MAIN COMPONENT VERIFICATION Objective: x

IQ-01

Assure that all main and auxiliary components of the Purified Water System are as per manufacturer/vendor specifications (Manuals, Spec sheets, P & IDs, etc.)

Procedure: a. Per equipment, collect and document the required information thru physical inspection (tag, engrave, plate, sticker, etc) b. Evaluate findings against specifications References Required: x Note: Vendor/Manufacturer documentation (Manuals, Spec sheets, P & IDs, etc.) does not count as Actual Result reference

Acceptance Criteria: x Actual results match expected results as per manufacturer written specifications

MAIN COMPONENT VERIFICATION

Filter set 1A & 1B SPEC Tag ID Cartridge Manufacturer Cartridge Part No. Housing Manufacturer Housing Part No. Quantity Tag ID Cartridge Manufacturer 1B Cartridge Part No. Housing Manufacturer Housing Part No. Quantity Comments/Observations: EXPECTED RESULT ACTUAL RESULT PASS/FAIL

IQ-01

PERFORMED BY/DATE

1A

Conformance to the acceptance criteria was evaluated and the final determination is as follows: Acceptance Criteria met? (YES/NO) __________ Reviewed by: If NO, refer to Deviation # __________ Date:

MAIN COMPONENT VERIFICATION

Filter set 2A & 2B SPEC Tag ID Cartridge Manufacturer Cartridge Part No. Housing Manufacturer Housing Part No. Quantity Tag ID Cartridge Manufacturer 2B Cartridge Part No. Housing Manufacturer Housing Part No. Quantity Comments/Observations: EXPECTED RESULT ACTUAL RESULT PASS/FAIL

IQ-01

PERFORMED BY/DATE

2A

Conformance to the acceptance criteria was evaluated and the final determination is as follows: Acceptance Criteria met? (YES/NO) __________ Reviewed by: If NO, refer to Deviation # __________ Date:

MAIN COMPONENT VERIFICATION

Filter set 3A & 3B SPEC Tag ID Cartridge Manufacturer Cartridge Part No. Housing Manufacturer Housing Part No. Quantity Tag ID Cartridge Manufacturer 3B Cartridge Part No. Housing Manufacturer Housing Part No. Quantity Comments/Observations: EXPECTED RESULT ACTUAL RESULT PASS/FAIL

IQ-01

PERFORMED BY/DATE

3A

Conformance to the acceptance criteria was evaluated and the final determination is as follows: Acceptance Criteria met? (YES/NO) __________ Reviewed by: If NO, refer to Deviation # __________ Date:

MAIN COMPONENT VERIFICATION

Filter set 4A & 4B SPEC Tag ID Cartridge Manufacturer Cartridge Part No. Housing Manufacturer Housing Part No. Quantity Tag ID Cartridge Manufacturer 4B Cartridge Part No. Housing Manufacturer Housing Part No. Quantity Comments/Observations: EXPECTED RESULT ACTUAL RESULT PASS/FAIL

IQ-01

PERFORMED BY/DATE

4A

Conformance to the acceptance criteria was evaluated and the final determination is as follows: Acceptance Criteria met? (YES/NO) __________ Reviewed by: If NO, refer to Deviation # __________ Date:

MAIN COMPONENT VERIFICATION

Filter set 5A & 5 B SPEC Tag ID Cartridge Manufacturer Cartridge Part No. Housing Manufacturer Housing Part No. Quantity Tag ID Cartridge Manufacturer 5B Cartridge Part No. Housing Manufacturer Housing Part No. Quantity Comments/Observations: EXPECTED RESULT ACTUAL RESULT PASS/FAIL

IQ-01

PERFORMED BY/DATE

5A

Conformance to the acceptance criteria was evaluated and the final determination is as follows: Acceptance Criteria met? (YES/NO) __________ Reviewed by: If NO, refer to Deviation # __________ Date: