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GENERAL
Initial examinati1onisgh fgr23equired, with or uwithout corrective lenses, to prove (1) near vision acuity of Snellen
English or equivalent Jaefg3egr J-14 at 2 inches; (2) far vision acuity of 20/40 or better and (3) color perception test for
red/green and blue1/yellfo4w d2ifferenti4altion.
For annlual re-certificationh, the examination is re2quired to prove near vision acuity or Snellen English or equivalent
Jaeger J-1 at 12 ignches.
This certificationf will be valid onl2yl if signed by one of the following:
Optometrist
Medical doctor
Registered nurse
Assistant
ASNT/SNT-TC-1a Level III
ANSI N45.2.6 Level III
Certified Physician's
Date of
eye test
Candidate
Signature:
(2)
(3)
Red/Green Differentiation
(b)
Blue/Yellow Differentiation
Comments:
Professional Address:
44545656
Medical Doctor
ASNT/SNT-TC-1a Level III
Registered Nurse
ANSI N45.2.6 Level III
Telephone Number: