WELDER and WELDING OPERATOR PERFORMANCE QUALIFICATION RECORD

Welders Name: Welders SS No. XXX-XXVARIABLE

Code or Specification Used: Welding Process and Type: Manual Semiautomatic Mechanized Automatic Backing: Base Metal Spec/P or M-Number Plate Plate Pipe Pipe Thick. Thick. Plate/Pipe Thickness Fillet Pipe/Tubular Outside Diameter Groove Pipe/Tubular Outside Diameter Fillet Filler Metal Specification No. Classification No. F No. Diameter Consumable Insert Penetration Enhancing Flux Deposited Weld Metal Thickness Current/Polarity & Current Range Metal Transfer Mode (GMAW or FCAW) Torch Shielding Gas Root Shielding Gas Position(s) Vertical Progression Type: NA Type: Flow: Flow: Qualified Position(s) (F, H, V, O, or All) Uphill Downhill Type/Polarity: Range: Amperes Yes Yes No No Plate/Pipe Thickness Groove Used Not Used Manual Semiautomatic Mechanized Automatic Required if used

Date:

ATF No: Test No. Reference WPS No: QUALIFICATION RANGE*

QUALIFICATION TEST DETAIL

Test Position(s) (1G, 2G, etc.): Uphill Downhill

* NOTE: Insert NA for Variables that are identified as Non-essential in the Code or Specification used for the Performance Qualification Test

MECHANICAL TEST RESULTS

Type And Figure No. Results Type And Figure No. Results

Guided mechanical Testing Conducted By:

Date:

NONDESTRUCTIVE EXAMINATION RESULTS

Radiographic Results: Radiographic Testing Conducted By: Welding Witnessed By: Visual Inspection: Pass Fail (reason ) Report No.

We certify that the statements in this record are correct and the test welds were prepared, welded and tested in accordance with the requirements of: AWS D1.1, AWS B2.1Other: Date Qualified: ATF Name and Number: Signed By: CWI No.

ATF WPQR Blank Form 2010-04-15.docx

AWSCertifiedWelderApplication
Pleaseprintinblueorblackink

$35,Certificationfeemustaccompanythisform.(Pricesaresubjecttochange.)

PersonalInformation.(Tobecompletedbytheapplicant)
LastName: City: Province/Country: S.S.#:XXXXX EmailAddress:

FirstName:

Apt./Ste.No.: State: ZipCode:

MI:

HomeAddress:

HomeTel.#: ( ) WorkTel.#: ( )

CheckheretohavetheWeldersCertificationmailedtotheemployersaddress.
CompanyName: CompanyAddress: City: Province/Country:

State: Ste.No.: ZipCode:

Uponobtainingmycertification,IgiveAWStherighttorevealmycertificationstatusasitrelatestoitsvalidityandtheexpirationdate only.Nootherinformationrelatedtomycertificationshallberevealed.YesNo.IfYes,pleaseinitialhere

TestInformation(TobecompletedbyFacilitysTestSupervisor)
AccreditedTestFacility: WPS:

Certificate#: DateTested:

IndicateWPSasrequiredbyAWSB2.1.IfSupplementGisused,indicatetheWPSNumberasassignedbytheemployer.ex:04/12/2012

QUALIFICATIONSRANGE:Placetheappropriateabbreviationineachcategorybox
Supplement Code Process Gas (optional) Filler Metal BaseMetal Position(s)

Thickness,Backing or Thickness,PipeOD&Backing

REVIEWED:FacilityTestSupervisor:

Signature

PrintedName

DateCWICertificationNumberExpirationDate
8669 Suite 130, Doral, Florida 33166 (800) 443 9353, Ext. 273 Fax 8669Doral DoralBoulevard Boulevard, Doral, Florida 33166 Tel: (800)Tel: 443 9353, Ext. 273Fax (305) 443(305) 64454436445 MethodofPayment

CWIStamp(required)

Check#:

Visa

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AmericanExpress

DinersClub

Discover

CreditCard#: Signature:

Exp.Date:

AWSUseOnly
DateReceived:

Account#:

Amount:

CertCWCertifiedWelderApplication09/20/12

 CertifiedWelderApplication
INSTRUCTIONSFORAPPLICATION
Thereisa$35feeforeachcertificationgranted.Forcreditcardinformation,fillouttheboxatthebottomoftheapplication.Pleasefillout aseparateapplicationforeachcertificationthattheweldertested. Personal Information (supplied by welder): The welder is responsible for maintaining the certification and AWS must have a personal addressinordertostayincontactwithhim/her.Allcertificationmaterialswillbesenttothewelder'shomeaddress,unlessspecifiedtobe senttoemployersaddress.RemembertocontactAWSifyouchangeyouraddress!IftheboxSendResultstoEmployer,ischecked,the employer'saddressmustbesupplied.AWSwillsendaconfirmationlettertothecompanyaddressindicatedbelowthebox. Test Information (supplied by the Facility Test Supervisor): When using Supplement G, AWS must have a copy of the actual WPS on file. If you have previously submitted the WPS or are utilizing an AWS B2 SWPS, the AWS Certification Department has a record of this information.AnyfurthertestsusingthatsameWPScanbereferencedontheapplication.IfthisisthefirsttimeaWPSisbeingused,please submitacopyofthatWPSandanysupportingpaperworkalongwiththeapplication. Under Qualifications, list the abbreviations that should appear on the welder certification card using the codes below. Note that some categories, such as Gas, may not apply in all situations (SMAW for example). Also, consider the typical essential variables of Welder Qualifications,suchasposition(s),upordownprogression,thickness,outsidediameter(OD,ifpipe),anduseornonuseofbacking. Authorization: If the welder wants the certification information to be released, for example, to people wishing to hire AWS Certified Welders,havetheweldersigninitials,whereindicatedontheapplication. Review: After completing the application, the Facility Test Supervisor must sign the document, indicating his CWI certificate number and itsexpirationdate.SignaturebytheATFSupervisoratteststothecompletenessandaccuracyoftherecordsupplied. GUIDETOINTERPRETINGABBREVIATIONSONAWSCERTIFIEDWELDERCARD EXAMPLE
Supplement G Code D1.1 Process GTAW FCAW Gas(optional) Ar100% CO2 FillerMetal ER70S2 E71T1 BaseMetal A106B Position(s) 4G 4G Thickness,Backing or Thickness,PipeOD&Backing L:1/83/4:4OD:WB L:1/83/4:4OD:WB

AWSSUPPLEMENTS C SheetMetalWelding(AWSD9.1) F ChemicalPlantandPetroleumPiping(ASMEB31.3andSec.IX) G GenericSupplement(CompanyfurnishedWPSandacceptancecriteria) B2.1 SWPS CODES: (ForSupplementGonly,referenceappropriateacceptancecriteria.) B2.1 AWSB2.1,StandardforWeldingProcedureandPerformanceQualification D1.1 AWSD1.1,StructuralWeldingCodeSteel D1.2 AWSD1.2,StructuralWeldingCodeAluminum D9.1 AWSD9.1,SheetMetalWeldingCode ASMEIX ASMESectionIX,QualificationStandardforWeldingandBrazingProcedures,Welders, Brazers,andWeldingandBrazingOperators D15.1 AWSD15.1,RailroadWeldingSpecificationCarsandLocomotives API API1104,WeldingofPipelinesandRelatedFacilities CUST OthercustomermaybeusedasindicatedontheemployersuppliedWPS *Otherstandards/codesmaybeusedasindicatedonthe employersuppliedWPS PROCESSES: SMAW ShieldedMetalArcWelding(SMAW) GMAW GasMetalArcWelding(GMAW) GMAWS GasMetalArcWeldingShortCircuit FCAW FluxCoredArcWelding(FCAW) GTAW GasTungstenArcWelding(GTAW) SAW SubmergedArcWelding(SAW) BZ Brazing GAS: AR Argon HE Helium Argon/CarbonDioxide Ar/CO2 CO2 CarbonDioxide Otherspecify

FILLERMETAL(AWSCLASSIFICATIONNUMBER) ER309L E7018A1L ER70S2 BASEMETAL AXXX ASTMDesignations(i.e.,A36) M MaterialNumbersfromB2 SAXXX (SA106,SA105,SA304L,etc.) PX (P1,P8,P44,etc.) POSITION 1G GrooveWeld,Flat 2G GrooveWeld,Horizontal 3G GrooveWeld,Vertical 4G GrooveWeld,Overhead 5G GrooveWeld,(Pipe)Vertical 6G GrooveWeld,(Pipe)45Vertical 6GR GrooveWeld,(Pipe)45withRestrictionRing 1F FilletWeld,Flat 2F FilletWeld,Horizontal 3F FilletWeld,Vertical 4F FilletWeld,Overhead V VerticalProgressionUp D VerticalProgressionDown A All THICKNESS U Unlimited(ex.1/8toUnlimited) L Limited(ex.1/83/4) xxxx Rangeinsheetgauges(ex.1118) x/x Thicknessinfractionsofaninch(ex.3/8) SCH Schedulelistingforpipethickness(ex.Sch40) WB Withbacking WOB Withoutbacking OD OutsideDiameter(pipe)

CertCWCertifiedWelderApplication09/20/12

MAINTENANCEOFWELDERCERTIFICATION

$15,Maintenancefeemustaccompanythisform.(Pricesaresubjecttochange.)

LastName: EmailAddress:

FirstName:

MI:

S.S.#:XXXXX Certification#:

Enterthedateyoumostrecentlyusedtheprocessesyouwouldliketomaintain.

Important:Failuretoincludedatesbelowwillresultinpaymentbeingforfeited.

SMAW GTAW

GMAW Other

FCAW

Yourcertificationisextendedfromthedatesyouhaveindicatedabove.Ex:04/12/2012

Verification:/Employer/TestSupervisor/Customer:Certifythattheabovenamedwelderusedtheweldingprocess(es)onthedatesindicated. Important:ThisformisNOTtobesignedbytheapplicant.(PleaseCircleOne)

PrintName: Company: Signature:

Copythisformasneeded.

Title: Date:

Phone: ( )

Ifyourmailingaddresshaschangedinthelastsixmonths,pleaselistnewaddressbelow: NewAddress: City: Province/Country:

Apt./Ste.No.: State: ZipCode:

YOURCERTIFICATIONISIMPORTANTTOYOUANDTOUS!
Usetheseformsbeforeyourexpirationdatetoproperlymaintainyourcertification.Certificationsinaccordancewith SupplementCorD9.1fortheSheetMetalWeldingCoderequiremaintenanceevery12months.Certificationsin accordancewithD1.1andallothercodesrequiremaintenanceevery6months.Checktherequirementsofthestandard thatgovernsyourcertificationtoassurethatmaintenanceisreceivedbyAWSattheproperintervals.Allchecksand AWS,8669 8669Doral DoralBoulevard, Boulevard Suite 130, Doral, Florida moneyordersmustbemadepayabletoAWSandmailedto:AWS, Doral, Florida 33166 . 33166.

WERECOMMENDSENDINGYOURFORMVIAUSMAILRETURNRECEIPTREQUESTED.

MethodofPayment
Check#:

Visa

MasterCard

AmericanExpress

DinersClub

Discover

CreditCard#: Signature:

Exp.Date:

AWSUseOnly
DateReceived: Account#:

Amount:

CertMaintenanceofWelderCertification09/20/12

GUIDE TO INTERPRETING ABBREVIATIONS ON AWS CERTIFIED WELDER CARD

EXAMPLE
Thickness, Backing - or -

Supplement
G

Code
D1.1

Process
GTAW FCAW

Gas (optional)
Ar 100% CO2

Filler Metal
ER70S-2 E71T-1

Base Metal
A106B

Position (s)
4G 4G

Thickness, Pipe OD & Backing

L: 1/8-3/4: 4 OD: WB L: 1/8-3/4: 4 OD: WB

AWS SUPPLEMENTS C Sheet Metal Welding (AWS D9.1) F Chemical Plant and Petroleum Piping (ASME B31.3 G B2.1 CODES:
and Sec. IX) Generic Supplement (Company-furnished WPS and acceptance criteria) SWPS

FILLER METAL (AWS CLASSIFICATION NUMBER) ER309-L E7018-A1L ER70S-2 BASE METAL AXXX ASTM Designations (i.e., A36) M Material Numbers from B2 SAXXX (SA106, SA105, SA304L, etc.) PX (P1, P8, P44, etc.) POSITION 1G Groove Weld, Flat 2G Groove Weld, Horizontal 3G Groove Weld, Vertical 4G Groove Weld, Overhead 5G Groove Weld, (Pipe) Vertical 6G Groove Weld, (Pipe) 45 Vertical 6GR Groove Weld, (Pipe) 45 with Restriction Ring 1F Fillet Weld, Flat 2F Fillet Weld, Horizontal 3F Fillet Weld, Vertical 4F Fillet Weld, Overhead V Vertical Progression Up D Vertical Progression Down A All THICKNESS U Unlimited (ex. 1/8 to Unlimited) L Limited (ex. 1/8-3/4) xx-xx Range in sheet gauges (ex. 11 - 18) x/x Thickness in fractions of an inch (ex. 3/8) SCH Schedule listing for pipe thickness (ex. Sch 40) WB With backing WOB Without backing OD Outside Diameter (pipe)

(For Supplement G only, reference appropriate acceptance criteria.) B2.1 AWS B2.1, Standard for Welding Procedure and Performance Qualification D1.1 AWS D1.1, Structural Welding Code - Steel D1.2 AWS D1. 2, Structural Welding Code - Aluminum D9.1 AWS D9.1, Sheet Metal Welding Code ASME IX ASME Section IX, Qualification Standard for Welding and Brazing Procedures, Welders, Brazers, and Welding and Brazing Operators D15.1 AWS D15.1, Railroad Welding Specification - Cars and Locomotives API API 1104, Welding of Pipelines and Related Facilities CUST Other customer may be used as indicated on the employer supplied WPS *Other standards/codes may be used as indicated on the employer supplied WPS

PROCESSES: SMAW Shielded Metal Arc Welding (SMAW) GMAW Gas Metal Arc Welding (GMAW) GMAW-S Gas Metal Arc Welding - Short Circuit FCAW Flux Cored Arc Welding (FCAW) GTAW Gas Tungsten Arc Welding (GTAW) SAW Submerged Arc Welding (SAW) BZ Brazing GAS: AR Argon HE Helium Ar/CO2 Argon/Carbon Dioxide CO2 Carbon Dioxide Other - specify

Cert- Guide to Interpreting Abbreviations-06/01/2012