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Design & Setup

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Document number
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Revision
A
Effective date
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Owner
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Draft
Report control
Report title / unique ID[Report ID]
Laboratory / address[Lab]
Test location[Location]
Customer / requestor[Customer]
Issue date[Date]
Authorizing person[Name]
Test item / sample
Item IDDescriptionCondition as receivedReceipt / sampling / test date
[ID][Description][Condition][Dates]
Test item / setup photograph
test article / setup
Objective and scope

State what was evaluated, against which requirement, and any exclusions.

Method / equipment
Method / procedureEquipment IDCalibration status / dueExternal provider?
[Method][Equip][Status][No / provider]
Test / environmental conditions
Temperature[Value]
Humidity[Value]
Supply / load / conditioning[Value]
Sampling plan[Reference / N/A]
Results
Requirement / parameterResultUnitUncertainty if relevantConformity / status
[Parameter][Result][Unit][Uncertainty]Pass / Fail / N/A
Result visualization
measured response / trend / comparison
Deviations / customer-supplied information

Identify deviations from method, customer-supplied data and anything affecting validity or interpretation.

Opinions / interpretations, where authorized

Clearly identify any interpretation, engineering judgement or opinion separately from measured results.

Conclusion / statement of conformity
State whether requirements were met and identify the decision rule where a conformity statement is made.
Notice
Report-use statementResults relate only to the items tested / sampled as identified. Apply laboratory reproduction and amendment controls where required.
Authorization
Prepared / reviewed
Date
Authorized for release
Date
Controlled structureISO/IEC 17025 (if accredited)

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