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FORM U-1A MANUFACTURER'S DATA REPORT FOR PRESSURE VESSELS

(Alternative Form for Single-Chamber, Completely Shop- or Field-Fabricated Vessels Only)
As Required by the Provisions of the ASME Boiler and Pressure Vessel Code Rules, Section VIII, Division 1

LARSEN & TOUBRO LIMITED ENGINEERING WORKSHOP,303/3,NH-4 BANGALORE HIGHWAY

1. Manufactured and certified by
NEERVALOOR VILLAGE, KANCHIPURAM,TAMILNADU-631561 INDIA
(Name and address of Manufacturer)
SPPD,LARSEN & TOUBRO LIMITED ENGINEERING WORKSHOP,303/3,NH-4 BANGALORE HIGHWAY NEERVALOOR VILLAGE,KANCHIPURAM-631561,TAMILNADU INDIA
2. Manufactured for
(Name and address of Purchaser)
LARSEN & TOUBRO LIMITED ENGINEERING WORKSHOP,303/3,NH-4 BANGALORE HIGHWAY NEERVALOOR VILLAGE,KANCHIPURAM-631561, TAMILNADU INDIA
3. Location of installation
(Name and address)

4. Type Vertical V124 NA 200348-M-BM-EQ-GA-0001 Rev-0 NA 2020

(Horizontal or vertical, tank) (Manufacturer’s serial number) (CRN) (Drawing number) (National Board number) (Year built)

5. ASME Code, Section VIII, Div. 1 Edition 2019 2996-1 NA

[Edition and Addenda, if applicable (date)] (Code Case number) [Special service per UG-120(d)]

6. Shell SA 516 GR.70 10mm 1.5 700mm 1000mm

(Material spec. number, grade) (Nominal thickness) (Corr. allow.) (Inner diameter) [Length (overall)]

Body Flanges on Shells

Bolting
Washer
No. Type ID OD Flange Thk Min Hub Thk Material How Attached Location Num & Size Bolting Material (OD, ID, thk) Washer Material

NA NA NA NA NA NA NA NA NA NA NA NA NA

7. Seams Type-1 Spot 0.85 NA NA Type-1 spot 0.85 1

[Long. (welded, dbl., sngl., lap, butt)] [R.T. (spot or full)] (Eff., %) (H.T. temp.) (Time, hr) [Girth (welded, dbl., sngl., lap, butt)] [R.T. (spot (Eff., %) (No. of courses)
or full)]
SA 516 GR.70 SA 516 GR.70
8. Heads: (a) Material (b) Material
(Spec. no., grade) (Spec. no., grade)

Location (Top, Minimum Corrosion Crown Knuckle Elliptical Conical Hemispherical Flat Side to Pressure
Bottom, Ends) Thickness Allowance Radius Radius Ratio Apex Angle Radius Diameter (Convex or Concave)

(a) TOP 8mm 1.5 NA NA 2:1 NA NA NA Concave

(b) BOTTOM 8mm 1.5 NA NA 2:1 NA NA NA Concave

Body Flanges on Heads

Bolting
Washer
Location Type ID OD Flange Thk Min Hub Thk Material How Attached Num & Size Bolting Material (OD, ID, thk) Washer Material
(a)
NA NA NA NA NA NA NA NA NA NA NA NA
(b)

1.0 Mpa(g) NA 75°C NA

9. MAWP at max. temp. .
(Internal) (External) (Internal) (External)
5°C 1.0 Mpa(g) Hydrostatic pressure 1.3 Mpa(g)
Min. design metal temp. at . Hydro., pneu., or comb. test pressure .
NA
Proof test .
10. Nozzles, inspection, and safety valve openings:
Purpose Material Nozzle Thickness Attachment Details
(Inlet, Outlet, Diameter Reinforcement Location
Drain, etc.) No. or Size Type Nozzle Flange Nom. Corr. Material Nozzle Flange (Insp. Open.)

INLET N1 1 DN 50 CL150/WNRF SA106 Gr.B SA105 8.74 1.5 NA UW16.1(Type-C) Cat-C

OUTLET N2 1 DN 50 CL150/WNRF SA106 Gr.B SA105 8.74 1.5 NA UW16.1(Type-C) Cat-C
INSPECTION N3-A 1 DN 50 CL150/WNRF SA106 Gr.B SA105 8.74 1.5 NA UW16.1(Type-C) Cat-C Shell
INSPECTION N3-B 1 DN 50 CL150/WNRF SA106 Gr.B SA105 8.74 1.5 NA UW16.1(Type-C) Cat-C Shell
SAFETY S1 1 DN 50 CL150/WNRF SA106 Gr.B SA105 8.74 1.5 NA UW16.1(Type-C) Cat-C
DRAIN D1 1 DN 50 CL150/WNRF SA106 Gr.B SA105 8.74 1.5 NA UW16.1(Type-C) Cat-C

11. Supports: Skirt NO Lugs - Legs 3 Other - Attached -

(Yes or no) (Number) (Number) (Describe) (Where and how)
12. Remarks: Manufacturer’s Partial Data Reports properly identified and signed by Commissioned Inspectors have been furnished for the following
items of the report: NA
(Name of part, item number, Manufacturer’s name and identifying stamp)
Hydrostatic test performed in vertical position with pressure at top most point of the vessel

(07/17)
 FORM U-1A Page 02 of 02

Manufactured by LARSEN & TOUBRO LIMITED ENGINEERING WORKSHOP,303/3,NH-4 BANGALORE HIGHWAY NEERVALOOR VILLAGE, KANCHIPURAM,TAMILNADU-631561 INDIA

Manufacturer’s Serial No. V124 CRN NA National Board No. NA

CERTIFICATE OF SHOP/FIELD COMPLIANCE

We certify that the statements made in this report are correct and that all details of design, material, construction, and workmanship of this vessel
conform to the ASME BOILER AND PRESSURE VESSEL CODE, Section VIII, Division 1. “U” Certificate of Authorization number 47569
expires
09.11.2020(Under Extension)
.

Date 24.08.2020 Co. name LARSEN & TOUBRO LIMTED ENGINEERING WORKSHOP
Signed
(Manufacturer) (Representative)

CERTIFICATE OF SHOP/FIELD INSPECTION

Vessel constructed by at
LARSEN & TOUBRO LIMTED ENGINEERING WORKSHOP KANCHIPURAM, TAMILNADU, INDIA .
I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and employed by
OneCIS insurance company of
330 Lynway,Suite 403,Lynn,Massachusetts 01901
have inspected the component described in this Manufacturer's Data Report on 24.08.2020 , and state that,
to the best of my knowledge and belief, the Manufacturer has constructed this pressure vessel in accordance with ASME BOILER AND PRESSURE
VESSEL CODE, Section VIII, Division 1. By signing this certificate neither the Inspector nor his/her employer makes any warranty, expressed or
implied, concerning the pressure vessel described in this Manufacturer's Data Report. Furthermore, neither the Inspector nor his/her employer
shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspection.
24.08.2020 NB 15807
Date Signed Commissions
(Authorized Inspector) (National Board Authorized Inspector Commission number)

(07/17)