WELDER and WELDING OPERATOR PERFORMANCE QUALIFICATION RECORD: Welder's Namé Welder's $$ N VARIABLE QUALIFICATION TEST DETAIL QUALIFICATION RANGE” Code or Specification Used: ‘Welding Process and Type: OWanval O Semiautomatic OWanual 0 Semiautomatic Oitechanized [) Automatic Oi echanized [) Automatic Backing: Tused TZ Not used Required if used Base Metal SpeciP or M-Number Plate/Pipe Thickness - Groove | Plate) Fipe D) Thick. Piate/Pipe Thickness - Filet _| Plate] Pipe C) Thick Fipe/Tubular Gutside Diameter — Groove Pipe/Tubular Outside Diameter — Fillet Filler Metal Specification No. Classification No. F No. Diameter Consumable insert | LJ Yes LJNo Penetration Enhancing Flux | C1Yes CINo Deposited Weld Metal Thickness CurrentiPolarity & Current Range TypelPolarity Range: Amperes Metal Transfer Mode (GMAW or FCAW) Torch Shielding Gas Type: Flow: Root Shielding Gas TINA Type: Flow: Position(s) Test Position(s) (1G, 26, ete.) Qualified Position(s) (F, H, V, , or All) Vertical Progression uphill D1 Downhill uphill D Downhill “NOTE Inset NA for Variables that are Wdentinied ss Non-essentialin the Code or Speciic ation used for the Performance Qualification Test MECHANICAL TEST RESULTS Type And Figure No. Type And Figure No. Guided mechanical Testing Conducted By: Date: NONDESTRUCTIVE EXAMINATION RESULTS Radiographic Results: Report No. Radiographic Testing Conducted By: Welding Witnessed By: ‘Visual Inspection: [] Pass [] Fail (reason We cerify that the statements in this record are correct and the test welds were prepared, welded and tested in accordance with the requirements of. AWSD1.1-,AWSB2.1- ther: Date Qualified: ATF Name and Number; a Signed By: # Signature