LABORATORY TESTING CAPABILITIES SURVEY

Prescribed by: DLA Troop Support Clothing &
Textiles Additional Quality Assurance Requirements
Sponsor: TA-DA

1. LABORATORY NAME

2. LABORATORY CONTACT (AREA CODE AND PHONE NO.)

3. PHYSICAL ADDRESS

4. ADMINISTRATIVE ORGANIZATION OF LABORATORY

5. NAME(S) AND TITLE(S) OF LABORATORY TESTING OFFICAL(S)

6. NUMBER AND CLASSIFICATION OF PERSONNEL INVOLVED IN TESTING

6a. PROFESSIONAL

6b. NON-PROFESSIONAL

CLASSIFICATION NUMBER CLASSIFICATION NUMBER
Chemists Technicians
Engineers Other:
Biologists
Textile Technologists
Other:
7. BASIC NATURE OF BUSINESS:
O Manufacture 1 Process O sell Di Test LT Research
8. TYPES OF ITEMS TESTED BY YOUR LABORATORY
9. NATURE OF TESTING CAPABILITIES 10. TYPE OF LABORATORY.
1 Chemical Physical 1 Biological 1 Company Laboratory 1 Independent Laboratory
C Colorfastness (1 Electrical [1 Academic or Non-Commercial Laboratory

1 Other: (specify)

(J Sales Service Laboratory
J Other: (specify)

11. RESPONSIBILITY FOR SAMPLING
1 Laboratory Personnel (J Factory Personnel

CJ Other (specify)

5 Quality Control Personnel (J Custom Personnel

12. WILL YOU PERMIT INSPECTION OF YOUR LABORATORY ON TWO (2) DAYS NOTICE?

ClYes [No

13. DO YOU MAINTAIN AN AREA FOR TESTING UNDER CONTROLLED STANDARD ATMOSPHERIC CONDITIONS?

ClYes [J No

13a. IF YES, NAME OR DESCRIBE THE FOLLOWING COMPONENTS OF THE SYSTEM

HUMIDIFIER

HEATER

AIR COOLER

TEMPERATURE REGULATOR

DLA FORM 6005, NOV 2018

REPLACES DSCP FORM 4083, WHICH IS OBSOLETE

PDF (DLA)


LABORATORY TESTING CAPABILITIES SURVEY

Prescribed by: DLA Troop Support Clothing &
Textiles Additional Quality Assurance Requirements
Sponsor: TA-DA

HUMIDITY REGULATOR

OTHER

13b. NAME OR DESCRIBE DEVICES USED TO MEASURE AND RECORD TEMPERATURE AND RELATIVE HUMIDITY

13c. WHAT TEMPERATURE AND RELATIVE HUMIDITY IS MAINTAINED (GIVE UPPER AND LOWER LIMIT)

13d. WHAT ARE THE APPROXIMATE DIMENSIONS OF THE CONDITIONED AREA

14, DOES THE ABOVE SYSTEM MAINTAIN THE SPECIFIC ATMOSPHERIC CONDITIONS CONSISTENTLY AND UNIFORMLY THROUGHOUT
THE AREA? IF YES, DESCRIBE HOW THIS WAS DETERMINED

17. LIST YOUR IMPORTANT TESTING DEVICES AS FOLLOWS (INCLUDE BASIC CHEMICAL EQUIPMENT AND LAUNDRY FACILITIES)

NAME AND MODEL OF APPROXIMATE | CALIBRATION INTERVAL | DATE OF LATEST
TESTING DEVICE PURPOSE OR FUNCTION AGE (YR/MONTHLY) CALIBRATION
DLA FORM 6005, NOV 2018 REPLACES DSCP FORM 4083, WHICH IS OBSOLETE PDF (DLA)


LABORATORY TESTING CAPABILITIES SURVEY

Prescribed by: DLA Troop Support Clothing &
Textiles Additional Quality Assurance Requirements
Sponsor: TA-DA

15. WHAT LABORATORIES, IF ANY, PERFORM TESTING FOR YOU? INDICATE LABORATORY(S), TEST(S), AND REASON(S)

16. OTHER RELEVENT INFORMATION

PLEASE RETAIN THE ENCLOSED DLA SUPPORT CLOTHING AND TEXTILES ADDITIONAL QUALITY ASSURANCE REQUIREMENTS FOR

REFERENCE ON TESTING POLICIES, PROCEDURES, REQUIREMENTS AND FORMS

*LCERTIFY THAT THE FOREGOING INFORMATION IS TRUE AND CORRECT.

PRINTED FULL NAME SIGNATURE,

DATE (MM/DD/YYYY)

* FALSE CERTIFICATIONS ARE COVERED BY A STATUTORY PROVISION REGARDING FALSE STATEMENTS, USC TITLE 18, SECTION 1001.
WHICH PROVIDES A FINE OF NOT MORE THAN $10,000 OR IMPRISONMENT OF NOT MORE THAN FIVE (5) YEARS, OR BOTH.

DLA FORM 6005, NOV 2018 REPLACES DSCP FORM 4083, WHICH IS OBSOLETE PDF (DLA)