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Customer

Logo

RECORD OF REPAIRS

Project No.:

Customer:

Type of NDT.

Welder Name:
Stamp No.

Sr.
No.

Report No:

Drawing No. / Tank No.

Weld Welder
Dia &
Piping
Stamp Thickness Class
No.
No.

PREPARED BY

Report
Date

Repair
1

2

ETIMAAD QA&QC

Accepte
d Date

Remarks

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-62
Rev.: 00