Format No: CL/FM/98

Rev No: 00; DT: 01/01/16

METALLOGRAPHY AND MICROSTRUCTURAL ANALYSIS REQUISITION

Work order no. : Date:

1. Material Specification (with relevant standard) :
2. Heat Treatment condition :
3. No of Samples & Identification No :
4. Form : Sheet/Plate/Bar/Rod/others
5. No of samples & Identification :
6. Test sample Representation :
7. Whether tested specimens are required back : Yes/No
8. Date of the report is required :
9. Nature of job
(Please contact metallography division for appropriate size
Before extraction for analysis)
Cutting Macrostructure Phase analysis
Mounting Microstructure Microhardness (HV/HK)
Polishing Inclusion rating
Etching Grain size measurement

User signature: Company name:

Name/Designation: Contact no:
FOR CMSS USE ONLY
Test in charge:

Recommended/Not recommended Approved/Not approved

Test control no : Date of compleation:

Mounted by : Date: Remarks (if any)
Polished by : Date:
Etched by : Date:
Analysis by : Date:

Signature of the test engineer/ in charge