BJD AGUILA 30 Jan 2019

Visual Examination Procedure for Piping for JG Summit

Stage1 Expansion Project Package 1 (Naphtha Cracking
Expansion)

TABLE OF CONTENTS

SECTION PAGE

I. ADDENDUM TO THE VISUAL EXAMINATION…………….…………….…..…………… 4

II. PROCEDURE……………………………………..…………….…………….…..…………..… 14

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 Visual Examination Procedure for Piping for JG Summit
Stage1 Expansion Project Package 1 (Naphtha Cracking
Expansion)

I. ADDENDUM TO THE VISUAL EXAMINATION FOR SHOP CONSTRUCTION & FIELD ASSEMBLY
OF POWER BOILERS, POWER PIPING, PRESSURE VESSEL & PARTS, AND SHOP & FIELD
REPAIRS AND ALTERATIONS

2.0 SCOPE
Additional Scope:

This procedure is intended for visual examination of welds for the JG Summit Stage 1
Expansion Project – Package 1 Naphtha Cracking Expansion Project.

3.0 REFERENCES

Project Specifications:

Document No. Document Title

Sec. C Part II 14.0 General Scope of Work – Quality
Management Requirements
A4-JGS1EP-ES-50-010 Specification for Construction Work of
Piping

A4-JGS1EP-EPC1-GS-80-011 Measuring and Test Equipment Control

Procedure
A4-JGS1EP-ES-55-004 Welding and NDE for pressure Retaining
Components
A4-JGS1EP-EPC1-GS-00-012 Project Quality Management Plan

A4-JGS1EP-EPC1-GS-80-009 Field Inspection and Test Procedure/Plan

Codes/Standard Documents:
Reference Title Description
ISO 9001:2015 Quality Management System – Requirements
American Society for Mechanical Engineers (ASME)
ASME Section I Boiler and Pressure Vessel Code –Rules for
Construction of Power Boilers, 2017 Edition
American Society for Mechanical Engineers (ASME)
ASME Section V Boiler and Pressure Vessel Code – Nondestructive
Examination, 2017 Edition
American Society for Mechanical Engineers (ASME)
ASME Section VIII Boiler and Pressure Vessel Code – Rules for
Div. 1 Construction of Pressure Vessel Code, 2017 Edition
Examination, 2017 Edition
American Society for Mechanical Engineers (ASME)
ASME Section IX Boiler and Pressure Vessel Code – Welding,
Brazing, and Fusing Qualifications, 2017 Edition
Examination, 2017 Edition
American Society of Mechanical Engineers (ASME),
ASME B31.3
Process Piping, 2016 Edition
American Welding Society (AWS) Structural Welding
AWS D1.1
Code – Steel 2015

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 Visual Examination Procedure for Piping for JG Summit
Stage1 Expansion Project Package 1 (Naphtha Cracking
Expansion)

Reference Title Description

Society for Nondestructive Testing (SNT) Technical

Council (TC), First Document (1A) Personnel
SNT-TC-1A
Qualification and Certification in Nondestructive
Testing, 2006 Edition

QMS Documents
Document No. Document Title
AGP-00000-P-N-13- Personnel Qualification and Certification in
0006.00 Nondestructive Examination
AGP-00000-P-T-13- Inspection and Testing Procedure
0001.00

5.0 RESPONSIBILITIES

5.1 Contractor/ Owner / Customer Representative

5.1.1 QC Inspector
5.1.1.1 Review and sign the Visual Examination Report.
5.2 Subcontractor
5.2.1 Project QC Lead
5.2.1.1 Determine the requirements for visual examination based on technical
specifications and responsible for the day to day visual examination activities.
5.2.1.2 Review and sign the Visual Examination Report.
5.2.2 QC Inspector/Visual Examiner
5.2.2.1 Perform the visual examination of welds.
5.2.2.2 Prepare the Visual Examination Report.

7.0 PERSONNEL QUALIFICATIONS

7.2 Visual Examiner shall have an annual vision test to assure natural or corrected near
distance acuity such that they are capable of reading a minimum of Jaeger No.1 or
equivalent type and size letter at a distance not less than 12 inches (30.5 cm) on a standard
Jaeger Test Chart. Equivalent near vision tests are acceptable. They shall be capable to
distinguish and differentiate contrast among colors using Ishihara method and shades of
gray. This shall be conducted upon initial certification and annually, thereafter. Visual Acuity
Record, Appendix C shall be prepared and administered by the Company Physician and/or
QA Manager.

9.0 PROCEDURES

Additional in sub-section 9.16 the Acceptance Criteria as per ASME B31.3 2016 Process Piping.

10.0 APPENDICES

Change the Appendix A the Acceptance Criteria as per ASME B31.3 2016 Process Piping.
Change the Appendix C – Visual Acuity Record and Appendix D - Visual Examination Report
Form.
Additional Appendix E, F, G and H of Visual Examination Procedure.

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 Visual Examination Procedure for Piping for JG Summit
Stage1 Expansion Project Package 1 (Naphtha Cracking
Expansion)

Appendix A (1/2)

Acceptance criteria as per ASME B31.3-2016 Process Piping:

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 Visual Examination Procedure for Piping for JG Summit
Stage1 Expansion Project Package 1 (Naphtha Cracking
Expansion)

Appendix A (2/2)

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 Visual Examination Procedure for Piping for JG Summit
Stage1 Expansion Project Package 1 (Naphtha Cracking
Expansion)

Appendix C

AGP-00000-FR-N-13-0011.00

VISUAL ACUITY RECORD

Sheet of

EXAMINATION PERFORMED

EMPLOYEE'S NAME EXAMINATION DATE

POSITION TITLE NEXT EXAMINATION DATE
DATE OF BIRTH EMPLOYEE ID NO.
LOCATION

JAEGER TEST
METHOD OF TEST

J-1 Held 12" (+/-1 inch) from the eyes J-2 Held 12" (+/-1 inch) from the eyes

NEAR VISION TEST

RIGHT EYE LEFT EYE BOTH EYES RESULTS

UNCORRECTED
ACCEPTABLE UNACCEPTABLE
CORRECTED

COLOR VISION TEST

Ishihara's Test Method (___ Plate Concise Edition). Hold plate 30"
(+/-1 inch from the individual titled so that the plane of the plate is at RESULTS
the right angles to the line of vision.

10 or more plates of plate numbers 1 through 11 ACCEPTABLE UNACCEPTABLE

9 or less plates of plate numbers 1 through 11 HSB-LP1 used ACCEPTABLE UNACCEPTABLE

RESTRICTIONS

Yes - Indicate corrective measure below No Restrictions

CORRECTIVE MEASURE (Required while witnessing nondestructive examinations)

Eye Glasses Contact Lenses Other Aid (Explain)

RESULTS EXPLAINED
The results of this Visual Acuity Test have been explained to me.

EMPLOYEE'S NAME/SIGN/DATE

COMMENTS
If no comments, write "NONE"

EXAMINED BY REVIEWED & APPROVED BY

NAME
SIGN
DATE

Rev.2, 19 Oct 2018

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 Visual Examination Procedure for Piping for JG Summit
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Appendix D

AGP-18059-FR-N-13-0003.00
VISUAL EXAMINATION REPORT
Sheet ______ of _______

PROJECT : REPORT No. :

J. O. A. No. / CUSTOMER : DATE EXAMINED :
ITEM DESCRIPTION : REF. DOC. NO. / REV. :
SPECIFICATION : LIGHT INTENSITY :
LIGHT METER :

TECHNIQUE USED LIGHT SOURCE

DIRECT VISUAL EXAMINATION DIRECT SUNLIGHT

REMOTE VISUAL EXAMINATION FLUORESCENT

TRANSLUSCENT VISUAL EXAMINATION OTHER LAMPS

JOINT WELDING WELDER'S

DRAWING NO. SHOPMARK THK DISPOSITION
NO PROCESS CODE

REMARKS

EXAMINED BY: WITNESSED BY: REVIEWED BY:

Customer Representative

QC INSPECTOR
NAME/SIGN/DATE NAME/SIGN/DATE NAME/SIGN/DATE

Rev. 0, 22 Jan. 2019

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 Visual Examination Procedure for Piping for JG Summit
Stage1 Expansion Project Package 1 (Naphtha Cracking
Expansion)

Appendix E

Report No
DAILY WELDING
INSPECTION REPORT Page : OF

Project Nam: Job No. :

Area / Unit : Date :

Subcon. Name :

Sh' Re Weld Resu Re

No t v Joint Size Th' type Welder No.
Line No. Mat'l spec. lt mar
. No No No. (In) k
1 2 1 2 3 (VT) ks
. .

Type of welding joint 1 : B (Butt), C (Branch Connection), F (Fillet), S (Socket)

2 : SW (Shop Welding), FW (Field Welding)

Inspected B Witnessed By Reviewed By

Sub-Con. Sign / Date VPCI Sign / Date Owner Sign / Date

Form No. : ITRF-PP-02 (Rev. 0) VENTANAS PHILIPPINES CONSTRUCTION INC.

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 Report No
Golden Joint Welding Inspection Report Page :

Project Name : Job No. :

Appendix F

Area / Unit : Date :

Hydro Pakage No. : Subcon Name :

Thic Welder No Pre- RT RT MT

Join Siz Visual
P-No. k Weld type Heat Rat Rat MT
S/NDw g no Line no t e GT SM 1 SM 2 Insp. Original R1 R2 PWHT Remark
(sch Tem e e Report
No (in) (A) (B) 1 2 (DECW- RPT No. RPT No.Resul RPT No.ResultRPT No. Resul
) p (%) (%)

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Expansion)

Type of Welding Joint =>1 : B (Butt), C (Branch Connection), F (Fillet), S (Socket) 2 : SW(Shop Welding), FW(Field Welding)

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Inspected By Witnessed By Reviewed By
Sub-Con. Sign/Date VPCI Sign/Date Owner Sign/Date

Form No. : ITRF-PP-07 (Rev. 0) VENTANAS PHILIPPINES CONSTRUCTION INC.

Stage1 Expansion Project Package 1 (Naphtha Cracking
Visual Examination Procedure for Piping for JG Summit
 Visual Examination Procedure for Piping for JG Summit
Stage1 Expansion Project Package 1 (Naphtha Cracking
Expansion)

Appendix G

VISUAL INSPECTION REPORT FOR Report No.: OFIP-000

ORIFICE FLANGE INSIDE
PENETRATION Page : OF

Project Name: Job No. :

Area / Unit : Date :

Subcon. Name :

No. Line No. Sheet No. Tag No. Joint No. Size Result Remarks

Grinding

Inspected By Witnessed By Reviewed By

Sub-Con. Sign / Date VPCI Sign / Date Owner Sign / Date

Form No. : ITRF-PP-05 (Rev. 0) VENTANAS PHILIPPINES CONSTRUCTION INC.

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Appendix H

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W1303-03, Rev. 1
Visual Examination for Shop Construction & Field
Assembly of Power Boilers, Power Piping, Pressure
Vessels & Parts, and Shop & Field Repairs and
Alterations

TABLE OF CONTENTS

Page

1. OBJECTIVE .......................................................................................................................................2

2. SCOPE..............................................................................................................................................2

3. REFERENCES ....................................................................................................................................2

4. DEFINITIONS ...................................................................................................................................3

5. RESPONSIBILITIES............................................................................................................................3

6. TOOLS & EQUIPMENT .....................................................................................................................3

7. PERSONNEL QUALIFICATION ..........................................................................................................4

8. TECHNIQUE .....................................................................................................................................4

9. PROCEDURE ....................................................................................................................................5

10. APPENDICES ....................................................................................................................................6

APPENDIX A – Acceptance Criteria as per para. 136.4.2 of ASME B31.1 ....................................... 7

APPENDIX B – Welding Inspection Checklist .................................................................................. 8

APPENDIX C – Visual Acuity Record ................................................................................................9

APPENDIX D – Visual Examination Report ....................................................................................10

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W1303-03, Rev. 1
Visual Examination for Shop Construction & Field
Assembly of Power Boilers, Power Piping, Pressure
Vessels & Parts, and Shop & Field Repairs and
Alterations

1. OBJECTIVE
This procedure provides a system of specific instructions as an aid to personnel required to perform
visual examination of welds in accordance with ASME Section V, Article 1 and 9.

2. SCOPE
This procedure applies to visual examination in accordance with the requirements of Article 1 and 9 of
ASME Section V, Latest Edition.

This is directed primarily to all personnel performing visual examination who have qualified and certified
in accordance with P1306, AG&P QMS Procedure for Personnel Qualification and Certification in
Nondestructive Examination.

3. REFERENCES

CODES, STANDARDS, LEGAL AND OTHER REGULATIONS

Reference Title Description
Quality Management System – Requirements
ISO 9001:2008
Clause 8.2.4 Monitoring and Measurement of Product
American Society of Mechanical Engineers (ASME)
ASME Section I Boiler and Pressure Vessel Code – Rules for Construction of Power Boilers,
2015 Edition
American Society of Mechanical Engineers (ASME)
ASME Section V Boiler and Pressure Vessel Code – Nondestructive Examination, 2015
Edition
American Society of Mechanical Engineers (ASME)
ASME Section VIII Div. 1 Boiler and Pressure Vessel Code – Rules for Construction of Pressure
Vessels , 2015 Edition
American Society of Mechanical Engineers (ASME)
ASME Section IX Boiler and Pressure Vessel Code – Welding, Brazing, and Fusing
Qualifications , 2015 Edition
American Society of Mechanical Engineers (ASME), Power Piping, 2014
ASME B31.1
Edition
Society for Nondestructive Testing (SNT) Technical Council (TC), First
SNT-TC-1A Document (1A) Personnel Qualification and Certification in Nondestructive
Testing, 2006 Edition

QMS DOCUMENTS
Document No. Document Title
P1306 Personnel Qualification and Certification in Nondestructive Examination
8.2.4P01 Inspection and Testing Procedure

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W1303-03, Rev. 1
Visual Examination for Shop Construction & Field
Assembly of Power Boilers, Power Piping, Pressure
Vessels & Parts, and Shop & Field Repairs and
Alterations

4. DEFINITIONS
DEFECT – One or more flaws whose aggregate size, shape, orientation, location, or properties
do not meet specified acceptance criteria and are rejectable.
DISCONTINUITY – A lack of continuity or cohesion: an intentional or unintentional in the physical
structure or configuration or a material or component.
EVALUATION OF – The process of deciding the severity of the condition after the indication has been
INDICATIONS interpreted. Evaluation leads to the decision as to whether the part must be
rejected, salvaged, or may be accepted for use.
IMPERFECTION – A departure of a quality characteristic from its intended condition.
INDICATION – The response or evidence from a nondestructive examination that requires
interpretation to determine its relevance.
VISUAL – A nondestructive examination method used to evaluate an item by observation
EXAMINATION such as: the correct assembly, surface conditions, or cleanliness of materials, parts
and components used in the fabrication and construction.
AWS-CWI – American Welding Society-Certified Welding Inspector
TWI-CSWIP – The Welding Institute – Certification Scheme for Welding and Inspection Personnel

5. RESPONSIBILITIES
QA MANAGER – Responsible for the administrative approval of this procedure. This procedure shall
be demonstrated to the satisfaction of the Authorized Inspector in accordance with
T-150 of ASME Section V when required by the Applicable Codes.
NDE LEVEL III – Responsible for the review of this procedure. He shall ensure that this is correct and
updated whenever there is a change in the Code Edition.
QC SUPERVISOR – Responsible for preparing and updating this procedure as directed by the QA
Manager. He is responsible for the direct supervision of the day to day visual
examination activities. He shall ensure that compliance with the requirements of
this procedure is maintained.
VISUAL – Responsible for the performance of the visual examination in accordance with this
EXAMINER procedure.

6. TOOLS & EQUIPMENT

6.1When it is necessary to substitute remote visual examination for direct visual examination, the
following tools/equipment may be used:
6.1.1 Mirror
6.1.2 Telescope
6.1.3 Borescope
6.1.4 Fiberoptics
6.1.5 Camera
6.1.6 Other suitable equipment
Such system shall have a resolution capability that is at least equivalent to that obtained by direct
visual observation.

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W1303-03, Rev. 1
Visual Examination for Shop Construction & Field
Assembly of Power Boilers, Power Piping, Pressure
Vessels & Parts, and Shop & Field Repairs and
Alterations
6.2Supplemental illumination, where required can be supplied by a flashlight or other auxiliary lighting.
In general, lighting will only be required when working in enclosed spaces such as internal inspection
of vessels.

7. PERSONNEL QUALIFICATION

7.1 The examiner shall have been qualified in accordance with the requirement of P1306, AG&P Quality
Management System “Procedure for Personnel Qualification and Certification in Nondestructive
Examination”.
7.2 Visual Examiner shall have an annual vision test to assure natural or corrected near distance acuity
such that they are capable of reading standard J-1 letters on standard Jaeger test type charts for
near vision. Equivalent near vision tests are acceptable. They shall be capable to distinguish and
differentiate contrast among colors using Ishihara method and shades of gray. This shall be
conducted upon initial certification and annually, thereafter. Visual Acuity Record, Appendix C shall
be prepared and administered by the Company Physician and/or QA Manager.
7.3 If a person is a holder of international welding certification such as AWS-CWI, TWI-CSWIP, or any
equivalent certification, he is qualified to conduct visual examination of welds in lieu of the
requirements of this procedure.

8. TECHNIQUE
8.1 Direct Visual Examination
Direct visual examination may usually be made when access is sufficient to place the eye within 24
in. (600 mm) of the surface to be examined and at an angle not less than 30 deg to the surface to
be examined. Mirrors may be used to improve the angle of vision, and aids such as a magnifying
lens may be used to assist examinations. Illumination (natural or supplemental white light) for the
specific part, component, vessel, or section thereof being examined is required. The minimum light
intensity at the examination surface/site shall be 100 fc (1000 lx). The light source, technique used,
and light level verification is required to be demonstrated one time, documented, and maintained
on file.
8.2 Remote Visual Examination
In some cases, remote visual examination may have to be substituted for direct examination.
Remote visual examination may use visual aids such as mirrors, telescopes, borescopes, fiber optics,
cameras, or other suitable instruments. Such systems shall have a resolution capability at least
equivalent to that obtainable by direct visual observation.
8.3 Translucent Visual Examination
Translucent visual examination is a supplement of direct visual examination. The method of
translucent visual examination uses the aid of artificial lighting, which can be contained in an
illuminator that produces directional lighting. The illuminator shall provide light of an intensity that
will illuminate and diffuse the light evenly through the area or region under examination. The
ambient lighting must be so arranged that there are no surface glares or reflections from the
surface under examination and shall be less than the light applied through the area or region under
examination. The artificial light source shall have sufficient intensity to permit “candling” any
translucent laminate thickness variations.

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W1303-03, Rev. 1
Visual Examination for Shop Construction & Field
Assembly of Power Boilers, Power Piping, Pressure
Vessels & Parts, and Shop & Field Repairs and
Alterations
9. PROCEDURE
9.1 Clean all surfaces to be examined. It should be free of irregularities which could mask or be
confused with a discontinuity.
9.2 Conduct direct visual, remote visual or translucent visual examination on the welds or structure
whichever technique is applicable.
9.3 Illuminate adequately all surfaces under examination by either natural or artificial means. The
minimum light intensity at the examination surface/site shall be 100 footcandles (1000 lux). The
light source, technique used and light level verification is required to be demonstrated one time,
documented and maintained on file.
9.4 When fit-up examinations of a butt weld is required, check the joint for proper alignment, root gap
and root face (land) on the edge preparation.
9.5 Check the surface to be joined to assure full penetration and smooth transition into the adjacent
base material.
9.6 Repair or put cracked or oversized tack welds into an acceptable condition.
9.7 Check socket or other fillet type welds for proper alignment, condition of tack welds, cleanliness
and base metal suitability.
9.8 For socket welds, verify if the proper gap between the end of the pipe and the bottom of the socket
has been preserved.
9.9 Where accessible, examine the inside surface of butt welds for complete penetration, irregularities
and defects.
9.10Examine the outside surfaces of butt welds, as well as the base material within a distance of one (1)
inch or either side of the weld for irregularities, arc strikes and defects.
9.11Check weld metal reinforcements to ensure if it is within the limits of the applicable code.
9.12Check fillet welds with a suitable gauge to the design dimensions specified.
9.13Examine all surfaces for arc strikes, jig marks and temporary attachment welds.
9.14Identify all defects with a crayon or other acceptable indelible markers and put the examiner’s
initials.
9.15Investigate all relevant indications to the extent that the examiner can evaluate such indications in
terms of the Visual Acceptance Criteria for weldments.
9.16Evaluate all examinations in terms of the acceptance standards of the applicable codes, standards,
procedures, and/or project specifications.
UG-97 of ASME Section VIII Div.1 states the following inspections during fabrication for pressure
vessel and parts:
a) When conditions permit entry into the vessel, as complete an examination as possible shall
be made before final closure.
b) The Inspector shall make an external inspection of the completed vessel at the time of the
final hydrostatic test or pneumatic test.
c) All welds, including the nozzle welds, of homogeneously lead-lined vessels shall be visually
inspected on the inside prior to application of lining. A visual examination of the lining shall

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W1303-03, Rev. 1
Visual Examination for Shop Construction & Field
Assembly of Power Boilers, Power Piping, Pressure
Vessels & Parts, and Shop & Field Repairs and
Alterations
be made after completion to assure that there are no imperfections which might impair the
integrity of the lining and subject the vessel to corrosion effects.
Refer to Appendix A for the acceptance criteria for power piping.
9.17Re-examine repairs by the same procedure used for the original examination.
9.18All indications observed as a result of the visual examination shall be reported in the Visual
Examination Report as shown in Appendix D. Also, update Welding Inspection Checklist as per
Appendix B.

10.APPENDICES
10.1Appendix A – Acceptance Criteria as per para. 136.4.2 of ASME B31.1
10.2Appendix B – Welding Inspection Checklist
10.3Appendix C – Visual Acuity Record
10.4Appendix D – Visual Examination Report

NOTE: Revision to appendices shall not require revision of this procedure.

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W1303-03, Rev. 1
Visual Examination for Shop Construction & Field
Assembly of Power Boilers, Power Piping, Pressure
Vessels & Parts, and Shop & Field Repairs and
Alterations
APPENDIX A

Acceptance Criteria
As per para. 136.4.2 of ASME B31.1

(A) Acceptance Standards. The following indications are unacceptable:

1) Cracks – external surface.

2) Undercut on surface which is greater than 1/32 in. (1.0 mm) deep, or encroaches on the
minimum required section thickness.
3) Undercut on the surface of longitudinal butt welds.
4) Weld reinforcement greater than specified in Table 127.4.2 shown below.
5) Lack of fusion on surface.
6) Incomplete penetration (applies only when inside surface is readily accessible).
7) Any other linear indications greater than 3/16 in. (5.0 mm) long.
8) Surface porosity with rounded indications having dimensions greater than 3⁄16 in. (5.0 mm) or
four or more rounded indications separated by 1⁄1 6 in. (2.0 mm) or less edge to edge in any
direction. Rounded indications are indications that are circular or elliptical with their length less
than three times their width.

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W1303-03, Rev. 1
Visual Examination for Shop Construction & Field
Assembly of Power Boilers, Power Piping, Pressure
Vessels & Parts, and Shop & Field Repairs and
Alterations
APPENDIX B

P1303-F14
WELDING INSPECTION CHECKLIST
Sheet of

PROJECT : AG&P DRAWING No. : REV. No.

J. O. A. No. / CUSTOMER : CUSTOMER DWG. REF. NO. :

ITEM DESCRIPTION : MODULE NO. : COIL NO. :

3,3,1* 6758&785$/ 7$1.6 9(66(/

% $ 7 & +   REPORT NO. / DATE

WELDED
:(/'(5

PROCESS

6&2'(
WELD SIZE & HEAT MILL

DATE
3$ *( /2 7 1 2  5 7 % HI R U H
JOINT No. DESCRIPTION PMI PWHT NDE Leak Test
TYPE THK NO. CERT. NO. 1 2  :( /'
* 
VISUAL 3: +7
5 7 $ I W HU 
& 2 1 6  WPS NO. ) (5 5 ,7 ( 57 +$ 5 ' 1 (66
3: +7
UT MT PT Vacuum

SHOP ERECTION
QC INSPECTOR QC SUPERVISOR CUSTOMER REPRESENTATIVE QC INSPECTOR QC SUPERVISOR CUSTOMER REPRESENTATIVE
SIGNATURE
NAME
DATE
Rev. 0, 13 Oct 2015

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W1303-03, Rev. 1
Visual Examination for Shop Construction & Field
Assembly of Power Boilers, Power Piping, Pressure
Vessels & Parts, and Shop & Field Repairs and
Alterations
APPENDIX C
F82470

VISUAL ACUITY RECORD

Sheet of

EXAMINATION PERFORMED

EMPLOYEE'S NAME EXAMINATION DATE

POSITION TITLE NEXT EXAMINATION DATE
DATE OF BIRTH EMPLOYEE ID NO.
LOCATION

JAEGER TEST
METHOD OF TEST

-+HOGLQFKIURPWKHH\HV -+HOGLQFKIURPWKHH\HV

NEAR VISION TEST

RIGHT EYE LEFT EYE BOTH EYES RESULTS

UNCORRECTED
$&&(37$%/( 81$&&(37$%/(
CORRECTED

COLOR VISION TEST

Ishihara's Test Method (___ Plate Concise Edition). Hold plate 30"
(+/-1 inch from the individual titled so that the plane of the plate is at RESULTS
the right angles to the line of vision.

RUPRUHSODWHVRISODWHQXPEHUVWKURXJK $&&(37$%/( 81$&&(37$%/(

RUOHVVSODWHVRISODWHQXPEHUVWKURXJK +6%/3XVHG $&&(37$%/( 81$&&(37$%/(

RESTRICTIONS

<HV,QGLFDWHFRUUHFWLYHPHDVXUHEHORZ 1R5HVWULFWLRQV

CORRECTIVE MEASURE (Required while witnessing nondestructive examinations)

(\H*ODVVHV &RQWDFW/HQVHV 2WKHU$LG([SODLQ

RESULTS EXPLAINED
The results of this Visual Acuity Test have been explained to me.

EM P LOYEE'S NA M E/SIGN/DA TE

COMMENTS
If no comments, write "NONE"

EXAMINED BY REVIEWED & APPROVED BY

NAME
SIGN
DATE

Rev.1, 16 Jul 2012

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W1303-03, Rev. 1
Visual Examination for Shop Construction & Field
Assembly of Power Boilers, Power Piping, Pressure
Vessels & Parts, and Shop & Field Repairs and
Alterations
APPENDIX D

P1303-F07
VISUAL EXAMINATION REPORT
Sheet of

PROJECT : REPORT No. :

J. O. A. No. / CUSTOMER : DATE EXAMINED :
ITEM DESCRIPTION : REF. DOC. NO. / REV. :
SPECIFICATION : LIGHT INTENSITY :
LIGHT METER :

TECHNIQUE USED LIGHT SOURCE

DIRECT VISUAL EXAMINATION DIRECT SUNLIGHT

REMOTE VISUAL EXAMINATION FLUORESCENT

TRANSLUSCENT VISUAL EXAMINATION OTHER LAMPS

JOINT WELDING WELDER'S

DRAWING NO. SHOPMARK THK DISPOSITION
NO PROCESS CODE

REMARKS

EXAMINED BY: REVIEWED BY: APPROVED BY:

QC INSPECTOR QC SUPERVISOR
NA M E/SIGN/DA TE NA M E/SIGN/DA TE NA M E/SIGN/DA TE

Rev. 0, 28 Oct. 2015

Page 10 of 10 W1303-03, Rev. 1 (Ref. Template: P1002-T01 Rev. 3, 2 Sep 16)