Application For Welder'S Test - Unrestricted License Form - Office Of The Fire Commissioner Page 2
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1
2WELDER QUALIFICATION RECORD (WQR)
Welder’s Name: _____________________________________________ Symbol No.: ________________________________________
Identification of WPS followed by welder during welding of test coupon: ____________________________________________________
Base material(s) welded: _________________________________ Thickness: ___________________
Test Coupon
Prod. Weld
Testing Conditions and Qualification Limits
Welding Variables (QW-350)
Actual Values
Range Qualified
Welding Process(es) Used:
Type of Welding (i.e., Manual, Semi-Automatic) Used:
Base Metal P- or S-Number:
To P- or S-
Number:
Plate
Pipe
(enter diameter if pipe or tube):
Backing (metal, weld metal, double-welded, etc):
Filler Metal or Electrode Specification(s) (SFA) (Info only:)
Filler Metal or Electrode Classification(s) (info only):
Filler Metal or Electrode F-Number(s):
Filler Type (solid/metal or flux cored/powder) (GTAW or PAW:)
Consumable Insert for GTAW or PAW:
Deposit Thickness for each process or electrode type, etc. (in.):
Process/Electrode 1:
3 layers minimum
Yes
No
Process/Electrode 2:
3 layers minimum
Yes
No
Welding Position (2G, 6G, 3F, etc.):
Vertical Progression (Uphill or Downhill):
Fuel Gas for OFW or Inert Gas Backing for GTAW, PAW,
GMAW:
Transfer Mode (spray/globular or pulse to short circuit- GMAW):
GTAW Current Type/Polarity (AC, DCEP, DCEN):
Results
Visual Examination of Fit-Up; Root Gap: ____________ Tack Welds: _________________ (Length: __________ Number: ___________)
Root Pass (Describe Discontinuity if unacceptable): ____________________________________________________________________
Completed Weld (Describe defects if unacceptable): ___________________________________________________________________
Bend Test:
Transverse Root and Face [QW-462.3(a)]
Longitudinal Root and Face [QW-462.3(b)]
Side [QW-462.2]
Pipe Bend Specimen, corrosion-resistant overlay [QW-462.5(c)]
Plate Bend Specimen, corrosion-resistant overlay [QW-
462.5(d)]
Macro Test for Fusion [QW-462.5(b)]
Macro Test for Fusion [QW-462.5(e)]
Type
Result
Type
Result
Type
Result
(For alternative qualification of groove welds by radiography to QW-191)
Radiographic Results: ____________________________________________________________________________________________
Appearance-Fillet Size (leg.): ________________ X _______________ inch.
Convexity:________ inch. or Concavity: __________inch.
Other Tests: ___________________________________________________________________________________________________
Record Information
Film or Specimens Evaluated by: __________________________Company: ________________________________________________
Welding Supervised by: __________________________________________________________________________________________
Mechanical Tests Conducted by; ____________________________________ Laboratory Test No: ______________________________
We certify that the statements in this record are correct and that the test coupons were prepared, welded and tested in accordance with
the requirements of Section IX of the ASME Boiler and Pressure Vessel Code.
Certified by: ______________________________________________________ Date: ________________________________________
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