FORM CODE : Q/P-010 ISO No. : REPORT No.

:
TECHNICAL
DESCIPLINE N.D.T
INSPECTION LINE No. : SIZE : JOINT No. : SHEET: MATERIAL :

4 + + + + +
4 2 3 + + + + +
2 + + + + +
K 1 + + + + + K
A B C D E
3

EXAMINATION RESULTS :

MEASUREMENTS
MEAN VALUE
LOCATION REMARK
HB
1 2 3 4

A 0

B 0

C 0

D 0

E 0

REMARKS :

ABBREVIATION : B.M : BASE METAL W.M : WELD METAL

H.A.Z : HEAT AFFECTED ZONE H.B : HARDNESS BRINEL

NASB NIROO CO. MAPNA CO. GHODS NIROO

NAME: B.BAGHERIAN NAME: NAME:

SIGN: SIGN: SIGN:

DATE: DATE: DATE:

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