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<br />DALE 11. SPEEDY <br />Professional Welding Consultant <br /> <br />Wt!Jn QlUllifitll,;.nl do Cn'ifltll';." . MII'nill" Tlst;"l <br />InJu.tri41InJp<<lill,. . lk'trufl;W tf N.,,-D~J"ul't;W uJlint <br /> <br />Type of Welder <br />Name <br />Welding Procedure Speci . ation No. <br /> <br />WELDER, WELDING OPERATOR OR TACK WELDER QUALIFICATION TEST RECORD <br />.s ~ -/1", 7?:> <br /> <br /> <br />Identification No. S'7 S/. ~. ~o? / <br />Date ~ / 90 <br /> <br />Record Actual Values <br />Used in Qualification <br /> <br />Qualification Range <br /> <br />Variables <br />Process/Type (5.16.2) <br />Electrode (single or multiple) <br />CurrenVPolarity <br /> <br /> <br /> <br />Position (5.16.5) <br />Weld Progression (5.16.7) <br /> <br />Backing (YES or NO) (5.16.18) <br />Material/Spec. (5.16.1) <br />Base Metal <br />Thickness: (Plate) <br />Groove <br />Fillet <br />Thickness: (Pipe/tube) <br />Groove <br />Fillet <br />Diameter: (Pipe) <br />Groove <br />Fillet <br />Filler Me'tal (5.16.3) <br />Spec. No. <br />Class <br />F-No. <br />Gas/Flux Type (5.16.4) <br />Other <br /> <br />/G <br /> <br />F.?xT <br /> <br />v<- <br /> <br /> <br />J:: <br /> <br /> <br />II <br />0- S?~ <br />:A <br /> <br />LI <br /> <br />r- t;>; /~ 6n"~ <br />f 7.>" i!... t:.:.n~<<-.'J <br /> <br />Type <br /> <br />~ <br /> <br />VISUAL INSPECTION (5.12.6 or 5.12.7) <br />Acceptable YES or NO~ <br /> <br />Guided Bend Test Results (5.26.1/5.29.1) <br />Result I Type <br /> <br />~~::r;t .. <br /> <br />Result <br /> <br />Flllel Test Results (5.26.2/5.28.3; 5.39.3/5.39.4) <br /> <br />Appearance ~ Fillet Size <br />Fracture Test Root Penetration A Macroetch <br />(Describe the location, nature, and size of any crack or tearing of the specimen.) <br /> <br />Inspected by ~~(I ~t1'dLA <br />Organization J4~<. C~I "-Jot. X'-~"""'o<.:tO? I <br /> <br />Test Number t3 ",-::tI- J <br />Date .:< . ~- O.e <br /> <br />Film <br />Identification <br />Number <br /> <br />Results <br /> <br />RADIOGRAPHIC TEST RESULTS (5.26.4/5.39.2) <br />Film <br />Remarks Identification Results <br />Number <br /> <br />Remarks <br /> <br />~.,.c;I <br />A/A <br />~ <br />A./A <br /> <br />Test Number <br />Date <br /> <br />Interpreted by <br />Organization <br /> <br />We, the undersigned, certify that the statements in this record are correct and that the test welds ~repared, welded, <br />and tested in accordance with the requirements of Section 5, ~a.rt..c.PIB of ANSI! AWS 01.1, ( <;(') Structural <br />Welding Code-Steel TAMPA AMALGAMi\1 t. year <br /> <br />Manufacturer o~ctor ~~ORPORATION <br />Authorized By -- ~ C J <br />Date / I <br />-z. IS-/OD <br />