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Instrument Data Form
Instrument Data Form
Instrument Data Form
MODIFICATION
Exact Replacement
Approved Functional Equivalent
DELETION
Change of Parameter
Relocated/Transferred
Decommissioned
Cannot Locate
Instrument Location
10.
Department:
(Items below are for general information for portable instruments):
11.
12.
13.
Building:
Floor & Area:
Specific Location/Room:
And
Or
calibration test points:
%FS
%Reading
Total Test Points
17. Output Signal Range (as applicable): Range: ______________________ Units of Measure: _____________
Units
Monthly
Schedule:
Quarterly
Semi-annual
Annual
Feb
Mar
Aug
Sep
Jan
Jul
Apr
Oct
May
Nov
Jun
Dec
(For Instruments classified as GMP Critical, the limit of calibration error allowed before quality is potentially compromised. Not applicable for
devices to be calibrated as a loop or test/laboratory instruments used for different functions.)
Component B:
Component C:
Component D:
Component E:
Component F:
Attach Instrument Data Forms for all components and Loop Data Form for Loop Calibrations
Section 4:
Comments and Characteristics: (Identify any special characteristics, e.g. non-linearity, special hysteresis or temperature
Originator (Signature):
Name (printed):
Date:
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YES
NO
Note: Instruments classified as GMP Utility may not require a calibration SOP or Calibration Sheet. If the instrument is classified as
GMP Utility, a Preventive Maintenance Task may used to check the instrument if it is not to be calibrated. Verify that a Preventive
Maintenance Task has been developed for the GMP Utility functionally checked instrument within the CCMS or CMMS.
30. Preventive Maintenance Task established for GMP Utility instrument:
YES
NO
If NO, explain the reason in Section 32, Explanations and General Comments, below.
31. Identify any exceptions to calibration program requirements: (Examples: Less than full range calibration, Non-standard calibration
frequency, lack of repeatability challenges, etc.)
Minimum Three Point
Calibration?
YES
NO
YES
NO
32. Explanations and General Comments:
YES
NO
YES
NO
YES
Name (printed):
Date:
Name (printed):
Date:
Name (printed):
Date:
NO
By (Calibration/Metrology Signature):
Only Calibration/Metrology Group approval is required for Exact Replacements and increasing the frequency of calibration.
End User Department (Signature):
Name (printed):
Date:
Name (printed):
Date:
Name (printed):
Date Entered:
Name (printed):
Date Entered:
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