NABL 151NABL NATIONAL ACCREDITATION BOARD FOR TESTING AND CALIBRATION LABORATORIES APPLICATION FORM for TESTING LABORATORIES ISSUE NO : 12 ISSUE DATE: 27.06.2012 AMENDMENT NO : 04 AMENDMENT DATE: 03.09.2015 2013 Change in fee/ GB Decision assessment charges structure 4 3-5/11 4.09.03.2012 Reasons Signature QO Signature Director Internal audit findings Quality manager shall APLAC finding have 4 days training Laboratory operating shifts shall identify the staff working in shift 3 3-5/11 4.09.06.AMENDMENT SHEET Sl no 1 2 Page No.2012 Laboratory locations 16.1 9/11 3.0 23.05.0 28. 13 7/11 1.2015 Change in fee/ GB Decision assessment charges structure 5 3 4 03.10.08.2015 Page No: 6/6 .4.2015 Change in fee/ GB Decision assessment charges structure 6 7 8 9 10 CONTENTS Sl. No: NABL 151 Issue No: 12 Application Form for Testing Laboratories Issue Date: 27. No Title Page 1 Information & Instructions for completing an Application Form 3 2 Application Form 5 National Accreditation Board for Testing and Calibration Laboratories Doc.04.1 Date of Amendment Amendment made 22.2012 Amend No: 04 Amend Date: -. 6/11 Clause No. Applicant laboratories are advised to ensure that the latest versions of NABL documents are available with them. The applicant laboratory shall intimate NABL about any change in the information provided in this application such as scope applied for accreditation. NABL 216 ‘Procedures for Dealing with Adverse Decisions’ and NABL 131 ‘Terms and Conditions for Obtaining and Maintaining Accreditation’ before filling up this form. etc. the laboratory shall take corrective action and inform NABL. additional requirements of NABL and the regulatory authorities.03. In case the space provided is insufficient. The applicant laboratory shall be given due notice of any intended changes relating to NABL accreditation criteria and will also be given such time.06. 10. The application shall consist of the following: Three copies of completed application form Two copies of laboratory Quality Manual Prescribed application fees Copy of NABL-131 duly signed. other validated methods are acceptable.) 7. location etc. 3. NABL 100 is available on NABL website. 8. NABL expects applicant laboratories that are to be accredited to follow the test methods as mentioned in the current National or International standards and as stipulated by regulatory bodies.09. 2. 6. The applicant laboratory shall provide photocopies of appropriate document in support of the legal identity claimed (eg. within 15 days from the date of changes. The application fee and other necessary charges related to accreditation process is given in NABL document NABL 100 ‘General Information Brochure’ under NABL Finance and NABL Fee Structure’. as applicable at all times.Information & Instructions for completing an Application Form 1. Registration Certificate under Companies Act. 5. please use additional pages clearly indicating to which section they relate to. 4. The satisfactory performance shall be defined in term of z score. 9. The laboratory shall also inform NABL in advance about any reservation with valid reason regarding appointment of Lead Assessor/ Assessor for the assessment. as in the opinion of NABL is reasonable to carry National Accreditation Board for Testing and Calibration Laboratories Doc. In cases. In case laboratory uses in-house validated methods the validation data should be submitted along with the application. personnel. Laboratories are advised to familiarize themselves with NABL 100 ‘General Information Brochure’. Separate application form shall be submitted for each discipline of testing.2015 Page No: 6/6 . where formal accredited /recognized PT programmes are not available. No: NABL 151 Issue No: 12 Application Form for Testing Laboratories Issue Date: 27. For unsatisfactory performance. The applicant laboratories must participate satisfactorily in the Proficiency Testing program conducted by NABL/ APLAC or any other national or international accredited/ recognized PT provider.2012 Amend No: 04 Amend Date: -. the laboratory will either initiate Inter laboratory comparison or participate in Appropriate ILC programme conducted by accredited /reputed laboratory. approval from local or regulatory bodies. Where such methods do not exist. The applicant laboratory shall undertake to carry out its testing activities in such a way as to meet the requirement of ISO/IEC 17025: 2005. 11. Application shall be made in the prescribed form NABL 151 only. Incomplete application and insufficient number of copies submitted may lead to rejection of application. The minimum stipulated participation is one type of test per discipline prior to grant of accreditation. standard (method) or technique used with year of publication range of testing/ limit of detection for each test (as applicable) uncertainty of measurement (MU) for each test (wherever applicable) at a confidence probability of 95% 13. d. d.out the necessary changes to its policies/practices & procedure(s). undertaking any check to verify testing capability of the laboratory. e.1 of application form.2) shall be complete to indicate unambiguously: a. 12. *** National Accreditation Board for Testing and Calibration Laboratories Doc. assessment visit and grant of accreditation shall be safeguarded and dealt with impartiality. 15. 16. Note: Laboratory operates from different locations in the same city may apply for NABL accreditation as a single laboratory. the laboratory shall unambiguously provide names of all authorized signatories who are responsible for authenticity and issue of test certificates and reports. examination of all relevant documentation and records. b. The laboratory shall inform NABL when such changes have been completed.06. By signing NABL 131 the laboratory agrees to comply at all times with Terms and Conditions of NABL. The laboratory shall take all necessary actions and discharge all non. b. interaction with all relevant personnel. 17.03. e. The details of each location shall be explicitly mentioned in 1.09. No: NABL 151 Issue No: 12 Application Form for Testing Laboratories Issue Date: 27. The laboratory shall offer the NABL or its representative cooperation in: a. The same shall be verified to the satisfaction of NABL. Particularly the scope of accreditation (para 2. c. In events where the laboratory operates from different city/ state. The tests those are performed at site should be clearly identified in the scope of accreditation. 14. The laboratory shall submit NABL 131 duly signed by the Chief Executive or his/her Authorized Representative to NABL Secretariat along with this application form. materials or items tested specific tests or types of tests performed specification. c.2012 Amend No: 04 Amend Date: -.2015 Page No: 6/6 . The application must be filled up carefully to provide required information in such a manner that further correspondence for seeking clarifications are not required. group of products.conformities raised during the assessment within a maximum time of two months. The final decision on accreditation shall rest with NABL. The procedure for processing of application for accreditation is given in NABL 100. The application shall be kept confidential by NABL and information obtained during the processing of application. offering access to relevant areas of the laboratory for witnessing the test being performed. The details of laboratory locations and the tests which the laboratory intends to cover vide NABL accreditation must be listed clearly. each laboratory shall be applied separately for accreditation. 1 Name of the Testing Laboratory MEASUREMATIC INDIA Locations and Address(s) : NO: 9.com Note: refer cl.03.2012 Amend No: 04 Amend Date: -.2. Palayamkottai. the test conducted) a. Maharaja Nagar.Application Form for Laboratory Accreditation We apply for NABL accreditation of our testing laboratory as per details given below: √ First Accreditation Renewal of Accreditation 1. Tirunelveli-627011.09. Laboratory Details 1.3 Name of Parent Organization ________________________________________________________ (if part of an organization) Telephone No. Permanent Facility √ Yes No b. __________________ e-mail ________________ 1. Copy of the certificate shall be enclosed) 330292206810 part-II Dated 24/09/2014 granted by Additional Director of Industries & Commerce(DIC) Tirunelveli-627011 Date of establishment : 09/04/2012 1. 0462-2572500 Fax No:_______E-mail : measurematicindia@gmail. Tirunelveli-627011. and name of authority who granted the registration. NO:9. 14TH Cross street. Telephone No.5 Type of laboratory by service open to others √ partly open to others an in-house activity 1.Maharaja nagar. Site Facility √ Yes No c.4 Legal identity of the laboratory and date of establishment (Please give Registration No. 13 for details on laboratory locations 1.7 Indicate exactly how the name and address of the laboratory are to appear on the certificate (the current bi-lingual system calls for this information) In English : MEASUREMATIC INDIA. Palayamkottai. _____________________ Fax No. Mobile facility Yes √ No Note: for details please refer NABL-130 1.06.6 Other accreditations : NABL ACCREDITAION IN ELECTRO-TECHNICAL CALIBRATION(Both Permanent & Site) Certificate No: C-0921 Valid Until : 13/05/2017 1. Tamil Nadu. 2 Category of Facility(s) applied under the scope of Accreditation (Please clearly indicate in the scope of accreditation. No: NABL 151 Issue No: 12 Application Form for Testing Laboratories Issue Date: 27. Tamil Nadu. para 2.2015 Page No: 6/6 . In Hindi : National Accreditation Board for Testing and Calibration Laboratories Doc. 14TH Cross street. 4 Contact person for NABL: G.2.Panneer selvam-Quality Manager.com 3.2 Scope of Accreditation Sl no Group of products.1 Senior Management (Name. Laboratories performing site testing shall clearly identify the specific tests on product(s)/ material performed at site separately.06.1. materials or items tested Specific tests or types of tests performed Specification.1 Discipline of Testing for which accreditation is sought Biological Mechanical Chemical Non-Destructive Electrical Optical/ Photometry Electronic Radiological Fluid-Flow Thermal Forensic Science √ 2. Accreditation Details 2. No: NABL 151 Issue No: 12 Application Form for Testing Laboratories Issue Date: 27.2015 Page No: 6/6 .1. 2.3 Person responsible for technical operations: K. Mob: 7708012504 3. Organization 3. In case of enhancement of scope.A Note 1.1.09.1. Mob : 9443301908 E-mail : [email protected]. Test methods and standards shall be mentioned along with the year of publication of the standard 4. telephone. Fax.Shanmuga sekar National Accreditation Board for Testing and Calibration Laboratories Doc.Raja-Technical Manager. Mob: 7708012501 3.1 Chief Executive of the laboratory: G. e-mail) 3.2 Person responsible for the management system: S.2012 Amend No: 04 Amend Date: -. it shall be specifically mentioned and clearly identified in the scope of accreditation 3. Measurement uncertainty shall be expressed as expanded uncertainty with 95% confidence level 3. Designation.Shanmuga sekar-Lab Manager. standard Range of testing/ (method) or technique used Limit of detection Measurement Uncertainty ( ) Refer Annexure . E(EEE) 4 Years 1)Labaratory Management & Internel Audit as Testing of Energy meter per ISO/IEC 17025:2005 2)Measurement of Uncertainty 4 Lab Operations S.2012 Amend No: 04 Amend Date: -.Anandha Ram 1 Years & 3 B.M.Nagarajan (Test Engineer) B.1 Authorized signatories for approval of test reports (Please refer relevant specific criteria for qualification and experience details) Sl no Laboratory/ Department/ Section Name & Qualification Experience in Designation of with years related to Signatory Specialization present work Relevant Training Authorized for which specific area of testing Specimen Signature 1)Quality 1 Lab Operations S.06.E(EEE) Months 1)Labaratory Management & Testing of Energy meter Internel Audit as per ISO/IEC 17025:2005 2)Measurement of Uncertainty 5 Lab Operations S.03.E(EEE) 6 years 1)Labaratory Management & Testing of Energy meter Internel Audit as per ISO/IEC 17025:2005 2)Measurement of 3 Uncertainty Lab Operations R.2 Authorized Signatories 3.3.2.2015 Page No: 6/6 .Panneer Selvam (Quality Manager) Management M.Muthuramach andran (Technical Assistant) Diploma (EEE) 1 Years & 11 Months 1)Labaratory Management & Internel Audit as Testing of Energy meter per ISO/IEC 17025:2005 2)Measurement of Uncertainty National Accreditation Board for Testing and Calibration Laboratories Doc.09.Raja (Technical Manager) B. No: NABL 151 Issue No: 12 Application Form for Testing Laboratories Issue Date: 27.E (Applied 5 Years & 9 Electronics) Months System Internal Audit Training Course conducted by LRQA Quality and Testing of Energy meter 2)Labaratory Management & Internel Audit as per ISO/IEC 17025:2005 2 Lab Operations K. Raja Technical Manager Academic and Professional Qualifications* Diploma in Printing Technology Experience related to present work (in years) 4 years Relevant Training 1)Labaratory Management & Internel Audit as per 4 R.3 Organization Chart 3.3.4.Panneer Selvam Quality Manager 3 K.E(EEE) 1 years & 3 Months Diploma in Electrical and Electronics Engineering ISO/IEC 17025:2005 2)Measurement of Uncertainty 1 years & 11 Months Note: Laboratory shall clearly indicate staff responsible for site testing Laboratory operating in shifts shall clearly identify the staff working in shifts * Please clearly indicate the area of specialization + Quality Manager shall have 4 days training course on laboratory management system from a reputed institute National Accreditation Board for Testing and Calibration Laboratories Doc.E(EEE) 6 Years Management & Internel Audit as per B. Indicate in an organization chart the operating departments of the testing laboratory for which accreditation is being sought (Refer Annexure – B) 3.Nagarajan 5 S M Anandha Ram 6 S.2 Indicate how the testing laboratory is related to external organizations or to its own parent organization (where applicable) 3.09.2012 Amend No: 04 Amend Date: -.1.E(Applied Electronics) 5 years & 9 Months B.3.06.E(EEE) 4 Years Test Engineer (Permanent Lab and On site Lab) Technical Assistant (Permanent Lab and On site Lab) 1)Labaratory B.3. No: NABL 151 Issue No: 12 Application Form for Testing Laboratories Issue Date: 27.03.1 Details of staff S l n o Name Designation+ 1 G.4 Employees 3.Muthu Ramachandran Test Engineer (Permanent Lab and On site Lab) ISO/IEC 17025:2005 M.2015 Page No: 6/6 .Shanmuga sekar Lab Manager 2 S. 0 to -0.3 Sr.010A≤1≤120A Power Factor Range : -1. + information should be provided for reference standards only and not for all testing and measuring equipment. In case the equipment is calibrated in-house. INDIA NATIONAL PHYSICAL LABORATORY. no.No :44977 2012 Voltage : 30V to 300V Current : 0.0 lag/lead Frequency: 40Hz to 70Hz Date of Calibration 29.08.2015 Applied Precision Model : PTE 2300E Sr.08.4.5 to +1.010A≤1≤120A Power Factor Range : -1. \ National Accreditation Board for Testing and Calibration Laboratories Doc. INDIA 4.03.5 to +1.2 List of reference materials/ reference standards available + Sl.2017 Due on 29. Equipment and Reference Materials/ Reference standards 4.2012 Amend No: 04 Amend Date: -.02.5 to 0 to +0.02 Reference Meter Due on 17.06.02 Reference Meter 2 Applied Precision PTE/Three Phase Portable Test Equipment Applied Precision PTE/Three Phase Portable Test Equipment Class 0. Name of reference material/ strain/ culture/ standard Source Date of expiry/ Calibration validity 1 MTE/Three Phase Test Bench MTE/Three Phase Portable Reference Standard Class 0.2017 Due on 29.2018 Calibrated by** NATIONAL PHYSICAL LABORATORY.No : 2614070115 Voltage : 5V to 500V Current : 0. same needs to be clearly indicated under this column.2015 Page No: 6/6 .0 to -0.2016 Calibration due on * Due on 17.02.1 List of equipment available Sl no 1 2 Name of equipment Model/ type/ year of make Three Phase Test Bench Standard Class 0. INDIA NATIONAL PHYSICAL LABORATORY.5 to 0 to +0.02 Reference Meter Range and accuracy Date of last calibration MTE Model:PRS 400.02 Reference Meter Three Phase Portable Test Equipment Class 0.0 lag/lead Frequency: 45Hz to 65Hz Date of Calibration 18.09. No: NABL 151 Issue No: 12 Application Form for Testing Laboratories Issue Date: 27.02.2018 Traceability NATIONAL PHYSICAL LABORATORY. INDIA * The laboratory to decide the calibration interval based on ISO 10012 or ILAC-G24 ** Please mention name of calibration agency.08. 1 Whether all requirements of ISO/IEC 17025: 2005 covering all activities of laboratory have been audited at least once in last one year YES/NO 5.06.02.03.1 Date /schedule of last Internal Audit __05.09. Internal Audit and Management Review 5.2016________________________________ National Accreditation Board for Testing and Calibration Laboratories Doc.2016______________________________________ 5.2012 Amend No: 04 Amend Date: -.1. No: NABL 151 Issue No: 12 Application Form for Testing Laboratories Issue Date: 27.2015 Page No: 6/6 .5.2 Date of last Management review ___________12.02. 5 %))______________________ 7. Proficiency Testing Participation in NABL/ APLAC/ any other Inter Laboratory Comparison (for details and requirements please refer to ISO/IEC 17043. pay all costs for pre-assessment. (Information regarding any individual or organization who provided consultancy (if any) for NABL accreditation shall be declared) 8.5 NUCLEUS CONSULTANTS. **NABL will accept at par cheques also. No: NABL 151 Issue No: 12 Application Form for Testing Laboratories Issue Date: 27. Product/ Material Details of Test(s) Date of Testing Nodal Laboratory/ Performance in PT Provider terms of Z (Accreditation Body/ score Country) Corrective Action Taken (if any) (Annexure-C) 7.03. which is enclosed and will abide by them.03. NABL 162 .22000+Tax(14. 8.2015 Page No: 6/6 .3 We agree to comply with accreditation procedures. All payments shall be made in favor of 'NABL' payable at New Delhi.3 DD / Cheque** number ___ DD Number: 003393 dated 07.2 We agree to comply fully with ISO/IEC 17025: 2005 for the accreditation of testing laboratory. Signature of laboratory head/ Laboratory director __________________________________________ Name & Designation ________________________________________________________________ Date & Place ______________________________________________________________________ National Accreditation Board for Testing and Calibration Laboratories Doc. Declaration by the laboratory We declare that 8. no. 8.CHENNAI_ has provided consultancy for preparing towards NABL accreditation.1 Number of groups* applied for accreditation___ONE___________________________________ 7. regional and local regulatory requirements for operating a laboratory. NABL 163) Sl. 8.06.09.6.(Rs.3 We agree to co-operate with the assessment team appointed by NABL for examination of all relevant documents by them and their visits to those parts of the laboratory that are part of the scope of accreditation. Refer relevant specific criteria for more details on groups.4 We satisfy all national. verification visit (if any).25190/.6 All information provided in this application is true.2012 Amend No: 04 Amend Date: -. assessment.2016 ___________________ *information regarding the groups applied for accreditation in each discipline. Application Fees 7.1 We are familiar with the terms and conditions of maintaining accreditation (NABL 131). surveillance and reassessment irrespective of the result. 8.2 Application fees (Rs. 8. 8. Declaration about the Consultant (if any) 15. Range of Testing and MU 8. Signature of Laboratory Head/Director ----------------------------------------------------------------------------------------Name & Designation ____________________________________________________________________ Date & Place __________________________________________________________________________ National Accreditation Board for Testing and Calibration Laboratories Doc.09. No: NABL 151 Issue No: 12 Application Form for Testing Laboratories Issue Date: 27.Check List Sl. Signed copy of NABL 131 (latest issue) Verified the above details and confirmed the availability of all required documents/ details as part of application form. Details of PT/ILC participation 13.03. Three copies of application in each discipline (eg. Details of Senior Management with Designation and Contact Details 9. Copy of Legal Identity (Registration Details of the Laboratory) 7. Application Form . List of staff and proposed Authorized Signatories 10. List of Equipments / Reference Material used with details of Traceability 12. Information / details provided as part of application Availability 1.06.9. Mechanical/Chemical/Electrical etc) 2. Application fees a) Information on total groups applied for accreditation b) Estimated applicable fees as per NABL 100 c) Demand Draft in favour of 'NABL' 6.2012 Amend No: 04 Amend Date: -. Two copies of Quality Manual (latest issue) according to ISO/IEC 17025: 2005 3. Scope of Accreditation with Test Methods. Dates of Internal Audit and Management Review 14.2015 Page No: 6/6 . Organization Chart enclosed 11. 45. Haryana Tel.org .National Accreditation Board for Testing and Calibration Laboratories NABL House Plot No. Sector.nabl-india. Gurgaon – 122002.: +91-124 4679700 Fax: +91-124 4679799 Website: www.44.