ANNEXE ‘AWS 01.1:2000 WELDER, WELDING OPERATOR, OR TACK WELDER QUALIFICATION TEST RECORD ‘Type of Welder Name Identification No, Welding Procedure Specification No. Rev Date - ~ Fiacord Actual Values a Used in Qualification (Qualifcation Range Variables Process/Type [Table 4.10, item (1)) Electrode (single or multiple) [Table 4.10, lem (8)] CurrenvPotarty Position [Table 4.10, item (4)] Weld Progression [Table 4.10, tem (6)] Backing (YES or NO) [Table 4.10, tem (7) Materia Spec. io Base Metal Thickness: (Plate) Groove Flot Thickness: (Pipe/tube) Groove Fillet Diameter: (Pipe) Groove Fillat Filler Metal [Table 4.10, tom (3)] Spec. No. Class F-No. [Table 4.10, Item (2) Gas/Flux Type [Table 4.10, ler (3)} Other VISUAL INSPECTION (4.8.1) Acceptable YESorNO Guided Bend Test Results (4.90.5) ‘Tyee Result Type Result Fillet Test Results (4.90.2.9 and 4.90.4.1) ‘Appearance Fillet Size Fracture Test Root Penetration Macroetch (Describe the location, nature, and size of any crack or tearing ofthe specimen) Inspected by “Test Number. Organization Date RADIOGRAPHIC TEST RESULTS (4.0.3.1) Film Identification Flim Identification Number Results Remarks Number Results Remarks Interpreted by Test Number, Organization Date We, the undersigned, certify thatthe statements inthis record are correct and that the test welds were prepared, welded, and tested in accordance wit the requirements of section 4 of AWS D1.1,( ) Siructural Welding Code—Stee!, wear Manufacturer oF Contractor Authorized By, Form E-4 Date 307[AWS 01.1:2000 ANNEXE REPORT OF RADIOGRAPHIC EXAMINATION OF WELDS. Project Quality requirements —section no Reported to WELD LOCATION AND IDENTIFICATION SKETCH Technique Source. Flim to source Exposure time Screens Film type (Describe length, width, and thickness of all joints radiographed) interpretation Repairs Wold identification | Area | Accept. | Reject | Accept. | Reject We, the undersigned, certify thatthe statement in this record are correct and that the test welds were prepared and tested in accordance with the requirements of AWS D1.1, ( ) Structural Welding Code— Stoo wea Radiographer(s) Manutacturer or contractor Interpreter Authorized by Test date Date Foum E-7 308