |
|                                |                   |                |
| 2.4.3 Personnel                | \- Personnel      |                |
| Responsibilities and           | Responsibilities  |                |
| Qualifications                 | and               |                |
|                                | Qualifications    |                |
| 2.4.4 Special Training         | Table             |                |
| Requirements and Certification |                   |                |
|                                | \- Special        |                |
|                                | Personnel         |                |
|                                | Training          |                |
|                                | Requirements      |                |
|                                | Table             |                |
+--------------------------------+-------------------+----------------+
| 2.5 Project Planning/Problem   | \- Project        |                |
| Definition                     | Planning Session  |                |
|                                | Documentation     |                |
| 2.5.1 Project Planning         | (including Data   |                |
| (Scoping)                      | Needs tables)     |                |
|                                |                   |                |
| 2.5.2 Problem Definition, Site | \- Project        |                |
| History, and Background        | Scoping Session   |                |
|                                | Participants      |                |
|                                | Sheet             |                |
|                                |                   |                |
|                                | \- Problem        |                |
|                                | Definition, Site  |                |
|                                | History, and      |                |
|                                | Background        |                |
|                                |                   |                |
|                                | \- Site Maps      |                |
|                                | (historical and   |                |
|                                | present)          |                |
+--------------------------------+-------------------+----------------+
| 2.6 Project Quality Objectives | \- Site-Specific  |                |
| and Measurement Performance    | PQOs              |                |
| Criteria                       |                   |                |
|                                | \- Measurement    |                |
| 2.6.1 Development of Project   | Performance       |                |
| Quality Objectives Using the   | Criteria Table    |                |
| Systematic Planning Process    |                   |                |
|                                |                   |                |
| 2.6.2 Measurement Performance  |                   |                |
| Criteria                       |                   |                |
+--------------------------------+-------------------+----------------+
| 2.7 Secondary Data Evaluation  | \- Sources of     |                |
|                                | Secondary Data    |                |
|                                | and Information   |                |
|                                |                   |                |
|                                | \- Secondary Data |                |
|                                | Criteria and      |                |
|                                | Limitations Table |                |
+--------------------------------+-------------------+----------------+
| 2.8 Project Overview and       | \- Summary of     |                |
| Schedule                       | Project Tasks     |                |
|                                |                   |                |
| 2.8.1 Project Overview         | \- Reference      |                |
|                                | Limits and        |                |
| 2.8.2 Project Schedule         | Evaluation Table  |                |
|                                |                   |                |
|                                | \- Project        |                |
|                                | Schedule/Timeline |                |
|                                | Table             |                |
+--------------------------------+-------------------+----------------+
| **Measurement/Data             |                   |                |
| Acquisition**                  |                   |                |
+--------------------------------+-------------------+----------------+
| 3.1 Sampling Tasks             | \- Sampling       |                |
|                                | Design and        |                |
| 3.1.1 Sampling Process Design  | Rationale         |                |
| and Rationale                  |                   |                |
|                                | \- Sample         |                |
| 3.1.2 Sampling Procedures and  | Location Map      |                |
| Requirements                   |                   |                |
|                                | \- Sampling       |                |
| 3.1.2.1 Sampling Collection    | Locations and     |                |
| Procedures                     | Methods/ SOP      |                |
|                                | Requirements      |                |
| 3.1.2.2 Sample Containers,     | Table             |                |
| Volume, and Preservation       |                   |                |
|                                | \- Analytical     |                |
| 3.1.2.3 Equipment/Sample       | Methods/SOP       |                |
| Containers Cleaning and        | Requirements      |                |
| Decontamination Procedures     | Table             |                |
|                                |                   |                |
| 3.1.2.4 Field Equipment        | \- Field Quality  |                |
| Calibration, Maintenance,      | Control Sample    |                |
| Testing, and Inspection        | Summary Table     |                |
| Procedures                     |                   |                |
|                                | \- Sampling SOPs  |                |
| 3.1.2.5 Supply Inspection and  |                   |                |
| Acceptance Procedures          | \- Project        |                |
|                                | Sampling SOP      |                |
| 3.1.2.6 Field Documentation    | References Table  |                |
| Procedures                     |                   |                |
|                                | \- Field          |                |
|                                | Equipment         |                |
|                                | Calibration,      |                |
|                                | Maintenance,      |                |
|                                | Testing, and      |                |
|                                | Inspection Table  |                |
+--------------------------------+-------------------+----------------+
| 3.2 Analytical Tasks           | \- Analytical     |                |
|                                | SOPs              |                |
| 3.2.1 Analytical SOPs          |                   |                |
|                                | \- Analytical SOP |                |
| 3.2.2 Analytical Instrument    | References Table  |                |
| Calibration Procedures         |                   |                |
|                                | \- Analytical     |                |
| 3.2.3 Analytical Instrument    | Instrument        |                |
| and Equipment Maintenance,     | Calibration Table |                |
| Testing, and Inspection        |                   |                |
| Procedures                     | \- Analytical     |                |
|                                | Instrument and    |                |
| 3.2.4 Analytical Supply        | Equipment         |                |
| Inspection and Acceptance      | Maintenance,      |                |
| Procedures                     | Testing, and      |                |
|                                | Inspection Table  |                |
+--------------------------------+-------------------+----------------+
| 3.3 Sample Collection          | \- Sample         |                |
| Documentation, Handling,       | Collection        |                |
| Tracking, and Custody          | Documentation     |                |
| Procedures                     | Handling,         |                |
|                                | Tracking, and     |                |
| 3.3.1 Sample Collection        | Custody SOPs      |                |
| Documentation                  |                   |                |
|                                | \- Sample         |                |
| 3.3.2 Sample Handling and      | Container         |                |
| Tracking System                | Identification    |                |
|                                |                   |                |
| 3.3.3 Sample Custody           | \- Sample         |                |
|                                | Handling Flow     |                |
|                                | Diagram           |                |
|                                |                   |                |
|                                | \- Example        |                |
|                                | Chain-of-Custody  |                |
|                                | Form and Seal     |                |
+--------------------------------+-------------------+----------------+
| 3.4 Quality Control Samples    | \- QC Samples     |                |
|                                | Table             |                |
| 3.4.1 Sampling Quality Control |                   |                |
| Samples                        | \-                |                |
|                                | Scree             |                |
| 3.4.2 Analytical Quality       | ning/Confirmatory |                |
| Control Samples                | Analysis Decision |                |
|                                | Tree              |                |
+--------------------------------+-------------------+----------------+
| 3.5 Data Management Tasks      | \- Project        |                |
|                                | Documents and     |                |
| 3.5.1 Project Documentation    | Records Table     |                |
| and Records                    |                   |                |
|                                | \- Analytical     |                |
| 3.5.2 Data Package             | Services Table    |                |
| Deliverables                   |                   |                |
|                                | \- Data           |                |
| 3.5.3 Data Reporting Formats   | Management SOPs   |                |
|                                |                   |                |
| 3.5.4 Data Handling and        |                   |                |
| Management                     |                   |                |
|                                |                   |                |
| 3.5.5 Data Tracking and        |                   |                |
| Control                        |                   |                |
+--------------------------------+-------------------+----------------+
| **Assessment/Oversight**       |                   |                |
+--------------------------------+-------------------+----------------+
| 4.1 Assessments and Response   | \- Assessments    |                |
| Actions                        | and Response      |                |
|                                | Actions           |                |
| 4.1.1 Planned Assessments      |                   |                |
|                                | \- Planned        |                |
| 4.1.2 Assessment Findings and  | Project           |                |
| Corrective Action Responses    | Assessments Table |                |
|                                |                   |                |
|                                | \- Audit          |                |
|                                | Checklists        |                |
|                                |                   |                |
|                                | \- Assessment     |                |
|                                | Findings and      |                |
|                                | Corrective Action |                |
|                                | Responses Table   |                |
+--------------------------------+-------------------+----------------+
| 4.2 QA Management Reports      | \- QA Management  |                |
|                                | Reports Table     |                |
+--------------------------------+-------------------+----------------+
| 4.3 Final Project Report       |                   |                |
+--------------------------------+-------------------+----------------+
| ## Data Review                 |                   |                |
+--------------------------------+-------------------+----------------+
| 5.1 Overview                   |                   |                |
+--------------------------------+-------------------+----------------+
| 5.2 Data Review Steps          | \- Verification   |                |
|                                | (Step I) Process  |                |
| 5.2.1 Step I: Verification     | Table             |                |
|                                |                   |                |
| 5.2.2 Step II: Validation      | \- Validation     |                |
|                                | (Steps IIa and    |                |
| 5.2.2.1 Step IIa Validation    | IIb) Process      |                |
| Activities                     | Table             |                |
|                                |                   |                |
| 5.2.2.2 Step IIb Validation    | \- Validation     |                |
| Activities                     | (Steps IIa and    |                |
|                                | IIb) Summary      |                |
| 5.2.3 Step III: Usability      | Table             |                |
| Assessment                     |                   |                |
|                                | \- Usability      |                |
| 5.2.3.1 Data Limitations and   | Assessment        |                |
| Actions from Usability         |                   |                |
| Assessment                     |                   |                |
|                                |                   |                |
| 5.2.3.2 Activities             |                   |                |
+--------------------------------+-------------------+----------------+
| 5.3 Streamlining Data Review   |                   |                |
|                                |                   |                |
| 5.3.1 Data Review Steps To Be  |                   |                |
| Streamlined                    |                   |                |
|                                |                   |                |
| 5.3.2 Criteria for             |                   |                |
| Streamlining Data Review       |                   |                |
|                                |                   |                |
| 5.3.3 Amounts and Types of     |                   |                |
| Data Appropriate for           |                   |                |
| Streamlining                   |                   |                |
+--------------------------------+-------------------+----------------+

**QAPP Worksheet #3** **Title:**

(UFP-QAPP Manual Section 2.3.1) **Revision Number:**

List those entities to whom copies of the approved **Revision Date:**

QAPP, subsequent QAPP revisions, addenda, and amendments. **Page**
*\_\_\_* **of** *\_\_\_*

**Distribution List**

  -------------- ----------- ------------------ ------------- ---------- ------------- ------------
  **QAPP         **Title**   **Organization**   **Telephone   **Fax      **E-mail      **Document
  Recipients**                                  Number**      Number**   Address**     Control
                                                                                       Number**

                                                                                       

                                                                                       

                                                                                       

                                                                                       

                                                                                       

                                                                                       

                                                                                       

                                                                                       

                                                                                       

                                                                                       
  -------------- ----------- ------------------ ------------- ---------- ------------- ------------

**QAPP Worksheet #4** **Title:**

(UFP-QAPP Manual Section 2.3.2) **Revision Number:**

Have copies of this form signed by key project personnel from each
organization **Revision Date:**

to indicate that they have read the applicable sections of the QAPP and
will **Page \_\_\_ of \_\_\_**

perform the tasks as described. Ask each organization to forward signed
sheets to

the central project file.

**Project Personnel Sign-Off Sheet**

**Organization:**\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

  --------------- ------------ ------------- ---------------- -------------
  **Project       **Title**    **Telephone   **Signature**    **Date QAPP
  Personnel**                  Number**                       Read**

                                                              

                                                              

                                                              

                                                              

                                                              

                                                              

                                                              

                                                              

                                                              

                                                              
  --------------- ------------ ------------- ---------------- -------------

**QAPP Worksheet #5 Title:**

(UFP-QAPP Manual Section 2.4.1) **Revision Number:**

Identify reporting relationships between all organizations **Revision
Date:**

involved in the project, including the lead organization and all
contractor and subcontractor **Page \_\_\_ of \_\_\_**

organizations. Identify the organizations providing field sampling,
on-site and off-site analysis,

and data review services, including the names and telephone numbers of
all project managers,

project team members, and/or project contacts for each organization.

**Project Organizational Chart**

![](media/image4.wmf)

**QAPP Worksheet #6 Title:**

(UFP-QAPP Manual Section 2.4.2) **Revision Number:**

Describe the communication pathways and modes of communication that will
**Revision Date:**

be used during the project, after the QAPP has been approved. Describe
the procedures **Page \_\_\_ of \_\_\_**

for soliciting and/or obtaining approval between project personnel,
between different

contractors, and between samplers and laboratory staff. Describe the
procedure that

will be followed when any project activity originally documented in an
approved QAPP

requires real-time modification to achieve project goals or a QAPP
amendment is required.

Describe the procedures for stopping work and identify who is
responsible.

**Communication Pathways**

  -------------------- ---------------- ---------- ---------- ------------------
  **Communication      **Responsible    **Name**   **Phone    **Procedure
  Drivers**            Entity**                    Number**   (Timing, Pathways,
                                                              etc.)**

                                                              

                                                              

                                                              

                                                              

                                                              

                                                              

                                                              

                                                              
  -------------------- ---------------- ---------- ---------- ------------------

**QAPP Worksheet #7 Title:**

(UFP-QAPP Manual Section 2.4.3) **Revision Number:**

Identify project personnel associated with each organization,
contractor, **Revision Date:**

and subcontractor participating in responsible roles. Include data
users, **Page \_\_\_ of \_\_\_**

decision-makers, project managers, QA officers, project contacts for

organizations involved in the project, project health and safety
officers,

geotechnical engineers and hydrogeologists, field operation personnel,

analytical services, and data reviewers. Identify project team members

with an asterisk (\*). Attach resumes to this worksheet or note the
location

of the resumes.

**Personnel Responsibilities and Qualifications Table**

  -------------- -------------- ------------------ ---------------------- ------------------
  **Name**       **Title**      **Organizational   **Responsibilities**   **Education and
                                Affiliation**                             Experience
                                                                          Qualifications**

                                                                          

                                                                          

                                                                          

                                                                          

                                                                          

                                                                          

                                                                          

                                                                          
  -------------- -------------- ------------------ ---------------------- ------------------

**QAPP Worksheet #8 Title:**

(UFP-QAPP Manual Section 2.4.4) **Revision Number:**

Provide the following information for those projects requiring personnel
**Revision Date:**

with specialized training. Attach training records and/or certificates
to **Page \_\_\_ of \_\_\_**

the QAPP or note their location.

**Special Personnel Training Requirements Table**

+-------+-----------+--------+------+---------+-------+-------------+
| **Pr  | **Sp      | **Tr   | **   | **Pe    | *     | **Location  |
| oject | ecialized | aining | Trai | rsonnel | *Pers | of Training |
| Funct | Training  | Prov   | ning | /Groups | onnel | Rec         |
| ion** | --**      | ider** | Da   | Re      | Ti    | ords/Certif |
|       |           |        | te** | ceiving | tles/ | icates^1^** |
|       | **Title   |        |      | Tra     | Orga  |             |
|       | or        |        |      | ining** | nizat |             |
|       | De        |        |      |         | ional |             |
|       | scription |        |      |         | Aff   |             |
|       | of        |        |      |         | iliat |             |
|       | Course**  |        |      |         | ion** |             |
+-------+-----------+--------+------+---------+-------+-------------+
|       |           |        |      |         |       |             |
+-------+-----------+--------+------+---------+-------+-------------+
|       |           |        |      |         |       |             |
+-------+-----------+--------+------+---------+-------+-------------+
|       |           |        |      |         |       |             |
+-------+-----------+--------+------+---------+-------+-------------+
|       |           |        |      |         |       |             |
+-------+-----------+--------+------+---------+-------+-------------+
|       |           |        |      |         |       |             |
+-------+-----------+--------+------+---------+-------+-------------+

^1^If training records and/or certificates are on file elsewhere,
document their location in this column. If training records and/or
certificates do not exist or are not available, then this should be
noted.

**QAPP Worksheet #9 Title:**

(UFP-QAPP Manual Section 2.5.1) **Revision Number:**

Complete this worksheet for each project scoping session held.
**Revision Date:**

Identify project team members who are responsible for planning **Page
\_\_\_ of \_\_\_**

the project.

### Project Scoping Session Participants Sheet

+-------------+-----------+-----------+---+----------+---------+---------+
| **Project   |           |           | * |          |         |         |
| Name\_\_\_\ |           |           | * |          |         |         |
| _\_\_\_\_\_ |           |           | S |          |         |         |
| \_\_\_\_\_\ |           |           | i |          |         |         |
| _\_\_\_\_** |           |           | t |          |         |         |
|             |           |           | e |          |         |         |
| **Projected |           |           | N |          |         |         |
| Date(s) of  |           |           | a |          |         |         |
| Sam         |           |           | m |          |         |         |
| pling\_\_\_ |           |           | e |          |         |         |
| \_\_\_\_\_\ |           |           | \ |          |         |         |
| _\_\_\_\_\_ |           |           | _ |          |         |         |
| \_\_\_\_\_\ |           |           | \ |          |         |         |
| _\_\_\_\_** |           |           | _ |          |         |         |
|             |           |           | \ |          |         |         |
| **Project   |           |           | _ |          |         |         |
| Ma          |           |           | \ |          |         |         |
| nager\_\_\_ |           |           | _ |          |         |         |
| \_\_\_\_\_\ |           |           | \ |          |         |         |
| _\_\_\_\_\_ |           |           | _ |          |         |         |
| \_\_\_\_\_\ |           |           | \ |          |         |         |
| _\_\_\_\_\_ |           |           | _ |          |         |         |
| \_\_\_\_\_\ |           |           | \ |          |         |         |
| _\_\_\_\_** |           |           | _ |          |         |         |
|             |           |           | \ |          |         |         |
|             |           |           | _ |          |         |         |
|             |           |           | \ |          |         |         |
|             |           |           | _ |          |         |         |
|             |           |           | \ |          |         |         |
|             |           |           | _ |          |         |         |
|             |           |           | \ |          |         |         |
|             |           |           | _ |          |         |         |
|             |           |           | \ |          |         |         |
|             |           |           | _ |          |         |         |
|             |           |           | \ |          |         |         |
|             |           |           | _ |          |         |         |
|             |           |           | \ |          |         |         |
|             |           |           | _ |          |         |         |
|             |           |           | \ |          |         |         |
|             |           |           | _ |          |         |         |
|             |           |           | \ |          |         |         |
|             |           |           | _ |          |         |         |
|             |           |           | \ |          |         |         |
|             |           |           | _ |          |         |         |
|             |           |           | \ |          |         |         |
|             |           |           | _ |          |         |         |
|             |           |           | \ |          |         |         |
|             |           |           | _ |          |         |         |
|             |           |           | \ |          |         |         |
|             |           |           | _ |          |         |         |
|             |           |           | \ |          |         |         |
|             |           |           | _ |          |         |         |
|             |           |           | \ |          |         |         |
|             |           |           | _ |          |         |         |
|             |           |           | \ |          |         |         |
|             |           |           | _ |          |         |         |
|             |           |           | \ |          |         |         |
|             |           |           | _ |          |         |         |
|             |           |           | \ |          |         |         |
|             |           |           | _ |          |         |         |
|             |           |           | \ |          |         |         |
|             |           |           | _ |          |         |         |
|             |           |           | \ |          |         |         |
|             |           |           | _ |          |         |         |
|             |           |           | \ |          |         |         |
|             |           |           | _ |          |         |         |
|             |           |           | \ |          |         |         |
|             |           |           | _ |          |         |         |
|             |           |           | \ |          |         |         |
|             |           |           | _ |          |         |         |
|             |           |           | \ |          |         |         |
|             |           |           | _ |          |         |         |
|             |           |           | \ |          |         |         |
|             |           |           | _ |          |         |         |
|             |           |           | \ |          |         |         |
|             |           |           | _ |          |         |         |
|             |           |           | \ |          |         |         |
|             |           |           | _ |          |         |         |
|             |           |           | * |          |         |         |
|             |           |           | * |          |         |         |
|             |           |           |   |          |         |         |
|             |           |           | * |          |         |         |
|             |           |           | * |          |         |         |
|             |           |           | S |          |         |         |
|             |           |           | i |          |         |         |
|             |           |           | t |          |         |         |
|             |           |           | e |          |         |         |
|             |           |           | L |          |         |         |
|             |           |           | o |          |         |         |
|             |           |           | c |          |         |         |
|             |           |           | a |          |         |         |
|             |           |           | t |          |         |         |
|             |           |           | i |          |         |         |
|             |           |           | o |          |         |         |
|             |           |           | n |          |         |         |
|             |           |           | \ |          |         |         |
|             |           |           | _ |          |         |         |
|             |           |           | \ |          |         |         |
|             |           |           | _ |          |         |         |
|             |           |           | \ |          |         |         |
|             |           |           | _ |          |         |         |
|             |           |           | \ |          |         |         |
|             |           |           | _ |          |         |         |
|             |           |           | \ |          |         |         |
|             |           |           | _ |          |         |         |
|             |           |           | \ |          |         |         |
|             |           |           | _ |          |         |         |
|             |           |           | \ |          |         |         |
|             |           |           | _ |          |         |         |
|             |           |           | \ |          |         |         |
|             |           |           | _ |          |         |         |
|             |           |           | \ |          |         |         |
|             |           |           | _ |          |         |         |
|             |           |           | \ |          |         |         |
|             |           |           | _ |          |         |         |
|             |           |           | \ |          |         |         |
|             |           |           | _ |          |         |         |
|             |           |           | \ |          |         |         |
|             |           |           | _ |          |         |         |
|             |           |           | \ |          |         |         |
|             |           |           | _ |          |         |         |
|             |           |           | \ |          |         |         |
|             |           |           | _ |          |         |         |
|             |           |           | \ |          |         |         |
|             |           |           | _ |          |         |         |
|             |           |           | \ |          |         |         |
|             |           |           | _ |          |         |         |
|             |           |           | \ |          |         |         |
|             |           |           | _ |          |         |         |
|             |           |           | \ |          |         |         |
|             |           |           | _ |          |         |         |
|             |           |           | \ |          |         |         |
|             |           |           | _ |          |         |         |
|             |           |           | \ |          |         |         |
|             |           |           | _ |          |         |         |
|             |           |           | \ |          |         |         |
|             |           |           | _ |          |         |         |
|             |           |           | \ |          |         |         |
|             |           |           | _ |          |         |         |
|             |           |           | \ |          |         |         |
|             |           |           | _ |          |         |         |
|             |           |           | \ |          |         |         |
|             |           |           | _ |          |         |         |
|             |           |           | \ |          |         |         |
|             |           |           | _ |          |         |         |
|             |           |           | \ |          |         |         |
|             |           |           | _ |          |         |         |
|             |           |           | \ |          |         |         |
|             |           |           | _ |          |         |         |
|             |           |           | \ |          |         |         |
|             |           |           | _ |          |         |         |
|             |           |           | \ |          |         |         |
|             |           |           | _ |          |         |         |
|             |           |           | \ |          |         |         |
|             |           |           | _ |          |         |         |
|             |           |           | \ |          |         |         |
|             |           |           | _ |          |         |         |
|             |           |           | * |          |         |         |
|             |           |           | * |          |         |         |
+-------------+-----------+-----------+---+----------+---------+---------+
| **Date of   |           |           |   |          |         |         |
| Session:**  |           |           |   |          |         |         |
|             |           |           |   |          |         |         |
| **Scoping   |           |           |   |          |         |         |
| Session     |           |           |   |          |         |         |
| Purpose:**  |           |           |   |          |         |         |
+-------------+-----------+-----------+---+----------+---------+---------+
| **Name**    | **Title** | **Affi    |   | **Phone  | *       | **      |
|             |           | liation** |   | \#**     | *E-mail | Project |
|             |           |           |   |          | Ad      | Role**  |
|             |           |           |   |          | dress** |         |
+-------------+-----------+-----------+---+----------+---------+---------+
|             |           |           |   |          |         |         |
+-------------+-----------+-----------+---+----------+---------+---------+
|             |           |           |   |          |         |         |
+-------------+-----------+-----------+---+----------+---------+---------+
|             |           |           |   |          |         |         |
+-------------+-----------+-----------+---+----------+---------+---------+
|             |           |           |   |          |         |         |
+-------------+-----------+-----------+---+----------+---------+---------+
|             |           |           |   |          |         |         |
+-------------+-----------+-----------+---+----------+---------+---------+
|             |           |           |   |          |         |         |
+-------------+-----------+-----------+---+----------+---------+---------+
|             |           |           |   |          |         |         |
+-------------+-----------+-----------+---+----------+---------+---------+
|             |           |           |   |          |         |         |
+-------------+-----------+-----------+---+----------+---------+---------+
|             |           |           |   |          |         |         |
+-------------+-----------+-----------+---+----------+---------+---------+
|             |           |           |   |          |         |         |
+-------------+-----------+-----------+---+----------+---------+---------+

Comments/Decisions:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Action Items:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Consensus Decisions:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

**QAPP Worksheet #10 Title:**

(UFP-QAPP Manual Section 2.5.2) **Revision Number:**

Clearly define the problem and the environmental questions that should
**Revision Date:**

be answered for the current investigation and develop the project **Page
\_\_\_ of \_\_\_**

decision "If\..., then\..." statements in the QAPP, linking data results
with

possible actions. The prompts below are meant to help the project team

define the problem. They are not comprehensive.

**Problem Definition**

+-----------------------------------------------------------------------+
| **The problem to be addressed by the project:**                       |
|                                                                       |
| **The environmental questions being asked:**                          |
|                                                                       |
| **Observations from any site reconnaissance reports:**                |
|                                                                       |
| **A synopsis of secondary data or information from site reports:**    |
|                                                                       |
| **The possible classes of contaminants and the affected matrices:**   |
|                                                                       |
| **The rationale for inclusion of chemical and nonchemical analyses:** |
|                                                                       |
| **Information concerning various environmental indicators:**          |
|                                                                       |
| **Project decision conditions ("If\..., then\..." statements):**      |
+-----------------------------------------------------------------------+

**QAPP Worksheet #11 Title:**

(UFP-QAPP Manual Section 2.6.1) **Revision Number:**

Use this worksheet to develop project quality objectives (PQOs) in terms
of type, quantity, and **Revision Date:**

quality of data determined using a systematic planning process. Provide
a detailed discussion **Page \_\_\_ of \_\_\_**

of PQOs in the QAPP. List the PQOs in the form of qualitative and
quantitative statements.

These statements should answer questions such as those listed below.
These questions are

examples only, however; they are neither inclusive nor appropriate for
all projects.

**Project Quality Objectives/Systematic Planning Process Statements**

+-----------------------------------------------------------------------+
| **Who will use the data?**                                            |
|                                                                       |
| **What will the data be used for?**                                   |
|                                                                       |
| **What type of data are needed? (target analytes, analytical groups,  |
| field screening, on-site analytical or off-site laboratory            |
| techniques, sampling techniques)**                                    |
|                                                                       |
| **How "good" do the data need to be in order to support the           |
| environmental decision?**                                             |
|                                                                       |
| **How much data are needed? (number of samples for each analytical    |
| group, matrix, and concentration)**                                   |
|                                                                       |
| **Where, when, and how should the data be collected/generated?**      |
|                                                                       |
| **Who will collect and generate the data?**                           |
|                                                                       |
| **How will the data be reported?**                                    |
|                                                                       |
| **How will the data be archived?**                                    |
+-----------------------------------------------------------------------+

**QAPP Worksheet #12 Title:**

(UFP-QAPP Manual Section 2.6.2) **Revision Number:**

Complete this worksheet for each matrix, analytical group, and
concentration level. **Revision Date:**

Identify the data quality indicators (DQIs), measurement performance
criteria (MPC), **Page \_\_\_ of \_\_\_**

and QC sample and/or activity used to assess the measurement performance
for both the

sampling and analytical measurement systems. Use additional worksheets

if necessary. If MPC for a specific DQI vary within an analytical
parameter, i.e., MPC

are analyte-specific, then provide analyte-specific MPC on an additional
worksheet.

**Measurement Performance Criteria Table**

  ----------------- ----------------- ------------ --------------- --------------- --------------
  **Matrix**                                                                       

  **Analytical                                                                     
  Group^1^**                                                                       

  **Concentration                                                                  
  Level**                                                                          

  **Sampling        **Analytical      **Data       **Measurement   **QC Sample     **QC Sample
  Procedure^2^**    Method/SOP^3^**   Quality      Performance     and/or Activity Assesses Error
                                      Indicators   Criteria**      Used to Assess  for Sampling
                                      (DQIs)**                     Measurement     (S),
                                                                   Performance**   Analytical (A)
                                                                                   or both
                                                                                   (S&A)**

                                                                                   

                                                                                   

                                                                                   

                                                                                   

                                                                                   

                                                                                   
  ----------------- ----------------- ------------ --------------- --------------- --------------

^1^If information varies within an analytical group, separate by
individual analyte.

^2^Reference number from QAPP Worksheet #21 (see Section 3.1.2).

^3^Reference number from QAPP Worksheet #23 (see Section 3.2).

**QAPP Worksheet #13** **Title:**

(UFP-QAPP Manual Section 2.7) **Revision Number:**

Identify all secondary data and information that will be used for
**Revision Date:**

the project and their originating sources. Specify how the secondary
data **Page \_\_\_ of \_\_\_**

will be used and the limitations on their use.

**Secondary Data Criteria and Limitations Table**

+------------+--------------+--------------+------------+-------------+
| *          | **Data       | **Data       | **How Data | **          |
| *Secondary | Source**     | Ge           | Will Be    | Limitations |
| Data**     |              | nerator(s)** | Used**     | on Data     |
|            | **           |              |            | Use**       |
|            | (Originating | **           |            |             |
|            | O            | (Originating |            |             |
|            | rganization, | Org., Data   |            |             |
|            | Report       | Types, Data  |            |             |
|            | Title, and   | Generatio    |            |             |
|            | Date)**      | n/Collection |            |             |
|            |              | Dates)**     |            |             |
+------------+--------------+--------------+------------+-------------+
|            |              |              |            |             |
+------------+--------------+--------------+------------+-------------+
|            |              |              |            |             |
+------------+--------------+--------------+------------+-------------+
|            |              |              |            |             |
+------------+--------------+--------------+------------+-------------+
|            |              |              |            |             |
+------------+--------------+--------------+------------+-------------+
|            |              |              |            |             |
+------------+--------------+--------------+------------+-------------+
|            |              |              |            |             |
+------------+--------------+--------------+------------+-------------+

**QAPP Worksheet #14** **Title:**

(UFP-QAPP Manual Section 2.8.1) **Revision Number:**

Provide a brief overview of the listed project activities. **Revision
Date:**

**Page \_\_\_ of \_\_\_**

**Summary of Project Tasks**

**QAPP Worksheet #15** **Title:**

(UFP-QAPP Manual Section 2.8.1) **Revision Number:**

Complete this worksheet for each matrix, analytical group, and
concentration **Revision Date:**

level. Identify the target analytes/contaminants of concern and
project-required **Page \_\_\_ of \_\_\_**

action limits. Next, determine the quantitation limits (QLs) that must
be met to

achieve the project quality objectives. Finally, list the published and
achievable

detection and quantitation limits for each analyte.

**Reference Limits and Evaluation Table**

Matrix:

Analytical Group:

Concentration Level:

+---------+-------+--------+--------+--------+--------+--------+--------+
| **An    | **CAS | **P    | P      | **Anal |        | ####   |        |
| alyte** | Num   | roject | roject | ytical |        |  Achie |        |
|         | ber** | Action | Quanti | Metho  |        | vable  |        |
|         |       | L      | tation | d^1^** |        | Labora |        |
|         |       | imit** | Limit  |        |        | tory L |        |
|         |       |        |        |        |        | imits2 |        |
|         |       | *      | *      |        |        |        |        |
|         |       | *(appl | *(appl |        |        |        |        |
|         |       | icable | icable |        |        |        |        |
|         |       | un     | un     |        |        |        |        |
|         |       | its)** | its)** |        |        |        |        |
+---------+-------+--------+--------+--------+--------+--------+--------+
|         |       |        |        | ###    | ###    | ###    | ##     |
|         |       |        |        | # MDLs | # Meth | # MDLs | ## QLs |
|         |       |        |        |        | od QLs |        |        |
+---------+-------+--------+--------+--------+--------+--------+--------+
|         |       |        |        |        |        |        |        |
+---------+-------+--------+--------+--------+--------+--------+--------+
|         |       |        |        |        |        |        |        |
+---------+-------+--------+--------+--------+--------+--------+--------+
|         |       |        |        |        |        |        |        |
+---------+-------+--------+--------+--------+--------+--------+--------+
|         |       |        |        |        |        |        |        |
+---------+-------+--------+--------+--------+--------+--------+--------+
|         |       |        |        |        |        |        |        |
+---------+-------+--------+--------+--------+--------+--------+--------+
|         |       |        |        |        |        |        |        |
+---------+-------+--------+--------+--------+--------+--------+--------+
|         |       |        |        |        |        |        |        |
+---------+-------+--------+--------+--------+--------+--------+--------+

^1^Analytical MDLs and QLs are those documented in validated methods.

^2^Achievable MDLs and QLs are limits that an individual laboratory can
achieve when performing a specific analytical method.

**QAPP Worksheet #16 Title:**

(UFP-QAPP Manual Section 2.8.2) **Revision Number:**

List all project activities as well as the QA assessments that will be
**Revision Date:**

performed during the course of the project. Include the anticipated
start and **Page \_\_\_ of \_\_\_**

completion dates.

**Project Schedule/Timeline Table**

+-----------+-----------+-----------+-----------+-----------+-----------+
| **Act     | **Organ   | **Dates   |           | **Deli    | **De      |
| ivities** | ization** | (MM       |           | verable** | liverable |
|           |           | /DD/YY)** |           |           | Due       |
|           |           |           |           |           | Date**    |
+-----------+-----------+-----------+-----------+-----------+-----------+
|           |           | **An      | **An      |           |           |
|           |           | ticipated | ticipated |           |           |
|           |           | Date(s)** | Date of   |           |           |
|           |           |           | Com       |           |           |
|           |           | **of      | pletion** |           |           |
|           |           | Ini       |           |           |           |
|           |           | tiation** |           |           |           |
+-----------+-----------+-----------+-----------+-----------+-----------+
|           |           |           |           |           |           |
+-----------+-----------+-----------+-----------+-----------+-----------+
|           |           |           |           |           |           |
+-----------+-----------+-----------+-----------+-----------+-----------+
|           |           |           |           |           |           |
+-----------+-----------+-----------+-----------+-----------+-----------+
|           |           |           |           |           |           |
+-----------+-----------+-----------+-----------+-----------+-----------+
|           |           |           |           |           |           |
+-----------+-----------+-----------+-----------+-----------+-----------+
|           |           |           |           |           |           |
+-----------+-----------+-----------+-----------+-----------+-----------+
|           |           |           |           |           |           |
+-----------+-----------+-----------+-----------+-----------+-----------+
|           |           |           |           |           |           |
+-----------+-----------+-----------+-----------+-----------+-----------+
|           |           |           |           |           |           |
+-----------+-----------+-----------+-----------+-----------+-----------+
|           |           |           |           |           |           |
+-----------+-----------+-----------+-----------+-----------+-----------+

**QAPP Worksheet #17 Title:**

(UFP-QAPP Manual Section 3.1.1) **Revision Number:**

Describe the project sampling approach. Provide the rationale **Revision
Date:**

for selecting sample locations and matrices for each **Page \_\_\_ of
\_\_\_**

analytical group and concentration level.

**Sampling Design and Rationale**

+-----------------------------------------------------------------------+
| **Describe and provide a rationale for choosing the sampling approach |
| (e.g., grid system, biased statistical approach):**                   |
|                                                                       |
| Describe the sampling design and rationale in terms of what matrices  |
| will be sampled, what analytical groups will be analyzed and at what  |
| concentration levels, the sampling locations (including QC, critical, |
| and background samples), the number of samples to be taken, and the   |
| sampling frequency (including seasonal considerations) \[May refer to |
| map or Worksheet #18 for details\]:                                   |
+-----------------------------------------------------------------------+

**QAPP Worksheet #18 Title:**

(UFP-QAPP Manual Section 3.1.1) **Revision Number:**

List all site locations that will be sampled and include sample ID
number, **Revision Date:**

If available. (Provide a range of sampling locations or ID numbers if a
site **Page \_\_\_ of \_\_\_**

has a large number.) Specify matrix and, if applicable, depth at which
samples

will be taken. Only a short reference for the sampling location
rationale is necessary

for the table. The text of the QAPP should clearly identify the detailed
rationale

associated with each reference. Complete all required information, using
additional

worksheets if necessary.

##### Sampling Locations and Methods/SOP Requirements Table

+--------+--------+--------+--------+--------+--------+--------+--------+
| **Sa   | **Ma   | **D    | **Anal | **C    | **     | **Sa   | **Rat  |
| mpling | trix** | epth** | ytical | oncent | Number | mpling | ionale |
| Locat  |        |        | G      | ration | of     | SOP    | for    |
| ion/ID |        | **(un  | roup** | L      | S      | Re     | Sa     |
| Nu     |        | its)** |        | evel** | amples | ferenc | mpling |
| mber** |        |        |        |        | (id    | e^1^** | Loca   |
|        |        |        |        |        | entify |        | tion** |
|        |        |        |        |        | field  |        |        |
|        |        |        |        |        | d      |        |        |
|        |        |        |        |        | uplica |        |        |
|        |        |        |        |        | tes)** |        |        |
+--------+--------+--------+--------+--------+--------+--------+--------+
|        |        |        |        |        |        |        |        |
+--------+--------+--------+--------+--------+--------+--------+--------+
|        |        |        |        |        |        |        |        |
+--------+--------+--------+--------+--------+--------+--------+--------+
|        |        |        |        |        |        |        |        |
+--------+--------+--------+--------+--------+--------+--------+--------+
|        |        |        |        |        |        |        |        |
+--------+--------+--------+--------+--------+--------+--------+--------+
|        |        |        |        |        |        |        |        |
+--------+--------+--------+--------+--------+--------+--------+--------+
|        |        |        |        |        |        |        |        |
+--------+--------+--------+--------+--------+--------+--------+--------+
|        |        |        |        |        |        |        |        |
+--------+--------+--------+--------+--------+--------+--------+--------+
|        |        |        |        |        |        |        |        |
+--------+--------+--------+--------+--------+--------+--------+--------+
|        |        |        |        |        |        |        |        |
+--------+--------+--------+--------+--------+--------+--------+--------+
|        |        |        |        |        |        |        |        |
+--------+--------+--------+--------+--------+--------+--------+--------+
|        |        |        |        |        |        |        |        |
+--------+--------+--------+--------+--------+--------+--------+--------+

^1^Specify the appropriate letter or number from the Project Sampling
SOP References table (Worksheet #21).

**QAPP Worksheet #19** **Title:**

(UFP-QAPP Manual Section 3.1.1) **Revision Number:**

For each matrix, analytical group, and concentration level, list the
analytical **Revision Date:**

and preparation method/SOP and associated sample volume, container
**Page \_\_\_ of \_\_\_**

specifications, preservation requirements, and maximum holding time.

**Analytical SOP Requirements Table**

+--------+--------+--------+--------+--------+--------+--------+--------+
| **Ma   | **Anal | **C    | **Anal | **     | **Cont | **     | **M    |
| trix** | ytical | oncent | ytical | Sample | ainers | Preser | aximum |
|        | G      | ration | and    | Vo     | (n     | vation | H      |
|        | roup** | L      | Prepa  | lume** | umber, | Requir | olding |
|        |        | evel** | ration |        | size,  | ements | Time   |
|        |        |        | Meth   |        | and    | (che   | (pr    |
|        |        |        | od/SOP |        | t      | mical, | eparat |
|        |        |        | Re     |        | ype)** | temper | ion/** |
|        |        |        | ferenc |        |        | ature, |        |
|        |        |        | e^1^** |        |        | light  | *      |
|        |        |        |        |        |        | protec | *analy |
|        |        |        |        |        |        | ted)** | sis)** |
+--------+--------+--------+--------+--------+--------+--------+--------+
|        |        |        |        |        |        |        |        |
+--------+--------+--------+--------+--------+--------+--------+--------+
|        |        |        |        |        |        |        |        |
+--------+--------+--------+--------+--------+--------+--------+--------+
|        |        |        |        |        |        |        |        |
+--------+--------+--------+--------+--------+--------+--------+--------+
|        |        |        |        |        |        |        |        |
+--------+--------+--------+--------+--------+--------+--------+--------+
|        |        |        |        |        |        |        |        |
+--------+--------+--------+--------+--------+--------+--------+--------+
|        |        |        |        |        |        |        |        |
+--------+--------+--------+--------+--------+--------+--------+--------+
|        |        |        |        |        |        |        |        |
+--------+--------+--------+--------+--------+--------+--------+--------+
|        |        |        |        |        |        |        |        |
+--------+--------+--------+--------+--------+--------+--------+--------+
|        |        |        |        |        |        |        |        |
+--------+--------+--------+--------+--------+--------+--------+--------+
|        |        |        |        |        |        |        |        |
+--------+--------+--------+--------+--------+--------+--------+--------+

^1^Specify the appropriate reference letter or number from the
Analytical SOP References table (Worksheet #23).

**QAPP Worksheet #20 Title:**

(UFP-QAPP Manual Section 3.1.1) **Revision Number:**

Summarize by matrix, analytical group, and concentration level
**Revision Date:**

the number of field QC samples that will be collected and sent to **Page
\_\_\_ of \_\_\_**

the laboratory.

**Field Quality Control Sample Summary Table**

<table>
<colgroup>
<col style="width: 7%" />
<col style="width: 8%" />
<col style="width: 10%" />
<col style="width: 10%" />
<col style="width: 8%" />
<col style="width: 8%" />
<col style="width: 7%" />
<col style="width: 8%" />
<col style="width: 8%" />
<col style="width: 8%" />
<col style="width: 10%" />
</colgroup>
<tbody>
<tr class="odd">
<td rowspan="2"><strong>Matrix</strong></td>
<td rowspan="2"><strong>Analytical Group</strong></td>
<td rowspan="2"><strong>Concentration Level</strong></td>
<td rowspan="2"><strong>Analytical and Preparation SOP
Reference<sup>1</sup></strong></td>
<td rowspan="2"><strong>No. of Sampling
Locations<sup>2</sup></strong></td>
<td rowspan="2"><strong>No. of Field Duplicate Pairs</strong></td>
<td><h2 id="inorganic">Inorganic</h2></td>
<td rowspan="2"><strong>No. of Field Blanks</strong></td>
<td rowspan="2"><strong>No. of Equip. Blanks</strong></td>
<td rowspan="2"><strong>No. of PT Samples</strong></td>
<td rowspan="2"><h2 id="total-no.-of-samples-to-lab">Total No. of
Samples to Lab</h2></td>
</tr>
<tr class="even">
<td><strong>No. of MS</strong></td>
</tr>
<tr class="odd">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
</tbody>
</table>

^1^Specify the appropriate reference letter or number from the
Analytical SOP References table (Worksheet #23).

^2^If samples will be collected at different depths at the same
location, count each discrete sampling depth as a separate sampling
location or station.

**QAPP Worksheet #21 Title:**

(UFP-QAPP Manual Section 3.1.2) **Revision Number:**

List all SOPs associated with project sampling including, but not
limited to, **Revision Date:**

sample collection, sample preservation, equipment cleaning and
decontamination, **Page \_\_\_ of \_\_\_**

equipment testing, inspection and maintenance, supply inspection and
acceptance, and

sample handling and custody. Include copies of the SOPs as attachments
or reference all

in the QAPP. Sequentially number sampling SOP references in the
Reference Number column.

The reference number can be used throughout the QAPP to refer to a
specific SOP.

### Project Sampling SOP References Table

+-----+---------------------+------------+--------+--------+---------+
| **  | **Title, Revision   | **O        | **Equ  | **Mo   | **Com   |
| Ref | Date and/or         | riginating | ipment | dified | ments** |
| ere | Number**            | Orga       | Type** | for**  |         |
| nce |                     | nization** |        |        |         |
| Nu  |                     |            |        | **P    |         |
| mbe |                     |            |        | roject |         |
| r** |                     |            |        | W      |         |
|     |                     |            |        | ork?** |         |
|     |                     |            |        |        |         |
|     |                     |            |        | **(    |         |
|     |                     |            |        | Y/N)** |         |
+-----+---------------------+------------+--------+--------+---------+
|     |                     |            |        |        |         |
+-----+---------------------+------------+--------+--------+---------+
|     |                     |            |        |        |         |
+-----+---------------------+------------+--------+--------+---------+
|     |                     |            |        |        |         |
+-----+---------------------+------------+--------+--------+---------+
|     |                     |            |        |        |         |
+-----+---------------------+------------+--------+--------+---------+
|     |                     |            |        |        |         |
+-----+---------------------+------------+--------+--------+---------+
|     |                     |            |        |        |         |
+-----+---------------------+------------+--------+--------+---------+
|     |                     |            |        |        |         |
+-----+---------------------+------------+--------+--------+---------+

**QAPP Worksheet #22 Title:**

(UFP-QAPP Manual Section 3.1.2.4) **Revision Number:**

Identify all field equipment and instruments (other than analytical
instrumentation) **Revision Date:**

that require calibration, maintenance, testing, or inspection and
provide the SOP **Page \_\_\_ of \_\_\_**

reference number for each type of equipment. In addition, document the
frequency

of activity, acceptance criteria, and corrective action requirements on
the worksheet.

**Field Equipment Calibration, Maintenance, Testing, and Inspection
Table**

  ------------- --------------- --------------- ------------ -------------- --------------- -------------- -------------- --------------- ----------------
  **Field       **Calibration   **Maintenance   **Testing    **Inspection   **Frequency**   **Acceptance   **Corrective   **Responsible   **SOP
  Equipment**   Activity**      Activity**      Activity**   Activity**                     Criteria**     Action**       Person**        Reference^1^**

                                                                                                                                          

                                                                                                                                          

                                                                                                                                          

                                                                                                                                          

                                                                                                                                          

                                                                                                                                          

                                                                                                                                          

                                                                                                                                          

                                                                                                                                          

                                                                                                                                          

                                                                                                                                          
  ------------- --------------- --------------- ------------ -------------- --------------- -------------- -------------- --------------- ----------------

^1^Specify the appropriate reference letter or number from the Project
Sampling SOP References table (Worksheet #21).

**QAPP Worksheet #23** **Title:**

(UFP-QAPP Manual Section 3.2.1) **Revision Number:**

List all SOPs that will be used to perform on-site or off-site analysis.
Indicate **Revision Date:**

whether the procedure produces screening or definitive data.
Sequentially number **Page \_\_\_ of \_\_\_**

analytical SOP references in the Reference Number column. Include copies
of the

SOPs as attachments or reference in the QAPP. The reference number can
be used

throughout the QAPP to refer to a specific SOP.

**Analytical SOP References Table**

+------+---------+---------+---------+---------+---------+---------+
| **R  | *       | **Def   | **Ana   | **Instr | **Organ | **M     |
| efer | *Title, | initive | lytical | ument** | ization | odified |
| ence | R       | or      | Group** |         | Per     | for     |
| Numb | evision | Sc      |         |         | forming | Project |
| er** | Date,   | reening |         |         | Ana     | Work?** |
|      | and/or  | Data**  |         |         | lysis** |         |
|      | N       |         |         |         |         | **      |
|      | umber** |         |         |         |         | (Y/N)** |
+------+---------+---------+---------+---------+---------+---------+
|      |         |         |         |         |         |         |
+------+---------+---------+---------+---------+---------+---------+
|      |         |         |         |         |         |         |
+------+---------+---------+---------+---------+---------+---------+
|      |         |         |         |         |         |         |
+------+---------+---------+---------+---------+---------+---------+
|      |         |         |         |         |         |         |
+------+---------+---------+---------+---------+---------+---------+
|      |         |         |         |         |         |         |
+------+---------+---------+---------+---------+---------+---------+
|      |         |         |         |         |         |         |
+------+---------+---------+---------+---------+---------+---------+

**QAPP Worksheet #24 Title:**

(UFP-QAPP Manual Section 3.2.2) **Revision Number:**

Identify all analytical instrumentation that requires calibration and
provide **Revision Date:**

the SOP reference number for each. In addition, document the frequency,
**Page \_\_\_ of \_\_\_**

acceptance criteria, and corrective action requirements on the
worksheet.

### Analytical Instrument Calibration Table

  ---------------- --------------- --------------- -------------- -------------- ------------- ----------------
  **Instrument**   **Calibration   **Frequency of  **Acceptance   **Corrective   **Person      **SOP
                   Procedure**     Calibration**   Criteria**     Action (CA)**  Responsible   Reference^1^**
                                                                                 for CA**      

                                                                                               

                                                                                               

                                                                                               

                                                                                               

                                                                                               

                                                                                               
  ---------------- --------------- --------------- -------------- -------------- ------------- ----------------

^1^Specify the appropriate reference letter or number from the
Analytical SOP References table (Worksheet #23).

**QAPP Worksheet #25 Title:**

(UFP-QAPP Manual Section 3.2.3) **Revision Number:**

Identify all analytical instrumentation that requires maintenance,
testing, or inspection **Revision Date:**

and provide the SOP reference number for each. In addition, document the
**Page \_\_\_ of \_\_\_**

frequency, acceptance criteria, and corrective action requirements on
the worksheet.

### Analytical Instrument and Equipment Maintenance, Testing, and Inspection Table

  --------------- --------------- ------------ -------------- --------------- -------------- -------------- --------------- ----------------
  **Instrument/   **Maintenance   **Testing    **Inspection   **Frequency**   **Acceptance   **Corrective   **Responsible   **SOP
  Equipment**     Activity**      Activity**   Activity**                     Criteria**     Action**       Person**        Reference^1^**

                                                                                                                            

                                                                                                                            

                                                                                                                            

                                                                                                                            

                                                                                                                            
  --------------- --------------- ------------ -------------- --------------- -------------- -------------- --------------- ----------------

^1^Specify the appropriate reference letter or number from the
Analytical SOP References table (Worksheet #23).

**QAPP Worksheet #26 Title:**

(UFP-QAPP Manual Appendix A) **Revision Number:**

Use this worksheet to identify components of the project-specific sample
handling system. **Revision Date:**

Record personnel, and their organizational affiliations, who are
primarily responsible for **Page \_\_\_ of \_\_\_**

ensuring proper handling, custody, and storage of field samples from the
time of collection,

to laboratory delivery, to final sample disposal. Indicate the number of
days field samples

and their extracts/digestates will be archived prior to disposal.

**Sample Handling System**

  -----------------------------------------------------------------------
  **SAMPLE COLLECTION, PACKAGING, AND SHIPMENT**

  Sample Collection (Personnel/Organization):

  Sample Packaging (Personnel/Organization):

  Coordination of Shipment (Personnel/Organization):

  Type of Shipment/Carrier:

  **SAMPLE RECEIPT AND ANALYSIS**

  Sample Receipt (Personnel/Organization):

  Sample Custody and Storage (Personnel/Organization):

  Sample Preparation (Personnel/Organization):

  Sample Determinative Analysis (Personnel/Organization):

  **SAMPLE ARCHIVING**

  Field Sample Storage (No. of days from sample collection):

  Sample Extract/Digestate Storage (No. of days from
  extraction/digestion):

  Biological Sample Storage (No. of days from sample collection):

  **SAMPLE DISPOSAL**

  Personnel/Organization:

  Number of Days from Analysis
  -----------------------------------------------------------------------

**QAPP Worksheet #27** **Title:**

(UFP-QAPP Manual Section 3.3.3) **Revision Number:**

Describe the procedures that will be used to maintain sample custody and
**Revision Date:**

integrity. Include examples of chain-of-custody forms, traffic reports,
sample **Page \_\_\_ of \_\_\_**

identification, custody seals, laboratory sample receipt forms, and
laboratory

sample transfer forms. Attach or reference applicable SOPs.

**Sample Custody Requirements**

+-----------------------------------------------------------------------+
| **Field Sample Custody Procedures (sample collection, packaging,      |
| shipment, and delivery to laboratory):**                              |
|                                                                       |
| Laboratory Sample Custody Procedures (receipt of samples, archiving,  |
| disposal):                                                            |
|                                                                       |
| **Sample Identification Procedures:**                                 |
|                                                                       |
| **Chain-of-custody Procedures:**                                      |
+-----------------------------------------------------------------------+

**QAPP Worksheet #28** **Title:**

(UFP-QAPP Manual Section 3.4) **Revision Number:**

Complete a separate worksheet for each sampling technique, analytical
method/SOP, **Revision Date:**

matrix, analytical group, and concentration level. If method/SOP QC
acceptance **Page \_\_\_ of \_\_\_**

limits exceed the measurement performance criteria, the data obtained
may be

unusable for making project decisions.

**QC Samples Table**

  --------------- ---------------------- -------------- -------- -------------- ------- ------------- -------- ----------- -------- --------------- -----------
  Matrix                                                                                                                                            

  Analytical                                                                                                                                        
  Group                                                                                                                                             

  Concentration                                                                                                                                     
  Level                                                                                                                                             

  Sampling SOP                                                                                                                                      

  Analytical                                                                                                                                        
  Method/ SOP                                                                                                                                       
  Reference                                                                                                                                         

  Sampler's Name                                                                                                                                    

  Field Sampling                                                                                                                                    
  Organization                                                                                                                                      

  Analytical                                                                                                                                        
  Organization                                                                                                                                      

  No. of Sample                                                                                                                                     
  Locations                                                                                                                                         

  **QC Sample:**  **Frequency/Number**   **Method/SOP            **Corrective           **Person(s)            **Data               **Measurement   
                                         QC Acceptance           Action**               Responsible            Quality              Performance     
                                         Limits**                                       for                    Indicator            Criteria**      
                                                                                        Corrective             (DQI)**                              
                                                                                        Action**                                                    

                                                                                                                                                    

                                                                                                                                                    

                                                                                                                                                    

                                                                                                                                                    

                                                                                                                                                    

                                                                                                                                                    
  --------------- ---------------------- -------------- -------- -------------- ------- ------------- -------- ----------- -------- --------------- -----------

**QAPP Worksheet #29** **Title:**

(UFP-QAPP Manual Section 3.5.1) **Revision Number:**

Identify the documents and records that will be generated for all
aspects of the **Revision Date:**

project including, but not limited to, sample collection and field
measurement, **Page \_\_\_ of \_\_\_**

on-site and off-site analysis, and data assessment.

**Project Documents and Records Table**

  -------------- -------------- -------------- -------------- --------------
  **Sample       **On-site      **Off-site     **Data         **Other**
  Collection     Analysis       Analysis       Assessment     
  Documents and  Documents and  Documents and  Documents and  
  Records**      Records**      Records**      Records**      

                                                              

                                                              

                                                              

                                                              

                                                              

                                                              

                                                              

                                                              

                                                              

                                                              

                                                              

                                                              

                                                              
  -------------- -------------- -------------- -------------- --------------

**QAPP Worksheet #30 Title:**

(UFP-QAPP Manual Section 3.5.2.3) **Revision Number:**

Identify all laboratories or organizations that will provide analytical
services **Revision Date:**

for the project, including on-site screening, on-site definitive, and
off-site **Page \_\_\_ of \_\_\_**

laboratory analytical work. Group by matrix, analytical group,
concentration,

and sample location or ID number. If applicable, identify the
subcontractor

laboratories and backup laboratory or organization that will be used if
the

primary laboratory or organization cannot be used.

**Analytical Services Table**

+------+------+------+-------+-------+-------+-----------+-----------+
| **   | **An | **C  | **S   | **    | *     | **Laborat | **Backup  |
| Matr | alyt | once | ample | Analy | *Data | ory/Organ | Laborat   |
| ix** | ical | ntra | Lo    | tical | Pa    | ization** | ory/Organ |
|      | Gro  | tion | catio | SOP** | ckage |           | ization** |
|      | up** | Lev  | ns/ID |       | Turna | **(Name   |           |
|      |      | el** | Numb  |       | round | and       | **(Name   |
|      |      |      | ers** |       | T     | Address,  | and       |
|      |      |      |       |       | ime** | Contact   | Address,  |
|      |      |      |       |       |       | Person    | Contact   |
|      |      |      |       |       |       | and       | Person    |
|      |      |      |       |       |       | Telephone | and       |
|      |      |      |       |       |       | Number)** | Telephone |
|      |      |      |       |       |       |           | Number)** |
+------+------+------+-------+-------+-------+-----------+-----------+
|      |      |      |       |       |       |           |           |
+------+------+------+-------+-------+-------+-----------+-----------+
|      |      |      |       |       |       |           |           |
+------+------+------+-------+-------+-------+-----------+-----------+
|      |      |      |       |       |       |           |           |
+------+------+------+-------+-------+-------+-----------+-----------+
|      |      |      |       |       |       |           |           |
+------+------+------+-------+-------+-------+-----------+-----------+
|      |      |      |       |       |       |           |           |
+------+------+------+-------+-------+-------+-----------+-----------+
|      |      |      |       |       |       |           |           |
+------+------+------+-------+-------+-------+-----------+-----------+
|      |      |      |       |       |       |           |           |
+------+------+------+-------+-------+-------+-----------+-----------+
|      |      |      |       |       |       |           |           |
+------+------+------+-------+-------+-------+-----------+-----------+
|      |      |      |       |       |       |           |           |
+------+------+------+-------+-------+-------+-----------+-----------+
|      |      |      |       |       |       |           |           |
+------+------+------+-------+-------+-------+-----------+-----------+

**QAPP Worksheet #31 Title:**

(UFP-QAPP Manual Section 4.1.1) **Revision Number:**

Identify the type, frequency, and responsible parties of **Revision
Date:**

planned assessment activities that will be performed for the project.
**Page \_\_\_ of \_\_\_**

**Planned Project Assessments Table**

  -------------- --------------- ------------ ---------------- ---------------- ---------------- ---------------- ----------------
  **Assessment   **Frequency**   **Internal   **Organization   **Person(s)      **Person(s)      **Person(s)      **Person(s)
  Type**                         or           Performing       Responsible for  Responsible for  Responsible for  Responsible for
                                 External**   Assessment**     Performing       Responding to    Identifying and  Monitoring
                                                               Assessment       Assessment       Implementing     Effectiveness of
                                                               (Title and       Findings (Title  Corrective       CA (Title and
                                                               Organizational   and              Actions (CA)     Organizational
                                                               Affiliation)**   Organizational   (Title and       Affiliation)**
                                                                                Affiliation)**   Organizational   
                                                                                                 Affiliation)**   

                                                                                                                  

                                                                                                                  

                                                                                                                  

                                                                                                                  

                                                                                                                  
  -------------- --------------- ------------ ---------------- ---------------- ---------------- ---------------- ----------------

**QAPP Worksheet #32** **Title:**

(UFP-QAPP Manual Section 4.1.2) **Revision Number:**

For each type of assessment describe procedures for handling **Revision
Date:**

QAPP and project deviations encountered during the planned **Page \_\_\_
of \_\_\_**

project assessments.

**Assessment Findings and Corrective Action Responses**

  -------------- ----------------- ----------------- ---------------- ----------------- ----------------- -------------
  **Assessment   **Nature of       **Individual(s)   **Timeframe of   **Nature of**     **Individual(s)   **Timeframe
  Type**         Deficiencies      Notified of       Notification**   **Corrective      Receiving         for
                 Documentation**   Findings (Name,                    Action Response   Corrective Action Response**
                                   Title,                             Documentation**   Response (Name,   
                                   Organization)**                                      Title, Org.)**    

                                                                                                          

                                                                                                          

                                                                                                          

                                                                                                          

                                                                                                          

                                                                                                          

                                                                                                          

                                                                                                          
  -------------- ----------------- ----------------- ---------------- ----------------- ----------------- -------------

**QAPP Worksheet #33 Title:**

(UFP QAPP Manual Section 4.2) **Revision Number:**

Identify the frequency and type of planned QA Management **Revision
Date:**

Reports, the project delivery dates, the personnel responsible **Page
\_\_\_ of \_\_\_**

for report preparation, and the report recipients.

**QA Management Reports Table**

+-------------+-------------+-------------+-------------+-------------+
| **Type of   | **Frequency | **Projected | **Person(s) | **Report    |
| Report**    | (daily,     | Delivery    | Responsible | R           |
|             | weekly      | Date(s)**   | for Report  | ecipient(s) |
|             | monthly,    |             | Preparation | (Title**    |
|             | quarterly,  |             | (Title and  |             |
|             | annually,   |             | Org         | **and       |
|             | etc.)**     |             | anizational | Org         |
|             |             |             | Aff         | anizational |
|             |             |             | iliation)** | Aff         |
|             |             |             |             | iliation)** |
+-------------+-------------+-------------+-------------+-------------+
|             |             |             |             |             |
+-------------+-------------+-------------+-------------+-------------+
|             |             |             |             |             |
+-------------+-------------+-------------+-------------+-------------+
|             |             |             |             |             |
+-------------+-------------+-------------+-------------+-------------+
|             |             |             |             |             |
+-------------+-------------+-------------+-------------+-------------+
|             |             |             |             |             |
+-------------+-------------+-------------+-------------+-------------+
|             |             |             |             |             |
+-------------+-------------+-------------+-------------+-------------+
|             |             |             |             |             |
+-------------+-------------+-------------+-------------+-------------+
|             |             |             |             |             |
+-------------+-------------+-------------+-------------+-------------+

**QAPP Worksheet #34 Title:**

(UFP-QAPP Manual Section 5.2.1) **Revision Number:**

Describe the processes that will be followed to verify project data.
**Revision Date:**

Manual (Section 5.1). Describe how each item will be verified, when
**Page \_\_\_ of \_\_\_**

the activity will occur, and what documentation is necessary, and
identify

the person responsible. *Internal* or *external* is in relation to the
data generator.

**Verification (Step I) Process Table**

  ---------------- --------------------------------- ------------- -----------------
  **Verification   **Description**                   **Internal/   **Responsible for
  Input**                                            External**    Verification
                                                                   (Name,
                                                                   Organization)**

                                                                   

                                                                   

                                                                   

                                                                   

                                                                   
  ---------------- --------------------------------- ------------- -----------------

**QAPP Worksheet #35 Title:**

(UFP-QAPP Manual Section 5.2.2) **Revision Number:**

Describe the processes that will be followed to validate project data.
**Revision Date:**

Validation inputs include items such as those listed in Table 9 **Page
\_\_\_ of \_\_\_**

of the UFP-QAPP Manual (Section 5.1). Describe how each item will be

validated, when the activity will occur, and what documentation is
necessary and

identify the person responsible. Differentiate between steps IIa and IIb
of validation.

**Validation (Steps IIa and IIb) Process Table**

  ----------- -------------- ---------------------------------- -----------------
  **Step      **Validation   **Description**                    **Responsible for
  IIa/IIb**   Input**                                           Validation (Name,
                                                                Organization)**

                                                                

                                                                

                                                                

                                                                

                                                                
  ----------- -------------- ---------------------------------- -----------------

**QAPP Worksheet #36 Title:**

(UFP-QAPP Manual Section 5.2.2) **Revision Number:**

Identify the matrices, analytical groups, and concentration levels that
each **Revision Date:**

entity performing validation will be responsible for, as well as
criteria **Page \_\_\_ of \_\_\_**

that will be used to validate those data.

**Validation (Steps IIa and IIb) Summary Table**

  ----------- ------------ -------------- ----------------- -------------- ----------------
  **Step      **Matrix**   **Analytical   **Concentration   **Validation   **Data Validator
  IIa/IIb**                Group**        Level**           Criteria**     (title and
                                                                           organizational
                                                                           affiliation)**

                                                                           

                                                                           

                                                                           

                                                                           

                                                                           

                                                                           
  ----------- ------------ -------------- ----------------- -------------- ----------------

**QAPP Worksheet #37 Title:**

(UFP-QAPP Manual Section 5.2.3) **Revision Number:**

Describe the procedures/methods/activities that will be used to
**Revision Date:**

determine whether data are of the right type, quality, and quantity
**Page \_\_\_ of \_\_\_**

to support environmental decision-making for the project. Describe

how data quality issues will be addressed and how limitations on the

use of the data will be handled.

**Usability Assessment**

+-----------------------------------------------------------------------+
| **Summarize the usability assessment process and all procedures,      |
| including interim steps and any statistics, equations, and computer   |
| algorithms that will be used:**                                       |
|                                                                       |
| **Describe the evaluative procedures used to assess overall           |
| measurement error associated with the project:**                      |
|                                                                       |
| **Identify the personnel responsible for performing the usability     |
| assessment:**                                                         |
|                                                                       |
| **Describe the documentation that will be generated during usability  |
| assessment and how usability assessment results will be presented**   |
|                                                                       |
| **so that they identify trends, relationships (correlations), and     |
| anomalies:**                                                          |
+-----------------------------------------------------------------------+