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Customer

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HARDNESS TEST REPORT

Project No.:

Customer:

Report No.:

Drawing No.:

Component:

Inspection Class:

NDT Ref. Code:

Material Description:

Extent of examination:

Ref. Procedure No.:
Equipment Type:

Weld Size /
Welder
Thickness Stamp No.

Weld No.

Impact Device:

Test Method
HV

HB

HRC

HS

Test Result
1

2

3

4

5

6

Results
7

8

9

10 Accepted Rejected

Position of measuring point:

PREPARED BY

ETIMAAD QA&QC

CUSTOMER

NAME:

NAME:

NAME:

DATE:

DATE:

DATE:

SIGNATURE:

SIGNATURE:

SIGNATURE:

Date: May 22, 2007
Page: 1 of 1

This document is the intellectual property of ETIMAAD. Any unauthorized use, including modification and reproduction
of the content is strictly prohibited. © Copyrights Ordinance 2006, All rights reserved.

Doc. No. QA&QC/FRM-57
Rev.: 00