Section IX, ASME Boiler & Pressure Code 2010

Welders Name Welding Process(ess) Date of Test

BASE METALS & JOINT DESIGN Material 1 P No. Material 2 P No. Thickness Joint Design Diameter Group No. Group No.

Identification No. WPS No. PQR No.

Revisi on Date Date

Specification Type and Grade Specification Type and Grade Position Progression

FILLER METALS & ELECTRICAL CHARACTERISTICS Specification No. (SFA) AWS NO. (Classification) F-No. A-No. (Weld Metal) Size of Filler Materials Weld Runs Weld Metal Thickness Process/es Current Polarity Amperes Volts GAS Shielding Gas Flux Type TEST RESULTS Visual Radiographic Magnetic Particle Penetrant Ultrasonic Macro Tensile Bend Fracture RANGE OF QUALIFICATION Materials Thickness Filler Metals Joint Types Process/es Diameter Positions

We certify that the statements in this record are correct and that the test welds were prepared, welded, and tested in accordance with the requirements of Section IX of the ASME Boiler and Pressure Vessel Code. DATE SIGNATURE WITNESSED BY FOR MANUFACTURER