Work Package o !"i#ting D$% &odiication Form 'o. (I)-*+* W.Q.C. -No. ,,,,,,,,, WELDER QUALIFICATION CERTIFICATE Date- ,,,,,,,,,,,, WELDER NAME : STAMP : DATE OF BIRTH : NATIONALITY : HAS BEEN QUALIFIED USING WPS NO : ________________ REV. _______________ PROCESS: TYPE : VARIABLES ACTUAL VALUES USED IN QUAL. QUALIFICATION RANGE BACKING - BASE METAL (P-NO) - PLATE OR PIPE (En!" #$%&!!" $' ($(!) GROOVE - FILLET - WELD THIC)NESS - GROOVE - FILLET - FILLER METAL - SPEC * CLASS - F-NO FILLER METAL VARIETY (GTAW) CONSUMABLE INSERT (GTAW) POSITION - WELDING PROGRESSION - BAC)ING GAS - GMAW TRANSFER MODE - CURRENT * POLARITY - GUIDED BEND TEST RESULTS - TYPE RESULTS TYPE RESULTS RADIOGRAPHIC TEST RESULTS - _______________________________ RADIGRAPHY REPORT NO :.____________________________ FILLET WELD TEST RESULTS FRACTURE TEST ____________________ LENGTH * PERCENT DEFECTS ___________________________________ MACROTEST FUSION + FILLET LEG SI,E: ___________________________________ APPEARANCE - TEST CONDUCTED BY : ____________________________________________________ CERTIF. No : ________________________ WE CERTIFY THE STATEMENTS IN THIS RECORD ARE CORRECT AND THAT THE TEST WELDS WERE PREPARED- WELDED AND TESTED IN ACCORDANCE WITH THE REQUIREMENTS OF ASME SECT. I. WELDING INSPECTOR QA/QC COMPANY Date %ignature Date %ignature Date %ignature