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Form Date
Form No.
Owner or User
vessel Name

Description
Name oI Process Owner or User Number
Location Jurisdiction/National Board Number
Internal Diameter ManuIacturer
Tangent Length/Height ManuIacturer`s Serial No.
Shell Material SpeciIication Date oI ManuIacture
Head Material SpeciIication Contractor
Internal Materials Drawing Numbers
Nominal Shell Thickness
Nominal Head Thickness Construction Code
Design temperature Joint EIIiciency
Maximum Allowable Working Type Heads
Pressure Type Joint
Maximum Tested Pressure Flange Class
Design Pressure Coupling Class
RelieI Valve Set Pressure Number oI Manways
Contents Weight
Special Conditions



Thickness Measurements
Sketch or
Location
Description
Location
Number
Original
Thickness
Required Minimum
Thickness
Date









Comments (See Note 2)

Method
Authorized Inspector

Notes:
1. Use additional sheets as necessary.
2. The location that each comment relates to must be described.