In the realm of regulatory compliance within Texas, the TDLR 002BLR form emerges as a pivotal document, serving entities that wish to undertake the repair, setting, and sealing of safety appliances on boilers as delineated by Texas Boiler Law. Managed by the Texas Department of Licensing and Regulation's Compliance Division - Boiler Program, this form acts as an application for the Certificate of Authorization, a requisite for companies aiming to demonstrate their capabilities in specialized processes including machining, welding, non-destructive examination (NDE), and heat treatment across various sections of the ASME Code. Moreover, it details the scope of operations, specifying whether the activities are to be performed in a shop environment, on-field, or both, alongside the types of test media such as air, gas, steam, or liquid that will be employed. With spaces allocated for essential information such as the owner/operator’s name, physical and mailing addresses, and details of an authorized representative, the form ensures a comprehensive registry for the state’s audit and compliance checks. Additionally, it underscores the agreement for unannounced visits by the Chief Inspector or designated representatives to assure adherence to the stipulated requirements, reinforcing the rigorous oversight maintained by the authorities to uphold safety and performance standards in boiler operations within Texas.
| Question | Answer |
|---|---|
| Form Name | Tdlr Form 002Blr |
| Form Length | 2 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 30 sec |
| Other names | blr002 tdlr boiler texas form |
TEXAS DEPARTMENT OF LICENSING AND REGULATION
Compliance Division - Boiler Program - 920 Colorado - Austin, TX 78701
P.O. Box 12157 • Austin, Texas 78711 •
APPLICATION FOR CERTIFICATE OF AUTHORIZATION TO
REPAIR, SET AND SEAL SAFETY APPLIANCES
Chief Inspector
Texas Department of Licensing and Regulation
P. O. Box 12157
Austin, Texas 78711
For Chief Inspector
Use Only
Approved _______
Not Approved ________
The owner/operator named below hereby attests that it can repair, set and seal safety and safety relief valves on boilers covered by the Texas Boiler Law and is prepared to demonstrate this activity within the following scope:
Location: |
Shop |
Field |
Shop and Field |
|
Special Processes: |
Machining |
Welding |
NDE |
Heat Treatment |
ASME Code Section: |
I |
IV |
VIII, Div. 1 |
|
Test Media: |
Air |
Gas |
Steam |
Liquid |
|
|
|
|
|
and makes application for
initial issuance
renewal of the owner/operator Certificate of Authorization.
In consideration of receipt of the owner/operator Certificate of Authorization we hereby agree that the Certificate shall be used exclusively for valves on boilers encompassed by the Texas Boiler Law at the location(s) listed below. Further, it is agreed that the Chief Inspector or his designated representative may make audits or unannounced visits as necessary to assure compliance with the requirements of the Texas Boiler Law and associated rules.
OWNER/OPERATOR NAME
_________________________________________________________________________________________________________________________________________________________________
Company or corporate name, department, division, etc.
PHYSICAL LOCATION |
MAILING ADDRESS |
___________________________________________________________________________ |
___________________________________________________________________________ |
Street address or closest intersection |
Address |
___________________________________________________________________________ |
___________________________________________________________________________ |
City, State, Zip Code |
City, State, Zip Code |
LIST ON BACK OF THIS FORM ADDITIONAL LOCATIONS
FOR CERTIFICATE OF AUTHORIZATION TO BE ISSUED.
AUTHORIZED REPRESENTATIVE
___________________________________________________________________________ |
___________________________________________________________________________ |
Print or Type Name |
Signature |
___________________________________________________________________________ |
___________________________________________________________________________ |
Title |
Date |
_________________________________________________________________________________________________________________________________________________________________
Telephone
P.O. BOX 12157 AUSTIN, TEXAS 78711 ( 512) 539 - 5707 ( 800) 722 - 7843 FAX ( 512) 539 - 5687
EMAIL ADDRESS: BOILERS@LICENSE.STATE.TX.US I NTERNET ADDRESS: W W W .LICENSE.STATE.TX.US
**The Department will add your email address to the Boiler Program email notification list, which automatically provides information from the Department on matters affecting the Boiler Program. Your email address is confidential pursuant to the Texas Public Information Act and the Department will not share it with the public. See additional information at the following link http://www.license.state.tx.us/newsletters/TDLRnotificationLists.asp
TDLR FORM 002BLR 7/08
ADDITIONAL LOCATIONS FOR CERTIFICATE OF AUTHORIZATION TO BE ISSUED
(1)________________________________________ |
(10)_______________________________________ |
Street address or closest intersection |
Street address or closest intersection |
__________________________________________ |
__________________________________________ |
City, State, Zip Code |
City, State, Zip Code |
(2)________________________________________ |
(11)_______________________________________ |
Street address or closest intersection |
Street address or closest intersection |
__________________________________________ |
__________________________________________ |
City, State, Zip Code |
City, State, Zip Code |
(3)________________________________________ |
(12)_______________________________________ |
Street address or closest intersection |
Street address or closest intersection |
__________________________________________ |
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City, State, Zip Code |
City, State, Zip Code |
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(13)_______________________________________ |
Street address or closest intersection |
Street address or closest intersection |
__________________________________________ |
__________________________________________ |
City, State, Zip Code |
City, State, Zip Code |
(5)________________________________________ |
(14)_______________________________________ |
Street address or closest intersection |
Street address or closest intersection |
__________________________________________ |
__________________________________________ |
City, State, Zip Code |
City, State, Zip Code |
(6)________________________________________ |
(15)_______________________________________ |
Street address or closest intersection |
Street address or closest intersection |
__________________________________________ |
__________________________________________ |
City, State, Zip Code |
City, State, Zip Code |
(7)________________________________________ |
(16)_______________________________________ |
Street address or closest intersection |
Street address or closest intersection |
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City, State, Zip Code |
City, State, Zip Code |
(8)________________________________________ |
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Street address or closest intersection |
Street address or closest intersection |
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City, State, Zip Code |
City, State, Zip Code |
(9)________________________________________ |
(18)_______________________________________ |
Street address or closest intersection |
Street address or closest intersection |
__________________________________________ |
__________________________________________ |
City, State, Zip Code |
City, State, Zip Code |