Order No.: Job No.: P.O. No.

: Date:

Ultrasonic Inspection Record Customer: Project: Test Procedure / Revision: Acceptance Criteria: Equipment Mfg.: Model #: Serial #: Transducer(s) Mfg.: Model #: Serial #: Size: Frequency: Cable Length/Type: Refracted Angle: Couplant: Dampening: Reject Control:
Examination Surface(s):

In accordance with ASME Section V Article 4 and VIP-UT-03

ASME VIII UW-53

Examination Parameters
Straight Beam DAC Curve 80% FSH

___

Reference Level______ dB Angle Beam DAC Curve

80% FSH 1/4t

Surface Condition: Test Direction: Contact / Immersion Area Gated: Screen Range: Scan Speed: Scan Level (dB): Other:

5/4t 0 5

Reference Level 15dB

Calibration Standard Identification and description including reference reflectors used. If applicable, include data correlating simulation block(s), and electronic simulator(s) with initial calibration.

Carbon Steel .375" Thick ASME Flat Basic Calibration Block w/ 1/4t, 1/2t, 3/4t, SDH & ID, OD Notches
Inspection Description

Inspector and Level: Remarks / Notes:

Date and Time of Inspection:

The undertaking of Vital Inspection Professionals to perform the services under this contract, purchase order or other similar agreements extends only to those services requested therein. Under no circumstances shall such services extend beyond the performance of the requested inspection of specific equipment and the preparation of reports or similar documents reflecting the inspection data obtained or the opinion formulated on the basis of such inspection. It is expressly understood that all descriptions, comment and expressions of opinion reflect the opinion or observation of the examiner and are not intended nor can they be construed as representation or warranties as to the actual circumstances. In performing the services requested, Vital Inspection Professionals used the degree, care and skill ordinarily exercised under similar circumstances by others performing such services in the same or similar locality. No other warranty, expressed or implied, is made or intended by Vital Inspection Professionals, Inc.

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Ultrasonic Inspection Record

Customer: Project:
Item Area Inspected EXAMINATION RESULTS Results Location and size of Indications

Notes:
All rejectable indications and repairs shall be recorded above. Areas of restricted access or inaccessible welds shall be recorded above. NRI = No Relevant Indications

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