CHECK SAMPLE RESULTS FOR PAST 12 MONTHS
Fill out one sheet for each parameter being requested
for accreditation
Company _________________________
Check Sample Program _____________ Lab. No. ________
Parameter for Comparsion ______________(ex. Available Phosphate)
Month/Yr ---------------Your Results ------------Avg./Program
---------%Difference
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Committe Only
No. Within Acceptable Limits _______
Pass or Fail
Reviewer/s __________________________________________________________