Form 720 94 – Fill Out and Use This PDF

	(TO BE ON CONTRACTOR LETTERHEAD)
Send to:	National ITC Corporation
	501 Shatto Place, Suite 201
	Los Angeles, CA 90020
	Office: (877) 457-6482 Fax: (213) 351-7632

N.I.T.C. Welding Re-Certification by Performance

We wish to use provision 3.1.9. (Performance Qualification). Of AWS “B2.1-84” Standard for Welding Procedure and Performance Qualification.

In order to be Re-Certified, the welders performance qualification shall remain in effect indefinitely unless the welder is not engaged in the process qualified for a period exceeding 12 months or there is some specific reason to question a welder’s ability. In these instances, re-qualification may be accomplished by making and testing one test weldment using the same process.

WELDER NAME:					S.S.# (last 6): XXX-	-
ADDRESS:				CITY:	STATE:	ZIP CODE:
WORK PHONE:				RESIDENCE:	CELLUAR:
LOCAL UNION:

PRESENT WELDING CERTIFICATIONS ARE:

	N.I.T.C. WELDING PROCEDURE(S)		CHECK	DATE OF MOST RECENT WELD
			PROCEDURE(S)	(must be on or before expiration date)
	W1-CSP-1	6” Downhill
	W2-CSP-1A	6” Uphill
	W3-CRM-5	6” Chrome
	W4-CRN-8	2” Stainless
	W5-CSP-1B	2” XX Uphill
	W6-STR-1	3/8” Plate Limited
	W7-STR-2	1” Plate Unlimited

Sincerely,

Print Name of Contractor or authorized representative		Signature of Contractor or authorized representative
(Individual that witnessed weld)		(Individual that witnessed weld)

Title of signer

Name of Company

(Please mail new picture to: N.I.T.C. 501 Shatto Place, Suite 201 Los Angeles, CA 90020 or email to: photo@nationalitc.com)

Form # 720-94 Rev 11-21-06 (weldrecert).doc