ML072770538

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September 2007 Evidentiary Hearing - Applicant Exhibit 24, ASME IWE Class Mc Containment Visual Examination Records, Recording the the VT-1 Visual Examinations of the Drywell Shell in All Ten Bays in the Sand Bed Region
ML072770538
Person / Time
Site: Oyster Creek
Issue date: 10/22/2006
From:
AmerGen Energy Co
To:
Office of Nuclear Reactor Regulation
SECY RAS
References
50-219-LR, AmerGen-Applicant-24, ER-AA-335-018, Rev 3, RAS 14231
Download: ML072770538 (52)


Text

Ul. NUCLEAR REGULATORY COMMISSION

'R4-51 /IA~31 ms ft MM~W LMQba awl\\E 1j Ooeift::.D-0'9-lt-Official Exhibit No.

OWREDI ca nsee Intervenor NRC Staff Other itnes IWs/Pan s MO)

AF4EMM WMMRAY

'§M-E IWE (Class MC)

APPLICANT'S EXH. 24 ER-AA-335-018 Revision 3 Page 27 of 29 ATTACHMENT 4 Containment Visual Examination Record Page 1 of I Station:

ef fIjUnit:

1 Exam Data Sheet. No.:

Exam Date: o-11-6-4, System: 1 Examination Procedure gR-AA--335-018 Rev. 3 Work Order No(s).:Ra/>88'O.Y-6 Location:

Building: g)(

Elev.: 15 '

Col.: fjht Row:

,jl/A Azimuth/Radius: ob Exam Tvoe: 1-- DV FIGV [ZVT-1 E]VT-3 Type Of Exam: M*Direct

[]Remote Matl. Tvpe: CIS I Design Drawing(s) 1 AA Visual Aids:

FrL.A.34LI6.l.*T Surface:

ID M

Surface / Components Coated: 1 YES E1 NO M&TE Used:

P I UTC or Serial No.

0j A Cal. Due Date: AJA Illumination Used FLASU,,-t-Illumination Verified:

Date:.. Iq-D, Time: z.)36 Special I Specific Instructions: I Component / Item Number and RESULTS Explanation / Notes Description NI RI TYPE I.N.

(As a minimum, Record Location and Size of (e.g. EIN, EID, etc.)

Recordable Indications as applicable) j75 fj?.fI5L SPEC*

Results Legend:

NI.- No Indications RI - Recordable Indication IN.- Indication Number (if applicable)

Recordable Indication Type Codes:

A.

Wear G.

Blistering M. Missing Components S.

Deviation From Design Drawing B.

Corrosion J Pitting H.

Peeling N.

Loose Components T.

Missing Paint Or Coating C.

Mech. Damage I.

Discoloration

0.

Tears U.

Bulges I Deformation D.

Erosion J.

Pitting P.

Coating Damaged V.

Missing / Incomplete Welds E.

Cracks K.

Nicks / Gouges Q.

Leakage/ Moisture W. Arc Strikes F.

Flaking L.

Dents R.

Dislodged Seal, Gasket, Z.

Other (Provide Explanation) or Moisture Barrier Supplemental Information: [R]Yes -&"W El Sketch []Photo

[LVideo El Other (Describe):

VISUAL EXAMINER SIGNATU RE:

r..

04 9.,

L Zf' D,:1-6 NDE LEVEL III SIGNATURE:

DATE:

/o Z - "to RESP. INDIVIDUAL SIGNATURE:

DATE:

FINAL DISPOSITION BY LEVEL III I RESP. INDIVIDUAL El Accept El Reject Comments:

ANII REVIEW SIGNATURE:

DATE:

DOCKETED USNRC October 1, 2007 (10:45am)

OFFICE OF SECRETARY RULEMAKINGS AND ADJUDICATIONS STAFF 00LR00027361

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1"pli-je- 013 ER-AA-335-018 Revision 3 Page 27 of 29 ATTACHMENT 4 ASME IWE (Class MC) Containment Visual Examination Record Page 1 of 1 Station: O1srfIa.

r Unit:

I-Exam Data Sheet. No.:

Exam Date: /6-ZO-8 System: 187 Examination Procedure 69-AA - 335 -o 18 Rev. 3 Work Order No(s).: 9267667-01, Location:

Building: g.,

.Elev.: 61 Col.:

1J),'i Row: J).

Azimuth/Radius: 30C Exam Type: LI DV IGV [OVT-i

.IVT-3 Type Of Exam:.JDirect

[iRemote Mati. Ty e: _C 6 Design Drawing(s)

,M,

  • Visual Aids: (6's*

iz.yr.

Surface:

ID (0*D)

Surface / Components Coated.:..d YES El NO M&TE Used:

,iM UTC or Serial No.

A.1 Cal. Due Date: 4,q Illumination Used f.45H Li d-4 Illumination Verified:

Date:

Time: 21-yo Special / Specific Instructions: I Component / Item Number and RESULTS Explanation I Notes Description NI RI TYPE I.N.

(As a minimum, Record Location and Size of (e.g. EIN, EID, etc.)

Recordable Indications as applicable)

Sg

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RECv.13 Results Legend:

NI -No Indications RI - Recordable Indication I.N.- Indication Number (if applicable)

RecordableIndication Type Codes:

A.

Wear G.

Blistering M.

Missing Components S.

Deviation From Design Drawing

  • B.

Corrosion I Pitting H.

Peeling N.

Loose Components T.

Missing Paint Or Coating C.

Mech. Damage I.

Discoloration

0.

Tears.

U, Bulges I Deformation D.

Erosion J.

Pitting P.

Coating Damaged V.

Missing I Incomplete Welds E.

Cracks K.

Nicks IGouges Q.

Leakage / Moisture W.

Arc Strikes F.

Flaking L.

Dents:'

R.

.Dislodged Seal, Gasket, Z.

Other (Provide Explanation) or Moisture Barrier Supplemental Information : IRYes [I]No LII Sketch DO-Photo LIVideo El Other (Describe):

VISUAL EXAMINER SIGNATURE:

,CC1LAS1'*

LEVEL 7'--1 DATE: J0- o-ZO NDE LEVEL III SIGNATURE:

-L h/4 /-

,2"06, DATE:

RESP. INDIVIDUAL SIGNATURE:

DATE:

FINAL DISPOSITION BY LEVEL IIl / RESP. INDIVIDUAL El Accept E] Reject Comments:

ANII REVIEW SIGNATURE:

DATE:

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ER-AA-335-018 Revision 3 Page 27 of 29 ASME IWE (Class MC)

ATTACHMENT 4 Containment Visual Examination Record Pacie I of 1 Station:

Unit:

Exam Data Sheet. No.:

Exam Date: Id6.

i6 Z System:

Examination Procedure El?..¢ Rev.

Work Order No(s)..

Location:

Building:

Elev.:

Col.:

Row:

Azimuth/Radius:

Exam Type: El DV [GV IKVT-1 E[VT-3 Type Of Exam: ZDirect EIRemote Mati. Type: C,,

Design Drawing(s)

S

_A Visual Aids: RLA,*iLT,,

Surface:

ID

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Surface / Components Coated: [K YES LI NO M&TE Used:

.,LA UTC or Serial No.

Ar Cal. Due Date:

A/A Illumination Used -FLCsLGcA-.

Illumination Verified:

Date: 1o-Z6. C Time: 1 Special / Specific Instructions: I.

Component / Item Number and RESULTS Explanation / Notes Description NI RI TYPE MN.

(As a minimum, Record Location and Size of (e.g. EIN, EID, etc.)

Recordable Indications as applicable)

A0 -rc: F~io0o? COA-T-r:

Results Legend:

NI - No Indications RI - Recordable Indication I.N.- Indication Number (if applicable)

Recordable Indication Type Codes:

A.

Wear G.

Blistering M. MissingComponents S.

Deviation From Design Drawing B.

Corrosion I Pitting H.

Peeling N.

Loose Components T.

Missing Paint Or Coating C.

Mech. Damage I.

Discoloration

0.

Tears U.

Bulges Deformation D.

Erosion J.

Pitting P.

Coating Damaged V.

Missing I Incomplete Welds E.

Cracks K.

Nicks I Gouges

0.

Leakage I Moisture.

W.

Arc Strikes F.:

Flaking L.

Dents R.

Dislodged Seal, Gasket, Z.

Other (Provide Explanation) or Moisture Barrier Supplemental Information: NYes LINo El*Sketch hoto " Video Other (Describe):

VISUAL EXAMINER SIGNATURE

. LEVEL" DATE: IO-.O.tK, NDE LEVEL III SIGNATURE:

-J /144 '.

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Z -z -

DATE:.

RESP. INDIVIDUAL SIGNATURE:

DATE:

FINAL DISPOSITION BY LEVEL III I RESP. INDIVIDUAL EL Accept

[I Reject Comments:

ANII REVIEW SIGNATURE:

DATE:

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1W.11 LA - 0014 P.2 1or (0 ER-AA-335-018 Revision 3 Page 27 of 29 ATTACHMENT 4 ASME IWE (Class MC) Containment Visual Examination Record Pacie I of I Station:O* *,

Unit:

I Exam Data Sheet. No.:

Exam Date: 10 -c1 -

13, System:

Examination Procedure?

Rev. 2 Work Order No(s)..R208ZcO0 -(

Location:

Building:

Elev.: I."

Col.:

r/p, Row: i,*J/

Azimuth/Radius:

z Exam Type: [I DV i'IGV §VT-1 I-VT-3 Type Of Exam:

)Direct E]Remote Mati. Type: -/

Design Drawing(s)

A Visual Aids: f-ALJ6&"

Surface:

ID QOD Surface / Components Coated: X YES 0I NO M&TE Used:

UTC or Serial No.

,./

!,Cal.

Due Date:

Illumination Used Filt t,rF.j-1 Illumination Verified:

Date: 10.1.r.-.

Time: 13 Zo Special I Specific Instructions:

Component I Item Number and RESULTS Explanation I Notes Description NI RI TYPE I.N.

(As a minimum, Record Location and Size of (e.g. EIN, EID, etc.)

Recordable Indications as applicable)

~~3~A/-r7 CT.i x

TPA2)D~

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~.t i4T4 2)A? %t*.,I-

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NI -No Indications RI - Recordable Indication I.N.- Indication Number (if applicable)

Recordable Indication Type Codes:

A.

Wear G.

Blistering M. Missing Components S.

Deviation From Design Drawing B.

Corrosion I Pitting H.

Peeling N. Loose Components T.

Missing Paint Or Coating.

C.

Mech. Damage I.

Discoloration

0.

Tears U.

Bulges I Deformation D.

Erosion J.

Pitting P.

Coating Damaged V.

Missing / Incomplete Welds E.

Cracks K.

Nicks 1 Gouges Q.

Leakage i Moisture W.

Arc Strikes F.

FRaking L.

Dents R.

Dislodged Seal, Gasket, Z.

Other (Provide Explanation) or Moisture Barrier Supplemental Information.:

Yes rNo Sketch oo 'lVideo ECOther (Describe):

VISUAL EXAMINER SIGNATUREg 2\\

LEVEL QI1 DATE: IO-1q9-0,.

NDE LEVEL Ill SIGNATURE:

rDATE:

iO "ZO'0, RESP. INDIVIDUAL SIGNATURE:

DATE:

0:

FINAL DISPOSITION BY LEVEL III / RESP. INDIVIDUAL El Accept [] Reject 5"e..-

Comments: 6M.o--"(I.Aef-A A10 -

12'3"e... d-tpo

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ANII REVIEW SIGNATURE:

DATE:

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,i.r ER-AA-335-018 Revision 3 I Page 27 of 29 ATTACHMENT 4 ASME IWE (Class MC) Containment Visual Examination Record Page I of I Station:*)**r..

Cr_-**lUnit:

I Exam Data Sheet. No.:

,JJA Exam Date: /10-1 6&

System: )17 Examination Procedure fR-AA-335'-dlb Rev. 3 Work Order No(s).:p.b.

q 1-Location:

Building:

Elev.:

Col.: PIA Row:

01,4 Azimuth/Radius: p5-o6 Exam Type: [I DV E.GV [KVT-1 EIJVT-3 Type Of Exam: 5QDirect

[]Remote Matl. Type: C157 T Design Drawing(s) g1A Visual Aids:.t.i*#siuC-Surface:

ID O

Surface / Components Coated: W YES El NO M&TE Used:

IiJA UTC or Serial No.

rj 1,

Cal. Due Date hlL, Illumination Used *le'tL*rIllumination Verified:.

Date: it-I q" 5,

Time:"Z. 3 Special / Specific Instructions: I/*

Component / Item Number and RESULTS Explanation / Notes Description NI R

I RedTYPE I.N.

(As a minimum, Record Location and Size of

.EINR EIDb etc.)

Recordable Indications as applicable) olzFer~eh CO'TNV4 14AS AM*EA Of "Cý 32 872-Cf Ar V L

  • 4,J

ýN Results Legend:

NI - No Indications RI - Recordable Indication I.N.- Indication Number (if applicable)

Recordable Indication Type Codes:

A.

Wear G.

Blistering M.

Missing Components S.

Deviation From Design Drawing B.

Corrosion i Pitting H.

Peeling N.

Loose Components T.

Missing Paint Or Coating C.

Mech. Damage I.

Discoloration

0.

Tears U.

Bulges I Deformation D.

Erosion J.

Pitting P.

Coating Damaged V.

Missing I Incomplete Welds E.

Cracks K.

Nicks I Gouges

0.

Leakage I Moisture W.

Arc Strikes F.

Flaking L.

Dents R.

Dislodged Seal, Gasket, Z.

Other (Provide Explanation) or Moisture Barrier Supplemental Information : W Yes !-'No Ii Sketch I'Photo rIVideo E] Other (Describe):

VISUAL EXAMINER SIGNATURE:

,---gt,

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LEVEL 11L DATE:

NDE LEVEL III SIGNATURE:

DATE:

RESP. INDIVIDUAL SIGNATURE:

DATE:

FINAL DISPOSITION BY LEVEL III / RESP. INDIVIDUAL LI Accept E] Reject Comments:

ANII REVIEW SIGNATURE:

DATE:

OCLR00027381

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ocZ ER-AA-335-018 Revision 3 Page 27 of 29 ATTACHMENT 4 ASME IWE (Class MC) Containment Visual Examination Record Page 1 of I Station: !.,STf (C Ca.C.Unit:

I Exam Data Sheet. No.:

Exam Date: iL-Z,064, 6310 System: IE-7 Examination Procedure C-A - 3357-18 Rev. 3 Work Order No(s).:-"-2 zB6 -

Location:

  • Building:

gy, Elev.:

I Col.:

A)11 Row: p/6 Azimuth/Radius:

o Exam Type: El DV EFGV [&T-1.- VT-3 Type Of Exam: RjDirect E]Remote Matl. Type:* C/_6 Design Drawing(s)

PIA Visual Aids: FLAHLI6LI4t-Surface:

ID D

Surface I Components Coated: R YES E] NO M&TE Used: N IA UTC or Serial No.

x)) A Cal. Due Date:

Ai 1-Illumination Used FtA61,5L%6l.*

Illumination Verified:

Date: IO-Z4o-D(

Time: 03/h9 Special /Specific Instructions: I..

'h Component / Item Number and RESULTS Explanation /Notes Description N1 RI TYPE I.N.

(As a minimum, Record Location and Size of (e~g. EIN, EID, etc.)

Recordable Indications as applicable)

CbATI-6 14A:5 AIZCE Refrrf Sa~c..6 SFPfiIZAT~o,4 Results Legend:

NI -No Indications RI - Recordable Indication I.N.- Indication Number (if applicable)

Recordable Indication Type Codes:

A.

Wear G.

Blistering M.

Missing Components S.

Deviation From Design Drawing B'

Corrosion I Pitting H.

Peeling N.

Loose Components T.

Missing Paint Or Coating C.

Mech. Damage I.

Discoloration

.0.

Tears U.

Bulges / Deformation D.

Erosion J.

Pitting P.

Coating Damaged V.

Missing / Incomplete Welds E.

Cracks K.

Nicks I Gouges Q.

Leakage / Moisture W.

Arc Strikes F.

Flaking L.

Dents R.

Dislodged Seal, Gasket, Z.

Other (Provide Explanation) or Moisture Barrier Supplemental Information: [Yes.No El Sketch J]Photo L-Video E] Other (Describe):

VISUAL EXAMINER SIGNATURE:

iE-6*

P.

LEVEL J DATE: /0-160 NDE LEVEL III SIGNATURE:

DATE:

/Q-

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RESP. INDIVIDUAL SIGNATURE:

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DATE:

FINAL DISPOSITION BY LEVEL III/ RESP. INDIVIDUAL El Accept El Reject Comments:

ANII REVIEW SIGNATURE:

DATE:

OCLR00027387

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ER-AA-335-018 Revision 3 Page 27 of 29 I ATTACHMENT 4 ASME IWE (Class MC) Containment Visual Examination Record Page 1 of 1 Station: O YSiv CgilY, Unit:

I Exam Data Sheet. No.:

Exam Date: /'0-"-

o, System: 18"7 Examination Procedure f*."j*j-33*T-OJ5 Rev. 3 Work Order No(s)..*12po ?0o-Location:

Building: 1(

Elev.: /5' Col.:,J)R Row: Pi14A Azimuth/Radius: ?c?° Exam Type:E LDV FIGV INVT-1 _IVT-3 Type Of Exam:

Direct L-Remote Matl. Type: CiS Design Drawing(s)

A.(I Visual Aids:

F.ASAW Surface:

ID (O

Surface / Components Coated: rg YES E] NO M&TE Used:

p*1A UTC or Serial No.

p IA-Cal. Due Date: v) A Illumination Used Illumination Verified:

Date:

Time: 3,5-Special / Specific Instructions: I Component I Item Number and RESULTS Explanation / Notes Description NI RI TYPE I.N.

(As a minimum, Record Location and Size of (e.g. EIN, EID, etc.)

Recordable Indications as applicable)

S13 coNTrAwmE14A 01 A S-328,Zi 064 fu. '3 Results Legend:

NI - No Indications RI - Recordable Indication I.N.- Indication Number (if applicable)

Recordable Indication Type Codes:

A.

Wear G.

Blistering M. Missing Components S.

Deviation From Design Drawing B.

Corrosion/ Pitting H.

Peeling N.

Loose Components T.

Missing Paint Or Coating C.

Mech. Damage I.

Discoloration

0.

Tears U.

Bulges / Deformation D.

Erosion J_

Pitting P.

Coating Damaged V.

Missing / Incomplete Welds E.

Cracks K.

Nicks i Gouges Q.

Leakage / Moisture W.

Arc Strikes F.

Flaking L.

Dents R.

Dislodged Seal, Gasket, Z.

Other (Provide Explanation) or Moisture Barrier Supplemental Information: TYes -

. _-I Sketch,gPhoto

-[--Video EL Other (Describe):

VISUAL EXAMINER SIGNATURE:.'0 LEVEL UT-DATE: It-lB-st3 NDE LEVEL III SIGNATURE:

-DATE:

I6-d f-t0 RESP. INDIVIDUAL SIGNATURE:.

"P ii"'

t..W

,o-Z~t.-Oo DATE:

FINAL: DISPOSITION BY LEVEL III / RESP. INDIVIDUAL LI Accept El Reject Comments:*

ANII REVIEW SIGNATURE:

DATE:

OCLR00027392

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'K-2ujZ'- 01(0 Igc Pýý 1 " dz'.5' ER-AA-335-018 Revision 3 Page 27 of 29 I

ATTACHMENT 4 ASME IWE (Class MC) Containment Visual Examination Record Page I of I Station: O '.ff.

Crja,4Unit:

I Exam Data Sheet. No.:

Exam Date: 1o0-ZO -64, System: 187 Examination Procedure

-..RA-335-bi Rev. 3 Work Order No(s).:,lbs 89 211-Location:

Building:

9,K Elev.:

/,5' Col.:

.) 1A Row: A)g.

Azimuth/Radius:. 2.55 Exam Type: E] DV ZIGV 10VT-1 FE-VT-3 Type Of Exam: EJDirect DRemote Matl. Type: 1 -J j Design Drawing(s)

Visual Aids:

fL. A 5 140)&14t.r Surface:

ID (OD)

Surface I Components Coated:

YES El NO M&TE Used:

UTC or Serial No. JU) A Cal. Due Date:

A Illumination Used rL.A1L,141-Illumination Verified:

Date: )0, 16 Time: 0 3 Special I Specific Instructions:

IVY Component I Item Number and RESULTS Explanation / Notes Description NI RI TYPE I.N.

(As a minimum, Record Location and Size of (e.g. EIN, EID, etc.)

Recordable Indications as applicable)

VJAPOKt Bfwl/

FL06 -

C c p ~r.1, 4

Results Legend:

NI - No Indications RI - Recordable Indication I.N.- Indication Number (if applicable)

Recordable Indication Type Codes:

A.

Wear G.

Blistering M.

Missing Components S.

Deviation From Design Drawing B.

Corrosion I Pitting H.

Peeling N.

Loose Components T.

Missing Paint Or Coating C.

Mech. Damage I.

Discoloration

0.

Tears U.

Bulges I Deformation D.

Erosion J.

Pitting P.

Coating Damaged V.

Missing i Incomplete Welds E.

Cracks K.

Nicks [Gouges Q.

Leakage I Moisture W.

Arc Strikes F.

Flaking L.

Dents R.

Dislodged Seal, Gasket, Z.

Other (Provide Explanation) or Moisture Barrier Supplemental Information: tYes -]No E] Sketch OPhoto L-Video [j Other (Describe):

VISUAL EXAMINER SIGNATURE:

_.7 7-i uhQý LEVEL Jr DATE: /l-Z0 -

NDE LEVEL III SIGNATURE:

ý;M f *a4ý_L L

7 DATE:

/l-Z z-O (

RESP. INDIVIDUAL SIGNATURE:

DATE:

FINAL DISPOSITION BY LEVEL III I RESP. INDIVIDUAL El Accept

[I Reject Comments:

ANII REVIEW SIGNATURE:

DATE:

OCLROO027396

IC - C I&

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Bay 15 OCLR00027397

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p~3 q~S Bay 15 right side 0CLR00027399

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jA'91Z.R-O/I ER-AA-335-018 Revision 3 I Page 27 of 29 ATTACHMENT 4 ASME IWE (Class MC) Containment Visual Examination Record Paqe I of I Station:

Unit: j Exam Data Sheet. No.:

Exam Date:

Staton:()45Tf Exm Dte:/6-z System: 1I7 Examination Procedure 99-AA-335-0t6 - Rev.3 Work Order. No(s).:g2aoq Z86h.6 Location:

Building: ?X Elev.://

Col.: N1,A Row:.l, Azimuth/Radius:.290 Exam Type: LI DV I"-]GV E-VT-1 2]VT-3 Type Of Exam: [fDirect LiRemote Mati. Type: 45 Design Drawing(s)

N/A Visual Aids: FL,*d/.&/Iwr" Surface:

ID Surface I Components Coated: [f YES E] NO M&TE Used: r UTC or Serial No.

N//A Cal. Due Date:

Illuminationused,

7.

Illumination Verified:

Date:/,.Zd.o 1

Time:l Special / Specific Instructions: I Component I Item Number and RESULTS Explanation I Notes Description NI RI TYPE I.N.

(As a minimum, Record Location and Size of (e.g. EIN. EID, etc.)

Recordable Indications as applicable)

~,CER0V~t.A~tP~SNI Results Legend:

NI - No Indications RI - Recordable Indication I.N.- Indication Number (if applicable)

Recordable Indication Type Codes:.

A.

Wear G.

Blistering M. Missing Components S.

Deviation From Design Drawing B.

Corrosion I Pitting H.

Peeling N.

Loose Components.

T.

Missing Paint Or Coating C.

Mach. Damage I.

Discoloration

0.

Tears U.

Bulges / Deformation D.

Erosion J.

Pitting P. f" Coating Damaged V.

Missing / Incomplete Welds E.

Cracks K.

Nicks I Gouges Q..

Leakage / Moisture W.

Arc Strikes*.

F.

Flaking L.

Dents R.

Dislodged Seal, Gaskel, Z.

Other (Provide Explanation) or Moisture Barrier Supplemental Information &i[Yes LINo

[L Sketch [nPhoto E]Video LI Other (Describe):

VISUAL EXAMINER SIGNATURE:

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2i' t2L,-

L.7

- C(o DATE:

RESP. INDIVIDUAL SIGNATURE:

DATE:

FINAL DISPOSITION BY LEVEL III I RESP. INDIVIDUAL EI Accept LI Reject Comments:

ANII REVIEW SIGNATURE:

DATE:

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  • ER-AA-335-018 Revision 3 Page 27 of 29 ATTACHMENT 4 ASME IWE (Class MC) Containment Visual Examination Record Page I of 1 Station: 0* 5TI& CgpCx Unit:

I-Exam Data Sheet. No.:

Exam Date: lo -2o.6 System: jb-7 Examination Procedure EA-/A-335-,D8 Rev. 3 Work Order No(s).:/?0a&6z4,-.A Location:

Building: j-,(

Elev.:

151 Col.: /4,4.

Row:

0/yi Azimuth/Radius: "3Z0t Exam Type. El DV []GV MVT-1 E]VT-3 Type Of Exam: lNDirect

-]Remote Matl. Type: 6A J

Design Drawing(s)

AAA Visual Aids:

Fhin itH" 7" Surface:

ID.D...

Surface / Components Coated: *J YES NO M&TE Used:.

).A UTC or Serial No.

,J)A*

C.al. Due Date:.,//

__illumination Used *-i.A5)11,16411"-

Illumination Verified:

Date: /&*

a*

Time:

/]

Special,/Specific Instructions: I W'IA

'Component / Item Number and

/RESULTS Explanation / Notes

Description NI1 RI TYPE I.N.

I(As a minimum, Record Location and Size of Ie.g. EIN, EID, etc.)

Recordable Indications as applicable)

ZE 3.eC3 Z8 27.7-t 't

)260, A3 Results Legend:

NI - No Indications RI - Recordable Indication I.N.- Indication Number (if applicable)

RecordableIndication Type Codes:

A.

Wear G,

Blistering M. Missing Components S.

Deviation From Design Drawing B.

Corrosion I Pitting H.

Peeling N.

Loose Components T.

Missing Paint Or Coating C.

Mech. Damage I.

Discoloration

0.

Tears U.

Bulges I Deformation

0.

Erosion J.

Pitting P.

Coating Damaged V.

Missing I Incomplete Welds E.

Cracks K.

Nicks I Gouges Q. Leakage I Moisture W.

Arc Strikes F.

Flaking L.

Dents R.

Dislodged Seal. Gasket, Z.

Other (Provide Explanation).

or Moisture Barrier Supplemental Information: [Yes r-No E] Sketch I*Photo E]Video E] Other (Describe):

VISUAL EXAMINER SIGNATURE:

Cow d.oc" LEVEL 2-21 DATE: l NDE LEVEL III SIGNATURE:

A X.,

DATE:

,10-zc-o0 RESP. INDIVIDUAL SIGNATURE:

DATE:

FINAL DISPOSITION BY LEVEL II I RESP. INDIVIDUAL El Accept El Reject Comments:

ANII REVIEW SIGNATURE:

DATE:

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