RT REQUESTION

PROJECT NO. : QA / QC FORM FORM NO. : QC-15

PROJECT NAME : DATE :

SITE INSPECTION & TEST RECORDS
REPORT NO : SHEET : OF :
SHT TYPE OF
X - RAY WELD WALL PIPE WELDER
LINE NO. ISO NO. SIZE WELD REMARK
NO. NO. NO. THK. CLASS STAMP

BW : BUTT WELD S : SOCKET WELD B : BRANCH M : MITER

APPROVED BY :
CONTR. QC DEP. INSPECTOR: CLINT / MC REPR.

NAME: NAME : NAME :

DATE / SIGN. : DATE / SIGN DATE / SIGN. :