FOURTH EXAMINATION FOR RECOGNITION OF COMPETENT PERSONS

FOR
INSPECTION & CERTIFICATION OF BOILERS AND BOILER COMPONENTS - 2018

HALL TICKET

Registration No.____________ Exam Centre: _______________________ Photograph

Name of the candidate: __RAJAN BABU BOSE___________________

Venue: (for official use) Schedule of Examination

Paper I 16/12/2018 09:30 to 12:30 Hrs.

Paper II 16/12/2018 14:00 to 17:00 Hrs.

Contact Address of the Candidate:

TUV India Pvt. Ltd.,
No. 28, Jeya Nagar Extension
1st Street, 5th Main
Karumandapam
Trichy- 620009
Tamil Nadu

Contact Telephone No. : 9843019477

Signature of the Candidate _____________________ Controller of Examination

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FOURTH EXAMINATION FOR RECOGNITION OF COMPETENT PERSONS

FOR
INSPECTION & CERTIFICATION OF BOILERS AND BOILER COMPONENTS - 2018

EXAMINATION CENTRE CHECK FORM

Registration No.____________ Exam Centre: _______________________
Photograph
Name of the candidate: __RAJAN BABU BOSE_______________________

Signature of the candidate: _________________________________

----------------------------
 FIFTH EXAMINATION FOR RECOGNITION OF COMPETENT PERSONS
FOR
INSPECTION & CERTIFICATION OF BOILERS AND BOILER COMPONENTS - AUGUST 2018

APPLICATION FORM

1. Name of the Applicant : Photograph

First Name Middle Name Surname

Rajan Babu Bose Affix Passport size

Photograph

2. Father's Name : R. BOSE

3. Present Address: 4. Permanent Address:

No. 28, Jeya nagar Extension, 16, Chokkalinga nagar
Ist Street, 5th Main, Koodal nagar
Karumanadapam

City: Trichy City: Madurai

Pincode : 620009 Pincode: 625018
State: Tamilnadu State: Tamilnadu
DD MM yyyy
5. Date of Birth Date: 28 Month: 11 Year: 1984

6. Nationality : INDIAN

7. Sex: (Tick'√') Male P Female Transgender

8. Telephone Nos. Office:--- Residence: 9843017566

Fax: Mobile 9843019477

E-Mail: rajanbabu@tuv-nord.com
9. Category: √ General SC ST
(Tick '√' appropriate box)
10. Name of the Present / TUV INDIA PVT. LTD.
Last Employer
Designation: Inspection Engineer
Address: 827, Anna Salai
2nd Floor, Dhun building
City: Chennai Pincode: 600002
State: Tamilnadu

11. Total Work Experience: Years 12 Months 2 Days 19

as on 25.10.2018

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12. Examination Centre:
First Choice First Choice Second Choice
Chennai Mumbai Hyderabad
13. Educational Qualification:
Month &Year of
S.No. Name of the Degree & Branch Board/University
Passing

1 BE - Mechanical Eng. Jun-06 Anna University

14. NDT Certification RT & UT

S.No. Level of Certification Year of Certification Valid upto Name of the Certifying Agency

1 UT-NDT- Level II 8/1/2008 7/1/2019 Radiant NDT Services

2 RT-NDT- Level II 8/1/2008 7/1/2019 Radiant NDT Services

15. Experience: (Training Period should not be included) *

Name of the Period Duration
S.No. Designation Nature of work
Employer From To (Yrs.)
Inspection,Testing and Certificaion of
Boiler Piping Components like
Gate,Globe,CheckValves,Control
6 Yrs. valves,Ball Valves,Boiler feed Pumps,
Condensate Pumps,Inspection of
1 TUV India Ltd. Inspection Engineer 2/6/2012 Present 08 Boiler raw materials like
months Plates,Pipes,Fittings,Flanges ,SG
iron and Steel cast parts,
Welding,NDT ,Hydro testing of
Pressure vessels

Bureau Veritas India Pvt 08 Project Site Inspection of Boiler

2 Ltd, Kolkatta
Surveyor-Mechanical 5/12/2011 11/15/2011
months
errection & Piping & Welding,NDT-
4x135MW CPP

Maintenance & Shut down proect -

Integral Services Co., 3yrs 06 Doha west power plant- 8x300MW -
3 WLL, Kuwait
Mechanical Engineer 9/18/2007 3/20/2011
months Boiler, turbine & desalination plant
maintenance- CPP

Prism Surface Coatings, Design, Engineering & Project-

4 Project Engineer 7/1/2006 Jul-07 01 yr Painting and Blasting booths
Bangalore

* Use additional sheets if required. ** Proof of experience from respective employers to be

enclosed

16. Whether disqualified/debarred from appearing in any earlier examination for Competent
Persons (if yes, details thereof) : NO

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17. DD No. Date: Amount:

Bank Name Branch:

18. Declaration by the candidate:

I hereby declare that all the information given in the application form and enclosures are true to the best of
my knowledge and belief. I agree to the condition that if any information or any statement is found to be
incorrect, my registration to the examination and subsequent issue of passing grade certificate and authorisation
card would be cancelled. I also understand that it is my responsibility to cross check information from the websites
as prescribed in the prospectus from time to time for the allotted examination centre and issue of hall ticket.
I shall inform about change in my e-mail ID, mailing address, telephone number, etc. if any to NPC, Chennai.
I shall also abide by decisions taken by Central boilers board examination standing committee from time to time.

Place: Trichy
Date: 19.10.2018 Signature of Candidate

List of enclosures to be attached with the application (tick the appropiate box)

1 Proof of Age P
2 Proof of Educational Qualification P
3 Copy of the valid Level II NDT Certification in RT & UT P
4 Proof of Experience P
5 Copy of SC/ST Certificate (if applicable) as per GOI format
6 Demand Draft P
7 Hall Ticket & Exam centre check form with photographs P
8 Self addressed cover (24 cm x10cm) with duly P
affixed Indian postal stamp of Rs.40/-

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