ML18151A156

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Inservice Insp Summary Rept for 1990 Refueling Outage. W/910312 Ltr
ML18151A156
Person / Time
Site: Surry Dominion icon.png
Issue date: 03/12/1991
From: Stewart W
VIRGINIA POWER (VIRGINIA ELECTRIC & POWER CO.)
To:
NRC OFFICE OF INFORMATION RESOURCES MANAGEMENT (IRM)
References
91-127, NUDOCS 9103140262
Download: ML18151A156 (302)


Text

{{#Wiki_filter:... ' ,. VIRGINIA ELECTRIC AND POWER COMPANY RICHMOND, VIRGINIA 23261 March 12, 1991 U.S. Nuclear Regulatory Commission Serial No.: 91-127 Attention: Document Control Desk NES/ETS Washington, D.C. 20555 Docket No.: 50-280 License No.: DPR32 Gentlemen: VIRGINIA ELECTRIC AND POWER COMPANY SURRY POWER STATION STATION UNIT 1 INSERVICE INSPECTION

SUMMARY

REPORT FOR THE 1990 REFUELING OUTAGE As set forth in the provisions of ASME Section XI, paragraph IWA 6230, enclosed is the lnservice Inspection Report for Surry Power Station Station Unit 1 for the 1990 refueling outage. This report is a summary of examinations performed during the outage to satisfy requirements for the second inservice inspection interval. In accordance with IWA-6220 of the 1980 Edition of ASME Section XI, Winter 1980 Addenda, a Form NIS-1, Owner's Report for lnservice Inspections, is provided with this report as Enclosure 1 and the NIS-2 Forms, Owner's Reports of Repair and Replacement, are provided as Enclosure 2. Should you require more detailed information, the entire report will be maintained on file at the station and the corporate office. Very truly yours,

                   ~tS~

W. L. Stewart Senior Vice President - Nuclear Enclosures cc: U. S. Nuclear Regulatory Commission Region II 101 Marietta Street, N. W. Suite 2900 Atlanta, Georgia 30323 Mr. W. E. Holland NRC Senior Resident Inspector Surry Power Station

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INSERVICE INSPECTION

SUMMARY

REPORT

  • 1990 REFUELING OUTAGE
  • REC'D W/LTR DTD 03/12/91. ... 9103140262 .
                  -NOTICE-THE ATTACHED FILES ARE OFFICIAL RECORDS OF .THE lNFORMATION &

REPORTS *.MANAGEMENT BRANCH. THEY HAVE BEEN CHARGED TO YOU FOR A LIMITED TIME PERIOD AND . MUST BE RETURNED TO THE RE-

        .CORDS & ARCHIVES SERVICES SEC-TION P1-22 WHITE FLINT. PLEASE DO NOT SEND DOCUMENTS CHARGED OUT THROUGH THE MAIL REMOVAL OF ANY PAGE(S) FROM DOCUMENT
         'FOR REPRODUCTION MUST BE RE-FERRED TO FILE PERSONNEL
                   -NOTICE-

ENCLOSURE 1 SURRY POWER STATION UNIT 1 FALL 1990 ISi INSPECTIONS NIS - 1 FORM V I I

INSERVICE INSPECTION REPORT of the Surry Nuclear Power Station Unit 1 P.O. Box 315 Surry, Virginia 23883 for Virginia Electric and Power Company 5000 Dominion Blvd. Glen Allen, Virginia 23060 Commercial Service Date: December 22, 1972 Operating Capacity: 822 MWe (net) Refueling Outage: 2nd Interval, 2nd/3rd Period

FORM NIS-1 OWNER'S REPORT FOR INSERVICE INSPECTIONS As required by the Provisions of the ASME Code Rules

l. Own<< Virginia Electric and Power Company, 5000 Dominion Blvd., Glen Allen, VA (Name and Address of Owner)
2. Plant Surry Power Station, P.O. Box 315, Surry, VA 23883 (Name and Address of Plant)
3. Plant Unit _ _ _1_ _ _ _ _ _ 4. Owner Certificate of Authorization (if required)_N-'-/A _______

S. Commercial Service Date 12/22/72 6. National Board Number for Unit _ _N_c/_A_________

7. Components Inspected Manufacturer Component or Manufacturer or Installer State or National Appurtenance or Installer Serial No. Province No. Board No.

Reactor Vessel Rotterdam RCPCRV 137-1 VA58201 30678 Steam Gen. A, B, C Westinghouse, Tampa Div. 2982, 2983 2981,

                                                                                 ~iii~~~                681, 682, 68:

Class 1 Piping Southwest Fab - - - - - - - - - Class 2 Piping Southwest Fab - - - - - - - - - R.C. Pump A, B, C Westinghouse 458,459,460 - - - - - - Non Regen . Letdown RX Joseph Oat & Sons 1674-2 VA59647 310 Regenerative 4195-A3-7 HX Sentry ~H§:iH:ij VA59812 369. 370. 37 Component Supports Class 1 2 and 3 - - - - - - - - - 1-874D Valve Velan - - - - - - - - - 1-889C Valve Velan - - - - - - - - - 1-874C Valve Velan - - - - - - - - - l-874E Valve Velan - - - - - - - - - 1-876B Valve Velan - - - - - - - - - l-876C Valve Velan - - - - - - - - - l-874B Valve Velan - - - - - - - - - Note: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is 81h in. x 11 in., (2) information in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sh~ets is recorded at the top of this form . (12/86) This form (E00029) may be obtained from the Order Dept., ASME, 22 Law Drive, Box 2300, Fairfield, NJ 07007-2300. Page 1 of 15

FORM NIS-1 (Back)

8. Examination Dates 7 /10/88 to 12 / 2 0/ 9 o 9. Inspection Interval from 12 122 182 to 12 122 192
10. Applicable Editions of Section XI _1_9_8_0 _ _ _ Addenda _W_8_0_ _ __
11. Abstract of Examinations. Include a list of examinations and a statement concerning status of work required for current interval. See pages QL~ through 15.
12. AbstractofConditionsNoted. See page 03 and Attachments 1, 2, 3, 4 and 5.
13. Abstract of Corrective Measures Recommended and Taken. See page 03 and Attachments 1, 2, 3, 4 and 5
  • B We certify that the statements made in this report are correct and the examinations and corrective mea-sures taken conform to the rules of the ASME Code, Section XI.

cm;fka<< of Amhori,.tion No. Of appliable) N/ A Exp;m;on Date N/ A Date March 05, 19 -2..!..._signed Vi';c~,_;,,j,9 fl,n;,-hz,tt- ~F-n.C.ey Owner

                                                                                                ~

CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State or Province of Virginia and employed by H

  • S
  • B *I* & I* Co of Hartford, CT }\ave inspected the components described in this Owner's Report during the period 12/22/89 to 2/22/92 , and state that to the best ofmy knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the inspection plan and as required by the ASME Code, Section XI.

By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspection.

    ~            J* ~

Inspector's Signature Commissions --~t/.=o..~S~4~3~------------- National Board, State, Province, and Endorsements Date 3 - 5:"' 19 1.J_

Examination Summary Virginia Electric and Power Company Surry Nuclear Power station Unit 1 Refueling outage 2nd Interval, 2nd Period/3rd Period Introduction Inservice examinations of Class 1 and Class 2 components and piping were conducted at Surry Power Station Unit 1 from July 10, 1988 to December 20, 1990. As allowed by IWB-2412, inspections for the Second Interval, Second and Third Inspection Periods were performed. Examination procedures were approved prior to the examinations. certification documents relative to personnel, equipment, and materials were reviewed and determined to be satisfactory. Inspections, witnessing, and surveillance of the examinations and related activities were conducted by personnel from the Hartford steam Boiler Inspection and Insurance Company, One state street, Hartford, CT 06102 (Mr. R.L. Coder); Surry Station Quality Assurance Department; and Surry technical staff. Limitations Some of*the arrangements and details of the piping system and

  • components were designed and fabricated before the access and examination requirements of Section XI of the 1974 Code could be applied; consequently some examinations are limited or not practical due to geometric configuration or accessibility.

Generally these limitations exist at fitting to fitting joints such as elbow to tee, elbow to valve, reducer to valve, etc., where geometry and sometimes surface condition preclude ultrasonic coupling or*access for the required scan length. Examination Examinations were conducted to review as much of the examination zones as was practical within geometric, metallurgical, and physical limitations. When the required ultrasonic examination volume or area could not be examined 100%, the examination was considered to be a partial (PAR) and so noted on the examination report. Generally PARs are noted at fitting to fitting assemblies and in areas where integrally welded supports (lugs, hangers, etc.) preclude access to some part of the examination. Page 2 of 15

  • Results Examination of components resulted in a total of 12 items being reported on the basis of procedure recording criteria, which generally are more critical than the specified ASME Section XI Acceptance Standards.

A summary of the indications and their dispositions follows: A) Examination of reactor closure head studs, nuts, and washers on ISO VPA-1-1400 revealed two damaged studs and one damaged washer. These deficiencies were dispositioned in Attachment 1 of this report. B) Examinations of valve internals on ISO VPA-1-6300, Items 69 and 80 noted deficiencies. These deficiencies were dispositioned in Attachment 2 and 3 of this report. C) The following component supports were inspected as part of the IWF inspection program. Inspection reports noted a deficiency, but Engineering evaluation determined the supports were fully operable. Evaluations of these deficiencies are included in Attachment 4 and 5 of this report. WMKS-1021A37 HOB WMKS-0112Al HOS WMKS-0103A2-1 H03 WMKS-0103A2-2 HOS WMKS-0103A2-3 H04 WMKS-0112Gl HllA WMKS-102Dl-l HOl MKS-125Al H02 Statement of Interval Status Virginia "Electric. and Power Company.. is*. currently on* schedule with its examination requirements. Page 3 of 15

ABSTRACT OF EXAMINATIONS:IWB,IWC,AND IWF INSPECTIONS

  • CATEGORY ITEM NUMBER ISOMETRIC ITEM INSPECTED EXAM METHOD INTERVAL/PERIOD AUGMENTED N/A VPA-1-1400 BOLTS,NUTS,WASHERS(l-58) VT 2/2
  • B-B B2,40 VPA-1-3100 W3-1 UT 2/3 3 B-D B3,140 VPA-1-3100 2BNIR VT 2/3 4 B-D B3.140 VPA-1-3100 2ANIR VT 2/3 5 B-D B3,140 VPA-1-3100 3ANIR VT 2/3 6 B-D B3.140 VPA-1-3100 3BNIR VT 2/3 7 B-F B5.30/B5.50 VPA-1-4300 W5DM PT,UT 2/3 8 B-G-1 B6.180 VPA-1-5100A ~A~l-24 UT 2/2 9 B-G-1 B6.180 VPA-1-5100A C 1-24 UT 2/3 10 B-G-2 B7.70 VPA-1-6300 19 VT 2/2 11 B-G-2 B7,70 VPA-1-6300 67 VT 2/2 12 B-G-2 B7.30 VPA-1-3100 A-32 STUDS AND NUTS VT 2/3 13 B-G-2 B7.50 VPA-1-4700 19 VT 2/3 14 B-G-2 B7.70 VPA-1-6300 47 VT 2/3 15 B-G-2 B7,70 VPA-1-6300 48 VT 2/3 16 B-G-2 B7.70 VPA-1-6300 77 VT 2/3 17 B-G-2 B7.70 VPA-1-6300 84 VT 2/3 18 B-G-2 B7.70 VPA-1-6300 80 VT 2/3 19 B-G-2 B7.70 VPA-1-6300 79 VT 2/3 20 B-J B9.11 VPA-1-4303 W7 PT,UT 2/2 21 B-J B9.11 VPA-1-4303 W4 PT,UT 2/2 22 B-J B9.11 VPA-1-4303 W8 PT,UT 2/2 23 B-J B9.31 VPA-1-4204 PT,UT 2/2 24 B-J B9.31 VPA-1-4205 WlfBC~

Wl BC PT,UT 2/2 25 B-J B9.32 VPA-1-4209 Wl BC) PT 2/2 26 B-J B9.40 VPA-1-4312 Wl PT 2/2 27 B-J B9.11 VPA-1-4303 W2 .PT,UT 2/3 28 B-J B9.11 VPA-1-4303 W3 PT,UT 2/3 29 B-J B9.11 VPA-1-4304 W6 PT,UT 2/3 30 B-J B9. ll VPA-1-4304 W5 PT,UT 2/3 31 B-J B9.ll VPA-1-4500 W8 PT,UT 2/3 B-J B9.21 VPA-1-4306 Wl4 PT 2/3 B-J B9.21 VPA-1-4306 Wl2 PT 2/3 B-K-1 B10 .10 MKS-0125Al H-05 PT 2/2 3 B-K-1 B10 .10 MKS-0122Ll H-02 PT 2/2 36 B-K-1 Bl0.10 MKS-0122Ll H-01 PT 2/2 37 B-K-1 Bl0.10 MKS-0122Dl H-01 PT 2/2 38 B-K-1 Bl0.10 MKS-0125Al H-02 PT 2/2 39 B-K-1 Bl0.10 MKS-0122A2 H-30 PT 2/2 40 B-K-1 Bl0.10 MKS-0122Ll H-03 PT 2/2 41 B-K-1 Bl0.10 VPA-1-4505 H-01 PT 2/2 42 B-K-1 Bl0.20 VPA-1-5100B Bi3SC PT 2/2 43 B-K-1 Bl0.20 VPA-1-5100B B 2SC PT 2/2 44 B-K-1 Bl0.20 VPA-1-5100B B 4SC PT 2/2 45 B-K-1 Bl0.20 VPA-l-5100B B~ lSC PT 2/2 46 B-K-1 Bl0.20 VPA-1-5100B C lSC PT 2/3 47 B-K-1 Bl0.20 VPA-1:..5100B C}4SC PT 2/3 48 B-M-2 B12.40 VPA-1-6300 69 VT 2/2 49 B-M-2 B12.40 VPA-1-6300 70 VT 2/2 50 B-M-2 B12.40 VPA-1-6300 74 VT 2/2 51 B-M-2 B12,40 VPA-1-6300 75 VT 2/2 52 B-M-2 B12,40 VPA-1-6300 77 VT 2/2 53 B-M-2 B12.40 VPA-1-6300 79 VT 2/2 54 B-M-2 B12.40 VPA-1-6300 80 VT 2/2 55 B-N-1 B13.10 VPA-l-1200A RV INTERIOR VT 2/2 56 C-A Cl.10 VPA-2-1140 W2,0"-57" UT 2/2 57 C-A Cl.20 VPA-2-1140 Wl,0"-56" UT 2/2 58 C-A Cl. 20 VPA-2-1150 Wl0,6"-19" UT 2/2 59 C-A Cl.30 VPA-2-1150 W4,6"-19" UT 2/2 60 C-A Cl. 30 VPA-2-1150 Wll,6"-19" UT 2/2 61 C-A Cl. 30 VPA-2-1150 Wl2,6"-19" UT 2/2 62 C-B C2.22 VPA-2-1100 A-9NIR VT 2/2 63 C-B C2.22 VPA-2-1100 A-lONIR VT 2/2 Page 4 of 15

ABSTRACT OF EXAMINATIONS:IWB,IWC,AND IWF INSPECTIONS CATEGORY ITEM NUMBER ISOMETRIC ITEM INSPECTED EXAM METHOD INTERVAL/PERIOD C-B C2.22 VPA-2-1100 B-W9NIR VT 2/3 c-c C3.10 VPA-2-1140 lWS PT 2/2 66 c-c C3.40 MKS-0123El H-04 PT 2/2 67 c-c C3.40 MKS-0123El H-09 PT 2/2 68 c-c C3.40 VPA-2-2201 H-05 PT 2/2 69 c-c C3.40 MKS-0122Al H-03 PT 2/2 70 c-c C3,40 VPA-2-2201 H-07 MT 2/2 71 c-c C3.40 VPA-2-2300 H-03 MT 2/2 72 c-c C3.40 VPA-2-2301 H-06 MT 2/2 2/2 73 F-A MKS-0125Al H-05 VT 74 F-C MKS-118Al H-04 VT 2/2 75 F-C MKS-118Al H-01 VT 2/2 76 F-C MKS-118Al H-03 VT 2/2 77 F-C MKS-118A2 H-10 VT 2/2 78 F-C MKS-118A2 H-31 VT 2/2 79 F-A MKS-118A2 H-32 VT 2/2 80 F-C MKS-122Al H-03 VT 2/2 81 F-A MKS-122A2 H-30 VT 2/2 82 F-C MKS-122Dl H-01 VT 2/2 83 F-A MKS-122Hl H-05 VT 2/2 84 F-A MKS-122Jl H-04 VT 2/2 85 F-A MKS-122Kl H-12 VT 2/2 86 F-A MKS-122Kl H-11 VT 2/2 87 F-B MKS-122Kl H-04 VT 2/2 88 F-C MKS-122Ll H-02 VT 2/2 89 F-C MKS-122Ll H-01 VT 2/2 90 F-A MKS-122Ll H-03 VT 2/2 91 F-C MKS-123G2 H-02 VT 2/2 92 F-A MKS-124Al H-20 VT 2/2 93 F-B MKS-125Al H-07 VT 2/2 94 F-A MKS-125Al H-04 VT 2/2 F-C MKS-125Al H-08 VT 2/2 F-C VPA-1-4210 H-01 VT 2/2 F-B VPA-1-4210 H-02 VT 2/2 F-A VPA-1-4306 H-02 VT 2/2 99 F-C VPA-1-4505 H-01 VT 2/2 100 F-A VPA-1-5100B 3SC VT 2/2 101 F-A VPA-l-5100B 2SC VT 2/2 102 F-A VPA-1-5100B 4SC VT 2/2 103 F-A VPA-l-5100B WlSC VT 2/2 104 F-A VPA-2-1140 lWS VT 2/2 105 F-C VPA-2-2201 H-05 VT 2/2 106 F-C VPA-2-2201 H-07 VT 2/2 107 F-A VPA-2-2300 H-03 VT 2/2 108 F-C VPA-2-2301 H-06 VT 2/2 109 TS3.2 WMKS-0100Dl HSS-02A VT 2/2 110 TS3.2 WMKS-OlOODl HSS-02B VT 2/2 111 TS3.2 WMKS-0100Dl HSS-03A VT 2/2 112 TS3.2 WMKS-0100Dl HSS-038 VT 2/2 113 TS3.2 WMKS-0100Dl HSS-04A VT 2/2 114 TS3.2 WMKS-0100Dl HSS-048 VT 2/2 115 TS3.2 WMKS-0100Dl HSS-05A VT 2/2 116 TS3.2 WMKS-0100Dl HSS-05B VT 2/2 117 TS3.2 WMKS-OlOODl HSS-06A VT 2/2 118 TS3.2 WMKS-OlOODl HSS-06B VT 2/2 119 TS3.2 WMKS-OlOOGl HSS-01 VT 2/2 120 TS3.2 WMKS-OlOOGl HSS-02 VT 2/2 121 TS3.2 WMKS-OlOOGl HSS-09 VT 2/2 122 F-C WMKS-01018A2 H-03 VT 2/2 123 F-A WMKS-01018A2 H-04 VT 2/2. 124 F-A WMKS-01018A2 H-05 VT 2/2 125 F-A WMKS-01018A2 H-06 VT 2/2 126 TS3,2 WMKS-010101 HSS-11 VT 2/2

  • Page 5 of 15

ABSTRACT OF EXAMINATIONS:IWB,IWC,AND IWF INSPECTIONS CATEGORY ITEM NUMBER ISOMETRIC ITEM INSPECTED EXAM METHOD INTERVAL/PERIOD TS3.2 WMKS-010101 HSS-12 VT 2/2 ..i: TS3.2 WMKS-0101Gl HSS-11 VT 2/2 129 TS3.2 WMKS-0101Gl HSS-12 VT 2/2 130 TS3.2 WMKS-OlOlGl HSS-15 VT 2/2 131 TS3.2 WMKS-OlOlGl HSS-16 VT 2/2 132 TS3.2 WMKS-0102Dl HSS-09 VT 2/2 133 TS3.2 WMKS-0102Dl HSS-10 VT 2/2 134 TS3.2 WMKS-0102Gl HSS-10 VT 2/2 135 TS3.2 WMKS-0102Gl HSS-13 VT 2/2 136 TS3.2 WMKS-0102Gl HSS-14 VT 2/2 137 TS3.2 WMKS-0102Gl HSS-17 VT 2/2 . 138 TS3.2 WMKS-0103A2-1 HSS-31 VT 2/2 139 TS3.2 WMKS-0103A2-1 HSS-32 VT 2/2 140 TS3.2 WMKS-0103A2-1 HSS-35A VT 2/2 141 TS3.2 WMKS-0103A2-1 HSS-35B VT 2/2 142 F-B WMKS-0103A2-1 H-87 VT 2/2 143 F-C WMKS-0103A2-1 H-03 VT 2/2 144 TS3.2 WMKS-0103A2-2 HSS-27 VT 2/2 145 TS3.2 WMKS-0103A2-2 HSS-28 VT 2/2 146 TS3.2 WMKS-0103A2-2 HSS-33A VT 2/2 147 TS3.2 WMKS-0103A2-2 HSS-33B VT 2/2 148 F-B WMKS-0103A2-2 H-88 VT 2/2 149 F-C WMKS-0103A2-2 H-05 VT 2/2 150 TS3.2 WMKS-0103A2-3 HSS-29 VT 2/2 151 TS3.2 WMKS-0103A2-3 HSS-30 VT 2/2 152 TS3.2 WMKS-0103A2-3 HSS-34A VT 2/2 153 TS3.2 WMKS-0103A2-3 HSS-34B VT 2/2 154 F-B WMKS-0103A2-3 H-89 VT 2/2 155 F-C WMKS-0103A2-3 H-04 VT 2/2 156 F-C WMKS-0112Al H-06 VT 2/2 157 F-A WMKS-0112AE1 H-01 VT 2/2 1 F-A WMKS-0112AE1 H-02 VT 2/2 F-B WMKS-0112AE1 H-03 VT 2/2 F-A WMKS-0112AE1 H-04 VT 2/2 161 F-A WMKS-0112AE1 H-05 VT 2/2 162 F-C WMKS-0112AE2 H-11 VT 2/2 163 F-A WMKS-0112AE2 H-12 VT 2/2 164 F-C WMKS-0112AE2 H-13 VT 2/2 165 F-A WMKS-0112AE2 H-14 VT 2/2 166 F-C WMKS-0112AE2 H-15 VT 2/2 167 F-C WMKS-0112AE2 H-16 VT 2/2 168 F-C WMKS-0112AE2 H-17 VT 2/2 169 F-A WMKS-0112AH1 H-01 VT 2/2 170 F-B WMKS-0112AH1 H-06 VT 2/2 171 F-C WMKS-0112AH2 H-lOA VT 2/2 172 F-C WMKS-0112AH2 H-10B VT 2/2 173 F-C WMKS-0112AH2 H-11 VT 2/2 174 F-C WMKS-0 ll 2AH2 H-13 VT 2/2 175 F-C WMKS-0112AH2 H-14A VT 2/2 176 F-C WMKS-0112AH2 H-14B VT 2/2 177 F-C WMKS-0112AH2 H-08A VT 2/2 178 F-B WMKS-0112AH2 H-08B VT 2/2 179 F-C WMKS-0112AH2 H-12 VT 2/2 180 F-A WMKS-0112AK1 H-02 VT 2/2 181 F-B WMKS-0112AK1 H-07 VT 2/2 182 F-A WMKS-0112AK1 H-08 VT 2/2 183 F-B WMKS-0112AK1 H-10 VT 2/2 184 F-A WMKS-0112AK1 H-12 VT 2/2 185 F-B WMKS-0112AK1 H-16 VT 2/2 186 F-C WMKS-0112AK1 H-18 VT 2/2 187 F-A WMKS-0112AL1 H-02 VT 2/2 188 F-A WMKS-0112AL1 H-03 VT 2/2 189 F-B WMKS-0112AL1 H-05 VT 2/2

  • Page 6 of 15

ABSTRACT OF EXAMINATIONS:IWB,IWC,AND IWF INSPECTIONS CATEGORY I _TEM NUMBER ISOMETRIC ITEM INSPECTED EXAM METHOD INTERVAL/PERIOD F-C WMKS-0112AL1 H-06 VT 2/2 VT 2/2 F-B WMKS-0112AL1 H-07 F-A WMKS-0112AN1 H-03 VT 2/2 193 F-B WMKS-0112AN1 *H-04 VT 2/2 194 F-A WMKS-0112AN1 H-06 VT 2/2 195 F-B WMKS-0112AN1 H-07 VT 2/2 196 F-C WMKS-0112AR1 H-01 VT 2/2 197 F-B WMKS-0112AR1 H-04 VT 2/2 198 F-A WMKS-0112AR1 H-11 VT 2/2 199 F-A WMKS-0112AR2 H-13 VT 2/2 200 F-B WMKS-0112AR2 H-14 VT 2/2 201 F-B WMKS-0112AR2 H-15 VT 2/2 202 F-C WMKS-0112AR2 ff-16 VT 2/2 203 F-A WMKS-0112AK1 H-17 VT 2/2 204 F-A WMKS-0112Bl H-10 VT 2/2 205 F-A WMKS-0112Cl H-11 VT 2/2 206 F-A WMKS-0112Cl H-12 VT 2/2 207 F-B WMKS-0112Cl H-13 VT 2/2 208 F-A WMKS-0112Cl H-14 VT 2/2 209 F-A WMKS-0112Cl H-18 VT 2/2 210 F-A WMKS-0112Cl H-20 VT 2/2 21i F-B WMKS-0112Cl H-21 VT 2/2 212 F-B WMKS-:Ol 12Cl H-22 VT 2/2 213 F-A WMKS-0112Cl H-OlA VT' 2/2 214 F-B WMKS-0112Cl H-01B VT 2/2 215 F-A WMKS-0112Cl H-02 VT 2/2 216 F-A WMKS-0112Cl H-03 VT 2/2 217 F-A WMKS-0112Cl H-04 VT 2/2 218 F-B WMKS-0112Cl H-'05 VT 2/2 219 F-A WMKS-0112Cl H-06 VT 2/2 220 F-A WMKS-0112Cl H-10 VT 2/2 F-B WMKS-0112Dl H-09 VT 2/2 F-B WMKS-0112Dl H-11 VT 2/2 F-C WMKS-0112Dl H-22 VT 2/2 ' F-C WMKS-0112Dl H-21A VT 2/2 225 F-C WMKS-0112Dl H-21B VT 2/2 226 F-A WMKS-0112El H-01 VT 2/2 227 F-B WMKS-0112El H-05 VT 2/2 228 F-B WMKS-0112El H-07 VT 2/2 229 F-B WMKS-0112El H-08 VT 2/2 230 F-B WMKS-0112El H-09 VT 2/2 231 F-B WMKS-0112El H-11 VT 2/2 232 F-B WMKS-0112El H-12 VT 2/2 233 F-B WMKS-0112El H-13 VT 2/2 234 F-A WMKS-0112El H-14 VT 2/2 235 F-C WMKS-0112E3 H-23 VT 2/2 236 F-C WMKS-0112E3 H-25 VT 2/2 237 F-A WMKS-0112E3 H-26 VT 2/2 238 F-A WMKS-0112E3 H-27 VT 2/2 239 F-C WMKS-0112E3 H....:30 VT 2/2 240 F-B WMKS-0112Fl H-14 VT 2/2 241 F-A WMKS-0112Fl H-17 VT 2/2 242 F-B WMKS-0112Fl H-19 VT 2/2 243 F-A WMKS-0112F1 H-01 VT 2/2 244 F-B WMKS-0112Fl H-02 - VT 2/2 245 F-A WMKS-0112F1 H-05 VT 2/2 246 F-A WMKS-0112Fl H-06 VT 2/2 247 F-B WMKS-0112Fl H-08 VT 2/2 248 F-B WMKS-0112Fl H-09 VT 2/2 249 F-A WMKS-0112Fl H-10 VT 2/2 250 F-A WMKS-0112Fl H-11 VT 2/2 251 F-A WMKS-0112Gl H-02 VT 2/2 252 F-B WMKS-0112Gl H-04 VT 2/2

  • Page 7 of 15

ABSTRACT OF EXAMINATIONS:IWB,IWC,AND IWF INSPECTIONS CATEGORY ITEM NUMBER ISOMETRIC ITEM INSPECTED EXAM METHOD INTERVAL/PERIOD F-A WMKS-0112Gl H-05 VT 2/2 F-A WMKS-0112Gl H-07 VT 2/2 255 F-B WMKS-0112Gl H-08 VT 2/2 256 F-A WMKS-0112Gl H-15 VT 2/2 257 F-B WMKS-0112Gl H-20 VT 2/2 258 F-B WMKS-0112Gl H-22 VT 2/2 259 F-C WMKS-0112Gl H-26A VT 2/2 260 F-C WMKS-0112Gl H-27 VT 2/2 261 F-C WMKS-0112Gl H-26B VT 2/2 262 TS3.2 WMKS-0112Gl HSS-60A VT 2/2 263 TS3.2 WMKS-0112Gl HSS-331 VT 2/2 264 TS3.2 WMKS-0112Gl HSS-330 VT 2/2 265 F-C WMKS-0112Gl H-12 VT 2/2 266 F-A WMKS-0112Gl H-24 VT 2/2 267 F-C WMKS-0112Gl H-llB VT 2/2 268 F-C WMKS-0112Gl H-llA VT 2/2 269 F-C WMKS-0112G2 H-26A VT 2/2 270 F-C WMKS-0112G2 H-26B VT 2/2 271 F-A WMKS-0112G2 H-27 VT 2/2 272 F-A WMKS-0112G2 H-28 VT 2/2 273 F-A WMKS-0112G2 H-29 VT 2/2 274 F-B WMKS-0112G2 H-30 VT 2/2 275 F-A WMKS-0112G2 H-31 VT 2/2 276 F-C WMKS-0112G3 H-37 VT 2/2 277 F-B WMKS-0112G3 H-34 VT 2/2 278 F-B WMKS-0112G3 H-35 VT 2/2 279 F-C WMKS-0112G3 H-36 VT 2/2 280 F-B WMKS-0112G4 H-42 VT 2/2 281 F-A WMKS-0112Jl H-03 VT 2/2 282 F-B WMKS-0112Jl H-05 VT 2/2 283 F-B WMKS-0112Jl H-06 VT 2/2 F-B WMKS-0112Jl H-07 VT 2/2 F-B WMKS-0112Jl H-09 VT 2/2 F-C WMKS-0112Jl H-01 VT 2/2 287 F-C WMKS-0112Ll H-31 VT 2/2 288 F-C WMKS-0112Ll H-32 VT 2/2 289 F-C WMKS-0112 L1 H-17 VT 2/2 290 F-B WMKS-0112L2 H-08 VT 2/2 291 F-B WMKS-0112L2 H-09 VT 2/2 292 F-A WMKS-0112L2 H-12 VT 2/2 293 F-A WMKS-0112L2 H-14 VT 2/2 294 F-B WMKS-0112L3-1 H-20 VT 2/2 295 F-B WMKS-0112L3-1 H-22 VT 2/2 296 F-B WMKS-0112L3-2 H-02 VT 2/2 297 F-A WMKS-0112Ml H-11 VT 2/2 298 F-A WMKS-0112Ml H-12 VT 2/2 299 F-B WMKS-0112Ml H-13 VT 2/2 300 F-A WMKS-0112Ml fi-14 VT 2/2 301 F-A WMKS-0112Ml H-15 VT 2/2 302 F-A WMKS-0112Ml H-16 VT 2/2 303 F-B WMKS-0112Ml H-17 VT 2/2 304 F-B WMKS-0112Ml H-18 VT 2/2 305 F-A WMKS-0112Ml . H-19 VT 2/2 306 F-A WMKS-0112Ml H-23 VT 2/2 307 F-A WMKS-0112Ml H-24 VT 2/2 308 F-C WMKS-0112Ml H-25 VT 2/2 309 F-B WMKS-0112Ml H-40 VT 2/2 310 F-B WMKS-0112M2 H-02 VT 2/2 311 F-A WMKS-0112M2 H-03 VT 2/2 312 F-B WMKS-0112M2 H-04 VT 2/2 313 F-B WMKS-0112M2 H-05 VT 2/2 314 TS3.2 WMKS-0112M2 HSS-26 VT 2/2 315 F-A WMKS-0112M3 H-26 VT 2/2 Page 8 of 15

ABSTRACT OF EXAMINATIONS:IWB,IWC,AND IWF INSPECTIONS CATEGORY ITEM NUMBER ISOMETRIC ITEM INSPECTED EXAM METHOD INTERVAL/PERIOD F-C WMKS-0112M3 H-27 VT 2/2 F-A WMKS-0112M3 H-28 VT 2/2 318 F-B WMKS-0112M3 H-29 VT 2/2 319 F-A WMKS-0112M3 H-34 VT 2/2 320 F-C WMKS-0112M3 H-35* VT 2/2 321 F-B WMKS-0112Tl H-02 VT 2/2 322 F-B WMKS-0112Tl H-03 VT 2/2 323 F-C WMKS-0112T2 H-18 VT 2/2 324 F-C WMKS-0112T2 H-11 VT 2/2 325 F-C WMKS-0112T2 H-06 VT 2/2 326 F-B WMKS-0112T2 H-08 VT 2/2 327 F-A WMKS-0112T2 H-09 VT 2/2 328 F-B WMKS-0112T2 H-19 VT 2/2

                                                                                ~~~

329 F-C WMKS-0112T3 H-16 VT 330 F-C WMKS-0112T3 H-12 VT 331 F-B WMKS-0112T3 H-13 VT 2/2 332 TS3.2 WMKS-0112T3 HSS-340A VT 2/2 333 TS3.2 WMKS-0112T3 HSS-3408 VT 2/2 334 F-C WMKS-0112T3 H-13 VT 2/2 335 F-C WMKS-0112T3 H-15 VT 2/2 336 TS3.2 WMKS-0117Al-1 HSS-01 VT 2/2 337 TS3,2 WMKS-0117Al-l HSS-02 VT 2/2 338 TS3,2 WMKS-0117Al-l HSS-03 VT 2/2 339 TS3,2 WMKS-0117Al-1 HSS-04 VT 2/2 340 TS3,2 WMKS-0117Al-l HSS-14 VT 2/2 341 TS3.2 WMKS-0117Al-l HSS-20 VT 2/2 342 TS3.2 WMKS-0117Al-l HSS-103 VT 2/2 343 TS3.2 WMKS-0117Al-1 HSS-104 VT 2/2 344 TS3.2 WMKS-0117Al-1 HSS-105 VT 2/2 345 TS3,2 WMKS-Oll 7Al-1 HSS-120A VT 2/2 346 TS3.2 WMKS-0117Al-1 HSS-120B VT 2/2 TS3.2 WMKS-0117Al-2 HSS-11 VT 2/2 TS3.2 WMKS-0117 A2 HSS-05 VT 2/2 TS3.2 WMKS-0117A2 HSS-06 VT 2/2 3 TS3,2 WMKS-0117A2 HSS-07 VT 2/2 351 TS3.2 WMKS-0117A2 HSS-15 VT 2/2 352 TS3.2 WMKS-0117 A2 HSS-08 VT 2/2 353 TS3.2 WMKS-0118Al HSS-142 VT 2/2 354 TS3.2 WMKS-0118Al HSS-143A VT 2/2 355 TS3,2 WMKS-0118Al HSS-1438 VT 2/2 356 F-A WMKS-0118Gl-2 H-09 VT 2/2 357 F-A WMKS-0118Gl-2 H-10 VT 2/2 358 F-A WMKS-0118Gl-2 H-11 VT 2/2 359 F-A WMKS-0118Gl-2 H-12 VT 2/2 360 F-A WMKS-0118Gl-2 H-13 VT 2/2 361 F-A WMKS-0118Gl-3 H-14 VT 2/2 362 F-A WMKS-0118Gl-3 H-15 VT 2/2 363 F-B WMKS-0118Gl-3 H-16A VT 2/2 364 F-B WMKS-0118Gl-3 H-16B VT 2/2 365 F-A WMKS-0118Gl-3 H-17 VT 2/2 366 F-A WMKS-0118Gl-3 H-18 VT 2/2 367 F-B WMKS-0118Gl-3 H-19 VT 2/2 368 F-A WMKS-0118Gl-3 H-20 VT 2/2 369 F-A WMKS-0118Gl-4 H-22 VT 2/2 370 F-A WMKS-0118Gl-4 H-23 VT 2/2 371 F-A WMKS-0118Gl-4 H-24A VT 2/2 372 F-A WMKS-0118Gl-4 H24B VT 2/2 373 F-A WMKS-0118Gl-4 H-26 VT 2/2 374 F-A WMKS-0118Gl-4 H-27 VT 2/2 375 F:-C WMKS-0118Gl-5 H-01 VT 2/2 376 F-C WMKS-0118Gl-5 H-02 VT 2/2 377 F-C WMKS-0118Gl-5 H-03 VT 2/2 378 F-C WMKS-0118Gl-5 H-04 VT 2/2 Page* 9 of 15

ABSTRACT OF EXAMINATIONS:IWB,IWC,AND IWF INSPECTIONS CATEGORY ITEM NUMBER ISOMETRIC ITEM INSPECTED EXAM METHOD INTERVAL/PERIOD F-C WMKS-0118Gl-5 H-05 VT 2/2 F-C WMKS-0118Gl-5 H-06 VT 2/2 381 F-C WMKS-0118Gl-5 H-07 VT 2/2 382 F-C WMKS-0118Gl-5 H-08 VT 2/2 383 TS3.2 WMKS-0122Al HSS-22 VT 2/2 384 TS3.2 WMKS-0122Al HSS-102 - VT 2/2 385 TS3.2 WMKS-0122A2 HSS-23 VT 2/2 386 TS3,2 WMKS-0122A2 HSS-25 VT 2/2 387 TS3.2 WMKS-0122Dl HSS-22A VT 2/2 388 TS3.2 WMKS-0122Dl HSS-22B VT 2/2 389 TS3.2 WMKS-0122Dl HSS-23 VT 2/2 390 TS3.2 WMKS-0122Dl HSS-24A VT 2/2 391 TS3,2 WMKS-0122Dl HSS-24B VT 2/2 392 TS3.2 WMKS-0122Dl HSS-28 VT 2/2 393 TS3.2 WMKS-012211 HSS-20* VT 2/2 394 TS3,2 WMKS-012211 HSS-19A VT 2/2 395 TS3.2 WMKS-0122Ll HSS-19B VT 2/2 396 F-C WMKS-0123Nl H-02B VT 2/2 397 F-C WMKS-0123Nl H-01 VT 2/2 398 F-C WMKS-0123N2 H-05A VT 2/2 399 F-C WMKS-0123N2 H-04 VT 2/2 400 F-C WMKS-0123N2 H-5B VT 2/2 401 TS3.2 WMKS-012381 MSS-116A VT 2/2 402 TS3.2 WMKS-0123Rl MSS-116B VT 2/2 403 TS3.2 WMKS-0123R2 MSS-115A VT 2/2 404 TS3,2 WMKS-0123R2 MSS-115B VT 2/2 405 TS3.2 WMKS-0124Al-1 HSS-110 VT 2/2 406 TS3.2 WMKS-0125Al-1 HSS-105 VT 2/2 407 TS3.2 WMKS-0125Al-1 HSS-106 VT 2/2 408 TS3.2 WMKS-0125Al-1 HSS-107 VT 2/2 409 TS3.2 WMKS-0125Al-l HSS-108 VT 2/2 4 TS3.2 WMKS-0125Al-2 HSS-102 VT 2/2 TS3.2 WMKS-0125Al-2 HSS-103 VT 2/2 TS3.2 WMKS-0125Al-2 HSS-104 VT 2/2 41 F-C WMKS-0127Cl H-01 VT 2/2 414 F-C WMKS-0127Cl H-03 VT 2/2 415 F-C WMKS-0127Cl H-04 VT 2/2 416 F-B WMKS-0127Cl H-02 VT 2/2 417 F-C WMKS-0127Cl H-05 VT 2/2 418 F-C WMKS-0127Cl H-06 VT 2/2 419 F-B WMKS-0127Cl H-07 VT 2/2 420 F-C WMKS-0127C2 H-11 VT 2/2 421 F-C WMKS-0127C2 H-09 VT 2/2 422 F-C WMKS-0127C2 H-12 VT 2/2 423 F-C WMKS-0127C2 H-13 VT 2/2 424 F-C WMKS-0127C2 H-14 VT 2/2 425 TS3.2* WMKS-0127C2 HSS-100 VT 2/2 426 TS3.2 WMKS-0127C2 HSS-101 VT 2/2 427 TS3.2 WMKS-0127C2 HSS-107 VT 2/2 428 F-C WMKS-0127C2 H-15 VT 2/2 429 F-C WMKS-0127El H-07 VT 2/2 430 F-C WMKS-0127El H-02 VT 2/2 431 F-A WMKS-0127El H-01 VT 2/2 432 F-B WMKS-0127El H-04 VT 2/2 433 F-A WMKS-0127El H-05 VT 2/2 434 F-A WMKS-0127El. H-06 VT 2/2 435 F-A WMKS-0127El H-08 VT 2/2 436 TS3.2 WMKS-0127El HSS-84 VT 2/2 437 F-C WMKS-0127E2 H-02 VT 2/2 438 F-C WMKS-0127E2 H-07 VT 2/2 439 F-B WMKS-0127E2 H-04 VT 2/2 440 F-A WMKS-0127E2 H-05 VT 2/2 441 F-A WMKS-0127E2 H-06 VT 2/2

  • Page 10 of 15

ABSTRACT OF EXAMINATIONS:IWB,IWC,AND IWF INSPECTIONS CATEGORY ITEM NUMBER ISOMETRIC ITEM INSPECTED EXAM METHOD INTERVAL/PERIOD F-A WMKS-0127E2 H-08 VT 2/2 4 TS3.2 WMKS-0127E2 HSS-85 VT 2/2 444 F-C WMKS-0127Gl-1 H-01 VT 2/2 445 F-A WMKS-0127Gl-1 H-04 VT 2/2 446 F-B WMKS-0127Gl-1 H-05 VT 2/2 447 F-B WMKS-0127Gl-1 H-07 VT 2/2 448 F-C WMKS-0127Gl-1 H-08 VT 2/2 449 F-A WMKS-0127Gl-1 H-11 VT 2/2 450 F-C WMKS-0127Gl-1 H-lOA VT 2/2 451 F-C WMKS-0127Gl-1 H-108 VT 2/2 452 F-C. WMKS-0127Gl-1 H-12 VT 2/2 453 F-A WMKS-0127Gl-2 H-16 VT 2/2 454 F-A WMKS-0127Gl-2 H-17 VT 2/2 455 F-A WMKS-0127Gl-2 H-18 VT 2/2 456 F-C WMKS-0127Gl-2 H-13 VT 2/2 457 F-C WMKS-0127Gl-2 H-14 VT 2/2 458 F-C WMKS-0127Gl-2 H-15 VT 2/2 459 F-A WMKS-0127G2 H-20 VT 2/3 460 F-A VPA-1-4309 H-03 VT 2/3 461 F-C VPA-1-4309 H-04 VT 2/3 462 F-C VPA-1-4310 H-04 VT 2/3 463 F-A VPA-1-51008 lSC VT 2/3 464 F-A VPA-1-51008 4SC VT 2/3 465 F-B WMKS-0127G2 H-21 VT 2/3 466 F-B WMKS-0127G2 H-22 VT 2/3 467 F-B WMKS-0127G2 H-23 VT 2/3 468 F-A WMKS-0127G2 H-24 VT 2/3 469 F-B WMKS-0127G2 H-25 VT 2/3 470 F-A WMKS-0127G2 H-26 VT 2/3 471 F-A WMKS-0127G2 H-27 VT 2/3 472 TS3.2 WMKS-0127G2 HSS-301 VT 2/3 4 TS3.2 WMKS-0127G2 HSS-302 VT 2/3 F-C WMKS-0127G2 H-19 VT 2/3 4 F-A WMKS-1018B4 H-01 VT 2/3 47 F-A WMKS-101884 H-02 VT 2/3 477 F-A WMKS-1018B4 H-03 VT 2/3 478 F-A WMKS-1018B4 H-05 VT 2/3 479 F-B WMKS-101884 H-19 VT 2/3 480 F-B WMKS-1018B4 H-20 VT 2/3 481 F-A WMKS-1021Al H-01 VT 2/3

  • 482 F-A WMKS-1021Al H-02 VT 2/3 483 F-A WMKS-1021Al H-03 VT 2/3 484 F-A WMKS-1021Al H-04 VT 2/3 485 F-C WMKS-1021All H-01 VT 2/3 486 F-B WMKS-1021All H-02 VT 2/3 487 F-A WMKS-1021A2 H-01 VT 2/3 488 F-A WMKS-1021A2 H-02 VT 2/3 489 F-A WMKS-1021A2 H-03 VT 2/3 490 F-A WMKS-1021A2 H-04 VT 2/3 491 F-B WMKS-1021A3 H-01 VT 2/3 492 F-A WMKS-1021A3 H-02 VT 2/3 493 F-C WMKS-1021A3 H-03 VT 2/3 494 F-A WMKS-1021A37 H-06 VT 2/3 495 F-A WMKS-1021A37 H-17 VT 2/3 496 F-B WMKS-1021A37 H-34 VT 2/3 497 F-8 WMKS-1021A37 H-08 VT 2/3 498 F-8 WMKS-1021A4-1 H-62 VT 2/3 499 F-A WMKS-1021A4-2 H-30 VT 2/3 500 F-A WMKS-1021A4-2 H-31 VT 2/3 501 F-A WMKS-1021A4-2 H-35 VT 2/3 502 F-B WMKS-1021A4-2 H-55 VT 2/3 503 F-B WMKS-1021A4-2 H-57 VT 2/3 504 F-B WMKS-1021A4-2 H-58 VT 2/3 Page 11 of 15

ABSTRACT OF EXAMINATIONS:IWB,IWC,AND IWF INSPECTIONS CATEGORY ITEM NUMBER ISOMETRIC ITEM INSPECTED EXAM METHOD INTERVAL/PERIOD F-B WMKS-1021A4-2 H-59 VT 2/3 F-B WMKS-1021A4-2 H-77 VT 2/3 507 F-C WMKS-1021A4-2 H-96 VT 2/3 508 F-A WMKS-1021A4-2 H-130 VT 2/3 509 F-B WMKS-1022A10 H-08 VT 2/3 510 F-B WMKS-1022A10 H-09 VT 2/3 511 F-B WMKS-1022Al0 H-10 VT 2/3 512 F-B WMKS-1022Al0 H-11 VT 2/3 513 F-C WMKS-1022Al0 H-12 VT 2/3 514 TS3.2 WMKS-1103A4 HSS-168 VT 2/3 515 TS3.2 WMKS-1103A4 HSS-169 VT 2/3 516 TS3.2 WMKS-1103A5 HSS-164 VT 2/3 517 TS3.2 WMKS-1103A5 HSS-165 VT 2/3 518 TS3.2 WMKS-1103A6 HSS-116 VT 2/3 519 TS3.2 WMKS-1103A6 HSS-117 VT 2/3 520 F-C WMKS-123Nl H-02A VT 2/3 521 F-C WMKS-0112AE2 H-18 VT 2/3 522 F-C WMKS-Ol12AE2 H-19 VT 2/3 523 F-C WMKS-0112AH1 H-02 VT 2/3 524 F-C WMKS-0112AK1 H-11 VT 2/3 525 F-C WMKS-0112Ll H-23 VT 2/3 526 F-C WMKS-0112Ll H-30 VT 2/3 527 F-C WMKS-0112Al H-05 VT 2/3 528 F-C WMKS-0118Gl-4 H-21 VT 2/3 Page 12 of 15

ABSTRACT .OF EXAHINATIONS:SYSTEM PRESSURE TEST PROGRAM LEADING ZONE FM TEST ZONE DESCRIPTION

  • TESTt PTtl . 11448-SPM-71A-l-l 11448-FM-71A-S-4 SW PUMP lC PTl2 11448-SPM-71A-2-l 11448-1M-71A-S-1&5 CW INTAKE PIPING;CC HEAT EXCHANGER(SW SIDE) 3 SPT#3 11448-SPM-71A-3-2 11448-FM-71A-S-3 SW PIPING TO/FROM B
  • C RSHX 4 SPTt4&6 11448-SPM-71B-l-l 11448-FM-71B-S-l,2,3,4,5&71D-S-l SW TO LUBE OIL PUMP & INT.SEAL COOLERS 5 SPTt5 11448-SPM-71B-2-l 11448-FM-71B-S-6 CC/SW TO CHG, PUMP SEAL COOLERS 6 SPTt7 11448-SPM-72A-l-l 11448-FM-72A-S-l CC PIPING TO/FROM "A" RHR HX 7 SPTt8 11448-SPM-72A-l-2 11448-FM-72A-S-2 CC PIPING TO/FROM "B" RHR HX 8 SPTt9 11448-SPM-72A-l-3 11448-FM-72A-S-4&5 CC PIPING TO 1-RC-P-lA,B,&C 9 SPT#lO 11448-SPM-72A-l-4 11448-FM-72B-S-l,72C-S-l,72D-S-l MISC, CLASS 3 CC PIPING 10 SPT#ll 11448-SPM-72B-2-l 11448-FM-72B-S-2 CC PIPING TO/FROM 2A VSHX 11 SPTtl2 11448-SPM-72B-2-2 11448-FM-72B-S-2 CC PIPING TO/FROM 2B VSHX 12 SPT#13 11448-SPM-72B-2-3 11448-FM-72B-S-2 CC PIPING TO/FROM 2C VSHX 13 SPTtl4 11448-SPM-72C-4-l 11448-FM-72C-S-2 CC PIPING TO/FROM lA&lB FCHX 14 SPTtl5 11448-SPM-72C-4-2 11448-FM-72C-S-3 CC PIPING TO/FROM NONREGEN, HX 15 SPTtl6 11448-SPM-72C-4-3 11448-FM-72C-S-4 CC TO/FROM SEAL WATER HX 16 SPTtl7 11448-SPM-72D-2-2 11448-FM-72D-S-2 CC TO CC H X'S - lA,lB,lC,lD 17 SPTU8 11448-SPM-72A-5-2 11448-FM-72A-S-3 CC PIPING TO EXCESS LETDOWN HX 18 SPTtl9 11448-SPM-71A-l-l 11448-FM-71A-S-4 SW PUMPS lA, lB 19 SPTJ20 11448-SPM-89A-l-4 11448-FM-89A-S-9 LHSI SUCTION FROM RWST 20 SPT#Zl 11448-SPM-89A-l-5 11448-FM-89A-S-10 LHSI SUCTION FROM SUMP 21 SPTt22 1144B~SPM-89A-l-6 11448-FM-89A-S-6 RWST CROSSTIE 22 SPTt23 11448-SPM-89A-3-l 11448-FM-89B-S-10 NITROGEN SUPPLY TO SI ACC 23 SPT#24 11448-SPM-89B-l-2 11448-FM-89B-S-l LOOP "A" SI ACC 24 SPTt25 11448-SPM-89B-l-5 1144B-FM-89B-S-6 SI ACC TEST LINE 25 SPTt26 11448-SPM-89B-l-6 11448-FM-89B-S-8 SI ACC MAKEUP LINES 26 SPTt27 11448-SPM-89B-l-7 11448-FM-89B-S-9 SI ACC VENT LINE 27 SPT#28 11448-SPM-89B-2-2 11448-FM-89B-S-2 LOOP "B" SI ACC 28 SPTJ29 11448-SPM-89B-3-2 1144B-FM-89B-S-3 LOOP "C" SI ACC 29 SPT#30 11448-SPM-87A-2-1 11448-FM-87A-S-3 RHR PIPING TO/FROM RCS 30 SPT#31 11448-SPM-87A-2-2 11448-FM-87A-S-4 RHR TO RWST PIPING 31 SPT#32 11448-SPM-87A-l-3 11448-FM-87A-S-1 1-RH-P-lA 32 SPT#33 11448-SPM-87A-1-4 11448-FM-87A-S-2 1-RH-P-lB 33 SPT#34 11448-SPM-B2B-2-5 11448-FM-82B-S-l RHR SAMPLE LINE 34 SPT#35 11448-SPM-BBC-1-2 11448-FM-88C-S-6 LOOP FILL HEADER 35 SPTt36 11448-SPM-88C-1-5 11448-FM-88C-S-7 REGEN, HX CHARGING SIDE 3 SPTt37 11448-SPM-88C-1-9 11448-FM-BBC-S-B LETDOWN HEADER PTJ38 11448-SPM-88C-2-1 11448-FM-88B-S-5 CH, HEADER & SEAL IN, FILTER PTJ39 11448-SPM-88C-2-2 11448-FM-88C-S-5 SEAL RETURN HEADER SPTJ40 11448-SPM-88C-2-3 11448-FM-88C-S-l RCP SEAL INJ, LINES 40 SPT#41 11448-SPM-88C-2-4 11448-FM-88C-S-2 RCP "A" SEAL RETURN LINE 41 SPTt42 11448-SPM-88C-2-5 11448-FM-88C-S-3 RCP "B" SEAL RETURN LINE 42 SPTt43 1144B-SPM-88C-2-6 11448-FM-88C-S-4 RCP "C" SEAL RETURN LINE 43 SPTt44 11448-SPM-88A-l-2 11448-FM-BBA-S-4 BA TRANSF, PUMP l-CH-P-2A 44 SPTt45 11448-SPM-88A-l-4 11448-FM-88A-S-6 BA TRANSF, PUMP 1-CH-P-2C 45 SPTt46 11448-SPM-BBA-l-3 11448-FM-88A-S-5 BA TRANSF, PUMP l-CH-P-2B 46 SPT#47 11448-SPM-BBA-l-5 11448-FM-88A-S-7 BA TRANSF, PUMP l-CH-P-2D 47 SPTt48 11448-SPM-88A-4-3 11448-FM-88B-S-l NON, REG, HX l-CH-E-2 CHGING 48 SPT#49 11448-SPM-8BB-l-4 11448-FM-BBB-S-2 VCT & LETDOWN HEADER 49 SPT#50 11448-SPM-88B-l-5 11448-FM-8BB-S-7 BA LINES TO CHG PPS 50 SPT#51 11448-SPM-88B-2-3 11448-FM-88B-S-4 CHGING ALT, HEADER 51 SPT#52 11448-SPM-88B-2-4 11448-FM-88B-S-7 A" LHSI PUMP CROSSTIE TO CHG PUMPS 52 SPTt53,53A 11448-SPM-88B-2-5 11448-FM-88B-S-6 CHGING PUMPS 1A,1B, & lC 53 SPTt54 11448-SPM-47B-l-l 11448-FM-47B-S-l FIRE PROT, PEN, PIPING 54 SPT#55 11448-SPM-47B-l-2 11448-FM-71A-S-2 SW PIPING TO/FROM 1-RS-E-lA, lD 55 SPTt56 11448-SPM-75G-l-1 11448-FM-75G-S-l COMP, AIR & PEN PIPING 56 SPTl57 11448-SPM-6BA-l-5 11448-FM-6BB-S-5 AUX, FDWTR X-CONN
.57 SPTt58     11448-SPM-68A-3-2  11448-FM-68A-S-4                                   1-CN-TK-lA & ASS, PIPING 58 SPT#59     11448-SPM-68A-3-3  11448-FM-68A-S-7                                      l-FW-P-2 ASS, PIPING 59 SPTi60     11448-SPM-SBA-3-4  11448-FM-68A-S-8                                    l-FW-P-3A & ASS, PIPING 60 SPT#61     11448-SPM-SBA-3-5  11448-FM-SBA-S-9                                    l-FW-P-3B & ASS, PIPING 61 SPTt62     11448-SPM-68A-3-6  11448-FM-68A-S-6                                 FIREWATER SUPPLY TO AUX, FW 62 SPTtS3     11448-SPM-84A-l-l  11448-FM-84A-S-l                                               RWST 63 SPT#S4     11448-SPM-84A-2-2  11448-FM-84A-S-6&7                              1-CS-P-A SUCT, & DIS, PIPING 64 SPT#65     11448-SPM-84A-2-3  11448-FM-84A-S-5&8                              1-CS-P-lB SUCT, & DIS, PIPING 65 SPT#S6     11448-SPM-84A-3-3  11448-FM-84A-S-4                                      RWST/CAT X-TIE PIPING 66 SPT#67     11448-SPM-84A-3-4  11448-FM-84A-S-3                                          RWCAT UG PIPING 67 SPT#SB     11448-SPM-84A-3-5  11448-FM-84A-S-2                                       RWCAT & ASS, PIPING 68 SPTl69     11448-SPM-BSA-1-2  11448-FM-85A-S-2                                    LEAKAGE MONIT, IN, CON 69 SPT#70     11448-SPM-BSA-3-6  11448-FM-86A-S-3                                       RX HEAD VENT SYSTEM 70 SPT#71     11448-SPM-BSB-2-l  11448-FM-BSB-S-3                                         PG HEADER TO CONT 71 SPT#72     11448-SPM-BSB-l-l  11448-FM-8SB-S-4                                    PRESS HEAD VENT SYSTEM 72 SPT#73     11448-SPM-64A-4-l  11448-FM-64A-S-4                            MS LINES TO l-FW-T-2 & MISC, ST TRAP 7  SPTt74     11448-SPM-75C-l-2  11448-FM-75J-S-l                                    UN, 2 IA TO UN, 1 CONT PTt75     11448-SPM-75C-1-l  11448-FM-75J-S-2                                    CONT, IA DISCHARGE LINE PT#76     11448-SPM-124A-l-2 11448-FM-124A-S-l                                         A" S/G BLOWDOWN 11448-SPM-124A-2-2 11448-FM-124A-S-2                                         B" S/G BLOWDOWN SPTt77 77 SPTt78     11448-SPM-124A-3-2 11448-FM-124A-S-3                                         C" S/G BLOWDOWN Page  13 of 15

ABSTRACT OF EXAMINATIONS SNUBBER PROGRAM An as-found visual inspection was performed on all snubbers. No inoperable snubbers were identified. Thirty snubbers were selected for functional testing. One mechanical snubber (1-WGCB-MSS-10) failed the functional test acceptance criteria. Since the failed snubber was from an independent test group and was not part of the 10% group selected for functional testing, no additional testing was required in the general population. The failed snubber was replaced with a new snubber. Two additional snubbers were functionally tested due to visual discrepancies. Test results were satisfactory. All snubbers were visually inspected and accepted prior to unit startup . Page 14 of 15

  • ABSTRACT OF EXAMINATIONS STEAM GENERATOR INSERVICE INSPECTION Inservice inspection of the "A","B" and "C" steam generators was performed.

For steam generator "A", no tubes were plugged as a result of the inservice inspection. For steam generator "B", no tubes were plugged as a result of the inservice inspection. However, two tubes previously plugged were replugged (Rll, C14 and R33, C43) in response to NRC Bulletin 89-01 concerns. For steam generator "C", two tubes (RlO, C53, and R25, C57) were removed to destructively examine anomalous eddy current indications. The results of the examination indicated no operationally induced degradation of the tube wall. These two tubes were subsequently plugged. Also, two tubes previously plugged were replugged (R2, C7 and R40, C70) in response to NRC Bulletin 89-01 concerns. Page 15 of 15

ENCLOSURE 1 SURRY POWER STATION UNIT 1 FALL 1990 ISi INSPECTIONS NIS - 2 FORMS

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( ,:_ol\)' ,)) Reviewed Copy To: Su isor - Maintenance Engineeri Additional Distribution Below: Page 1 of '2-rorm No 72G7691Feo 881

V n ATTACHMENT- 3 Information Transmittal Record -- Continuation Sheet - Maintenance VIROIIIIIA POWEi Engineering - Nuclear Power Station ADM 11 mmary of Dl1cusalon (COnttnu*d) 4-, (coN r ' 'D) S'7S-T£r/ 1~1vc,;1u££/L /l\..;.*)1c./?-r£ THA, TH' s* v 1rc 1/E ,.Jr., 5 _,IV,:)r i~.l'JJ) A H!STC.~Y or- flA5--r u.:fiJ:fiC~. T /."' C1VJT ,._,A~

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I I l 1. 1------------------------------------------ Page __,.Z,=-- of '2-. Form No. 726953(Fct> 881

AttachI!1en~t 4

            *VIROINIA POWER Memorandum NDRIHCAROUNA POWER To          Mr. D. L. Rogers               Office/Location    ISI Engr./Surry From        M. S. Whitt                    Office/Location    Ci vi 1 Des. /Surry Date               November 12, 1990 REVIEW OF COMPONENT SUPPORT DISCREPANCIES In accordance with your memoranda forwarding results of ASME Section XI, IWF Inspections (most recent memorandum dated November 6, 1990), Engineering has reviewed the eight identified discrepancies.

Drawings Hangers U1WMKS-1021A37 H-08 UlWMKS-0112Al H-05 UlWMKS-0103A2-1 H-03 UlWMKS-0103A2-2 H-05 UlWMKS-0103A2-3 H-04 UlWMKS-011261 H-llA U1WMKS-123Hl H-22 VPA-1-4301 H-01 Attachment 1 provides a summary of these reviews. Is is concluded that none of the eight reported discrepancies results in adversely impairing the operability of any of the affected supports. If you have any questions or need additional information, please contact me at extension 84-780. M. S. Whitt CC: A. R. Fletcher R. K. MacManus W. D. Grady DEO File sl n-MSW-1112B Form No. 728431 (Oct 89) (Formerly 97024020)

Attacqment 4 ATTACJIIENT 1 REVIEW OF IDENTIFIED DISCREPANCIES Ul-WMKS-1021A37, H-08 (11448-PSSK-1021A37.8) Grout and concrete were missing from under the baseplate; the area of missing grout/concrete is approximately 2" x 8" x 3" deep. This support was inspected by Engineering and the discrepancy was confirmed .* However, the calculation for the support indicates loads of only 141 pounds vertical load. Under this low load, the baseplate is considered acceptable as is. However, a Field Change to EWR 89-660 will be issued to correct the discrepancy. Ul-WMKS-0112Al, H-05 (11448-PSSK-112Al.5) The load scale for this spring was missing. This support was walked-down by Engineering. The spring load indicator indicated a load in approximately the middle of the load scale. Therefore, the spring is considered to be operable. Corrective action is to install the correct spring scale and if required, reset spring to 3470 pounds (cold set). Ul-WMKS-0103A2-1, H-03 (11448-PSSK-103Al.3) The spring scale indicated a load of 38,600 pounds vs. the required cold set load of 35,810 pounds (hot set load is 35,140 pounds). This load is within 10%, but exceeds the maximum allowable difference of+/- 300 pounds. Engineering review of this condition has determined that the spring is operable, but should be reset to 35,810 pounds+/- 100 pounds (cold set). Ul-WMKS-0103A2-2, H-05 (11448-PSSK-103Al.5) The spring scale indicated a load of 37,508 pounds vs. the required cold set load of 35,576 pounds (hot set load is 34,576 pounds). This load is within 10%, but exceeds the maximum allowable difference of+/- 300 pounds. Engineering review of this condition has determined that the spring is operable, but should be reset to 35,576 pounds+/- 100 pounds (cold set). Ul-WMKS-0103A2-3, H-04 (11448-PSSK-103Al.4) The spring scale indicated a load of 37,308 pounds vs. the required cold set load of 34,620 pounds (hot set load is 33,953 pounds). This load is within 10%, but exceeds the maximum allowable difference of+/- 300 pounds. Engineering review of this condition has determined that the spring is operable, but should be reset to 34,620 pounds+/- 100 pounds (cold set) . s 1n-MSW-1112C

Attachment 4 Ul-WMKS-011261, H-11A (11448-PSSK-11261.11)

  • The load scale for this spring was missing. This support was walked down Engineering. The spring load indicator was observed to be within about 1/8" that of the "B" spring of the pair. Therefore, the spring is considered to operable. Corrective action is to install the correct spring scale and required, to reset the spring to 2110# +/- 100# (cold set).

by of be if U1-WMKS-123H1, H-22 (11448-PSSK-123Hl.22) It was reported that the integral welded attachment size was incorrect per the PSSK drawing. Discussions with Mr. Dwight Woodyard determined that the thickness of the reinforcement pad was reported to be over 1-inch vs. the 1/2-inch thickness on the PSSK drawing. However, Engineering inspection and ISi verification determined that it was in fact 0.6-inches thick, which is within tolerance of the PSSK drawing. Therefore, the support is operable, and no corrective action is required.

          "VPA-1-4301; H-01"   (No PSSK Exists ON 11448-MKS-122A2)
          "This support was rejected because the required setting of the spring can could not be verified. This information was not available because the hanger was supposedly removed some time ago (confirmed through conversation with Drawing Update) and explains why the hanger does not appear on Station MKS or WMKS drawings. The hanger does appear on a Westinghouse isometric drawing, VPA-4301, but this drawing is old and uncontrolled."

This spring support was reviewed by Engineering. The spring is not included in the pipe stress analysis (Stone &Webster Calculation 12846.22-NP(N)-537-X12, Rev. 2) or on the controlled station piping isometric drawing (11448-MKS-122A2, Rev. 2), but its existence does not adversely affect operability of the system. As corrective action, a Field Change to EWR 89-660 will be issued to completely remove the spring hanger. sln-MSW-1112C

Attachment 5 VIRSINIA POWER Memorandum IIIDlffHCAROUNA POWER To Mr. D. L. Rogers Offlce/l..Ocation IS I Engr. /Surry From M. S. Whitt Offlce/l..Ocation Civil Des ./Surry Date November 28, 1990 REVIEW OF COMPONENT SUPPORT DISCREPANCIES In accordance with your memorandum dated 11/12/90 forwarding results of an ASME Section XI, IWF Inspection of support H-01 of 11448-MKS-10201 and a subsequent memorandum dated 11/26/90 forwarding results of an ASME Section XI, IWF Inspection of Support H-02 of 11448-MKS-125Al, Engineering has reviewed the identified discrepancies. Attachments 1 and 2 provide a su11111ary of this review. It is concluded that the identified discrepancies do not adversely impair the operability of the affected supports. Our previous memorandum dated November 12, 1990 provided the results of reviews of discrepancies on the following supports: Drawings Hangers

  • UlWMKS-1021A37 U1WMKS-0112Al UlWMKS-0103A2-1 U1WMKS-0103A2-2 U1WMKS-0103A2-3 UlWMKS-011261 H-08 H-05 H-03 H-05 H-04 H-llA U1WMKS-123Hl H-22 VPA-1-4301 H-01 None of the identified discrepancies adversely impairs the operability of any of the affected supports. Corrective actions as required for all supports will be specified in a Field Change to EWR 89-660, but these need not be performed until the next outage of sufficient length.

sln-MSW-11128 Form No. 728431 (Oct 89) (Formerly 97024020)

Attachment 5

  • D. L. Rogers Page 2 If you have any questions or need additional information, please contact me at extension 84-780.
                                                   ~S~W~

M. S. Whitt CC: A. R. Fletcher R. K. MacManus W. D. Grady DEO File

  • sln-MSW-1112B

Attachment 5

  • ATTACHMENT 1 REVIEW OF IDENTIFIED SUPPORT DISCREPANCY Ul-MKS-0102Dl, H-01 (11448-PSSK-102Dl.1)

The load scale for this spring was missing. This support was walked-down by Engineering, and it is found that the load indicators of both the springs are at about one third of the scale from bottom and the load scales are missing from both the springs. The springs are Grinnell Fig. 98 Type A Size 17 and hot load setting is 10432 lbs and cold load setting is 11557 lbs. The working range of the spring is from 7000 lbs to 12000 lbs and the range of the load scale is from 6000 lbs to 13000 lbs. Considering the location of the load indicators at the one third point and the range of the load scale, it is concluded that the springs are within the working range and set at approximately the correct load. Therefore, the spring is considered to be operable in the as-found condition. Therefore, there is no effect on the continued operability of the system *

  • However, the missing load scales are to be replaced during the next outage, and this corrective action will be addressed in the Field Change to EWR 89-660 which will be issued to document corrective action for the identified ISI discrepancies *
  • yrn-ARN-1126c

Attachment 5 ATTACHMENT 2 REVIEW OF IDENTIFIED SUPPORT DISCREPANCY Ul-MKS-125Al, H-02 (11448-PSSK-124Al.2) The inspection report indicated that the spring load scale was missing. This support was walked-down by Engineering and it was found that the support in question has two constant springs. A constant spring is designed to maintain a constant load throughout the range of the pipe movement. The*load for constant springs is pre-set at the factory and there is no spring scale on the outside of the spring. The indicator on the spring indicates the position of the spring from low to high. During the walkdown it was found that one of the two -constant support components is at the end of the working range and the second constant support component is within the working range. The support component that is at the* end of the range does not exhibit physical signs of excessive loading and is considered at normal load at the end of the range. A review of drawing 11448-FP-9E indicates that the piping movement at the support location is 2-3/8" in the positive vertical direction. This displacement will move the constant support further into the component working range during normal operation as required. The springs are considered to be operable in the as-found condition. The Field Change to EWR 89-660 which will address corrective action for all ISI discrepancies will provide instructions to adjust the spring which is at the end of the range, to move the indicator further into the normal working range. However, this need not be done until the next outage of sufficient length *

  • sl n-WMG-1128I

OWNER'S DATA REPORT FOR REPAIRS AND REPLACEMENTS for Surry Power Station Unit 1 P.O. Box 315 Surry, Virginia 23883 for Virginia Electric and Power Company 5000 Dominion Blvd. Glen Allen, Virginia 23060 Commercial Service Date: December 22, 1972 Operating Capacity: 822 MWe (net) Refueling Outage 2nd Interval, 2nd/3rd Period

FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS A* Required by the Provisions of the ASME Code Section XI

1. Owner Virginia Electric and Power Co. Date I - :Z.8 - '11 Name 5000 Dominion Blvd., Glen Allen, VA ShNt _ _,;..__ Of I Addr- 23060
2. Plant Surry Power Station Unit ONE.

Name P.O. Box 315, Surry, VA 23883 Wo # 3800 /03~88 Addr- Repair Organlzetlon P.O. No., Job No., etc.

3. Work Perfonned by Virginia Power Type Code Symbol Stamp_...N1,1/uA:>.--------

Name Authorization No. _........,N~{.1.A.___________ P.O. Box 315 1 SurrY 1 VA 23883 Expiration Date _ _...,N~/..,A.___________ Addrea 4, Identification of System CONTAltJME/'JI SPRA'<

5. (el Applicable Construction Coda 831.1 19...6..Z_Edition, _ _.Ni.{uA~___ Addende,N-1, N-7 Code eas.*

(bl Applicable Edition of Section XI Utilized for Repairs or Replacements 19 80W80

6. Identification of Components Repaired or Replaced and Replacement Components ASME Code National Repaired, Stamped Nemeof Name of Manufacturer Board Other Vear Replaced, (Yes Component Manufacturer Serial No.- No. Identification Built or Replacement or Nol
    \JAL\>>:=                \ll'\r..T              ~-1.1uo.71.f           NIA            01-c.s- JI/          VfJ~wJAl       RE.PLN"FI\   U!,J~N VALVE.                  \JOGT                 36-302358                NIA           01-cs-111                j'}gt:t R£PLACf.MEIIIT l)f..ll<tlOUJtJ
7. Description of Work REPAU2. I/ RE.f>LAcE. .VALVE.
8. Tests Conducted: Hydrostatic 0' Pneumatic O Nominal Operating Pressure 0 Other O Pressure t1.r,c i>c.'u~;.,psi Test Temp. A/'ltld-~ C ° F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided 11 I size is 8% in. x 11 in., 121 informa-tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form *
  • 112/821 This Form (E00030) may be *obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.V. 10017

FORM NIS-2 (Back)

9. Remarks 'JALllE:. Po -if" N:S- ~41617 Applicable Manufacn.irur'1 Data Reporu to be attached CERTIFICATE OF COMPLIANCE We cenify that the statements made in the report are correct and this Rl=-PLACEMJJT conforms to the rules of the ASME Code, Section XI. repair or replncement Type Code Symbol Stamp _ _. . . . , , . . . . . . ~ - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -

Cenificate of Authorization No. _ _N~/_A___________ Expiration Date _...;N;.;.L./~A~----------- CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State or Province of VA and employed by HSBI&I Co, of tfa Yi Fo,,.. J J. ct have inspected the components described in this Owner's Repon during the period f:}.,J:>-8:t to ~,1,1,-'(l.. , and state that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Aepon in accordance with the requirements of the ASME Code, Section XI. By signing this cenificate neither the Inspector nor his employer makes any warranty. expressed or implied, concerning the examinations and corrective measures described in this Owner's Repon. Funhermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspection.{)~/ ~

   -----'1/.t....,.~""-"------    *---~~-~-----Commissions_..,VuA_._.,S..:,4c..3,.__ _ _ _ _ _ _ _ _ _ _ _ _ _ __

lnspec:tor'1 Signature National Board, State, Province, and Endor1ement1 Date_ _ _ _ --=-1_-_Jc.-.-_ _19 '1 /

  • FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI
1. Owner Virginia Electric and Power Co. Date / - 2:8-CJI Name 5000 Dominion Blvd., Glen Allen, VA Address 23060
2. Plant Surry Power Station Unit aNE.

N11m11 P.O. Box 315, Surry, VA 23883 WO :It- 3800080790 Address Repair Organization P.O. No., Job No., etc.

3. Work Performed by Virginia Power Type Code Symbol Stamp~N,..../~A~-------

Name Authorization No. -~N-L~A~--------- P.O. Box 315, Surry, VA 23883 Expiration Date _ __._N,_,/.....A..,__ _ _ _ _ _ _ __ Address

4. Identification of System CH§Mlc.AL AND VDL.UME eotl\TRol-
5. (al Applicable Construction Code B31. l 19-2l__Edition,_~N.,../'""'A~_ _ _ Addenda,N-1, N-7 Code Casa (bl Applicable Edition of Section XI Utilized for Repairs or Replacements 19 80W80
6. Identification of Components Repaired or Replaced and Replacement Components ASME Code National Repaired, Stamped Name of Name of Manufacturer Board Other Year Replaced, (Yes Component Manufacturer Serial No. No. Identification Built or Replacement or No)

Fir,! VALVE. ~ - ~ 5 3617l/F316ET'f NIA OI-C.H-'12 UNk'IIIOIIIJI R&>LACE.O 111.ivu~wa.\ VALVE Rccic:wa.L l,/-<f52.C5 NIA 01 -e,1 C/2. /'l'iJI I12EPLACa\EWT ll,\)~ PIPE 1/NKJJOWtJ llNkN6WrJ NIA Ol-cH-'12. ()Al~ R£:p1 Al"EO U~l<'t.101/11.l PIPE:. &bc.oa< i WILU>X 2SA-lf786-N NIA 0/-CH-CJZ /986 REPLACEM911 uA11'f\!OIA'N CONNEC.TOR llNKNOt>JN UtJKtJOl).ltl NIA 01-0l-'12.. UIJKN"IUN REPLAc£D (hl/OIDWi.\

7. Description of Work R,E:Ptf,CE VIILVE PE.R c.WR '3'1-J./:3/
8. Tests Conducted: Hydrostatic ~neumatic O Nominal Operating Press,ure 0 Other O Pressure /, ~ f X ~~i Test Temp. Abd,,£,U,- °F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is 8% in. x 11 in., (2) informa-tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form .
  • (12/82) This Form (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017

FORM NIS-2 (Back)

9. Remarks ~V.;.,...,'}=L~Vr:=--,_,Pc,#"--__._.N.._A;:_-____.4:...;:'=:i:a....3....cZ~5--_J- - - - - - - - - - - - - - - - - -

Applicable Manufacturer's Data Reports to be attached PIPE. 'P()~ NS - 30960 - L CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this l<cPLACe.N\ENT conforms to the rules of the ASME Code, Section XI. repair or replacement Type Code Symbol Stamp _ _. . . . . . , , _ , _ . ~ - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Certificate of Authorization No. _ _N~/_A_ _ _ _ _ _ _ _ _ _ _ Expiration Date _..;N-'-'--/"-A'-------------- Signed____,~_.~>f'._.~*~=r,-r= -~ /-=f~£~:.Z-~-~-='ti~,.,v,~~~-~--Date--~~~~~~-.S:~---, 19

                                              .,..,.....                                                                                                 91' Q w n e ~ n e e , Title CERTIFICATE OF INSERVICE INSPECTION
  .I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State or Province of VA                                            and employed by                HS BI &I Co.                                                    of tla.tl:f-orJJ                 c+/-                                                                have inspected the components described in this Owner's Report during the period                                                   {~-~l.-~'{     to   l-l'.l-91.                     , and state that to the best of my kn*owledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section XI.

By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer* shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspection. r ____:{'.:llnspector's CJ+-._4,..M ____ *"ature ......,--P::t-*

                                                       ~ * - - ~ ~ - - - -_
  • __ Commissions-~V~A~~5~4~3 _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __

National Board, State, Province, and Endorsements

  • FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI
1. Owner Virginia Electric and Power Co. Date /- 2.8- 9/

Name 5000 Dominion Blvd., Glen Allen, VA Sheet 2 of 2.. Addrea 23060

2. Plant Surry Power Station Unit ON£ Name P.O. Box 315, Surry, VA 23883 WO 11- 3800080790 Addrea Repair Organlzetlon P.O. No., Job No., etc.
3. Work Performed by Virginia Power Type Code Symbol Stamp_.N.,_/'-'A'-'----------

Name Authorization No. _ __,_Nu:/_,_A-'---------- P.O. Box 315, Surry, VA 23883 Expiration Date _ _.;.N!...1/~A....__ _ _ _ _ _ _ __ Address

4. Identification of System CHEMICAL ANb VtJW!IIE Ci)NTR<Jl-
5. (al Applicable Construction Code 831, l 19..Q]__ Edition, _ _,_N.,_,/'--'A..,__ _ _ Addenda,N-1, N- 7 Code Case (bl Applicable Edition of Section XI Utilized for Repairs or Replacements 19 80W80
6. Identification of Components Repaired or Replaced and Replacement Components ASME Code National Repaired, Stamped Name of Name of Manufacturer Board Other Year Replaced, (Yes Component Manufacturer Serial No. No. Identification Built or Replacement . or Nol C.ONNE:c.T6R 2" FR/SCJ.1/(0TJkl 331982 NIA OI-CH-'12.. tqqo RJ:o, .OcEW=Nr vi,1:NruitJ SJlJD5 ~ NUTS UtJ KIJOW IJ Ul'IK!'olOWi..l NIA ol-C.H-'12. Ut-J~ovlN Rf;PLA-CE.D UtJi<:1.JOW~

I SflJDS 2. -13 CARDINAL IND. '-15116 NIA OI-CH-Cf2. /990 REPLAcE.MENT IJtJ~cwiJ 1'JUTS +/--13 CARDINAL 1/IJD. 4-6576 NIA OI-O,-C/2. /qC/0 R.EPLAc.ENIEJlT IJNKJ/OWN

7. Description of Work REPLAc.E. VALYE PER, EW.R B9- 4-SI
8. Tests Conducted: Hydrostatic B Pneumatic O Nominal Operating Pressure 0 Other O Pressureb L.rlfA{W psi Test Temp.a.Ad'.,.!.vY °F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1 I size is 8% in. x 11 in., (21 informa-tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form.

(12/821 This Form (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017

FORM NIS-2 (Back)

9. Remarks -~Co~N~N=EC~T_OB.~~Po~#--"5.5=...:.Y_-_..,,.3'-Ll..:8;_56_7-'----'------------------

Appllcable Manufacturer's Data Reports to ba attached STUDS PO# CS'(- 2..94697- 2.., NUT.S PD# CSY-317574--:L CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this gEPL..Ac£Mi=NT conforms to the rules of the ASME Code, Section XI. repair or replacement Type Code Symbol Stamp _ _......._1-J,.J..___ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ Certificate of Authorization No. N/ A Expiration Date __N_,_/..;;.A-'------------ Signed  ?} if:_ / 4.L/ o/w..er or O w ~ n e e , Title orProvinceof VA

                                                 ..2:S'Z:Hfv,,ve!2,,e'Date 4&:W CERTIFICATE OF INSERVICE INSPECTION andemployedby       HSBI&I Co.

5' , 19 9,, I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State of J../o.1e TE() v* dJ c -r have inspected the components described in this Owner's Report during the period /'J--;).1--2'.1 to ,. ... ~.:J.-9?. , and state that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section XI. By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any ki~d arising from or connected with this inspection. f?~1, ~t- f. fuA ..

   ------+l.1~~~-V---'-----~~--'---"'~'-"c....c..--'----Commissions_...V...,A"'"-..,,5~4~3~----------------

1nspector's Signature National Board, State, Province, and Endorsements Date_ _ _ _ _3-,;*_-_s"""-**___19 qI

  • FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI
1. Owner Virginia Electric and Power Co. Date_"'""J_--".ZS-=---q..i.=....J_ _ _ _ _ _ _ _ _ __

Name 5000 Dominion Blvd., Glen Allen, VA Sheet _ _~/__ o f _ ~ - - - - - - - - - - Addrea 23060

2. Plant Surry Power Station Unit ---=O'-'N.......,c=--------------

Name P.O. Box 315, Surry, VA Addrea 23883 woRepair ~3$00 IOY:9B8 Organization P.O. No., Job No., etc.

3. Work Performed by Virginia Power Type Code Symbol Stamp__._N.,../.....,A~-------

Name Authorization No. _ __,_N.,,../~A~--------- P.O. Box 315, Surry, VA 23883 Expiration Date _ ___,_N~/~A~--------- Address

4. Identification of System CHEMIC.AL.. AND \/OLlJME CONTROL
5. (a) Applicable Construction Code 831. 1 19__g_l__Edition, _ __,_N,.,./__,_A_,___ _ _ Addenda,N-l , N- 7 Code Case (b) Applicable Edition of Section XI Utilized for Repairs or Replacements 19 80W80
6. Identification of Components Repaired or Replaced and Replacement Components ASME Code National Repaired, Stamped Name of Name of Manufacturer Board Other Year Replaced, (Yes Component Manufacturer Serial No. No. Identification Built or Replacement . or No)
  'IALVE. RELi e.F        CROSBY              IJI\I LVE. 1'cl-l.SF        c.ROS6'(           2,-RV-52.JWS UNKNO 511-O't302
7. Description of Work RE:f>U\-GE- 'IALVE ( FREE.'Z.£ SEAL)
8. Tests Conducted: Hydrostatic Other O O Pneumatic Pressure {1/<J ~

0 Nominal Operating Pressure psi Test Temp. /ti iJ 7"' if° F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is 8% in. x 11 in., (2) informa-tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form .

  • (12/82) This Form (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017

FORM NIS-2 (Back)

9. Remarks 'JALVE. po1f SY- I546Y: - I Applicable Manufacturer's Date Reporu to be attached STUDS Po~ CSY-31624-:1- 2.

NUTS CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this REfl.A¢MENT conforms to the rules of the ASME Code, Section XI. ~epair or.replacement Type Code Symbol Stamp _ _...._.+-'-..._--------------------------------- Certificate of Authorization No. _ _N....:../_A_ _ _ _ _ _ _ _ _ _ _ Expiration Date --'N:.:..L.f.:.A.:.....___________

               /1      ~      ,J Signed_..,~~_,__.,q~c......,k,-~=----=-~"""""~/
                                                             .               .I>-:       ,::_~~(5'6'~

____.IJ:...=c:u..liL..L.r.,.,2.::.JC...___ _ _ _ Oate Ld-{fr

  • 2.r:
  • 19 91 Owner or O w ~ ~ t l e CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State or Province of VA and employed by HSBI &I Co. of
                                                        ...,.d"'-,j.J..,c>=...t-_,___-______________ have inspected the components described

_ _ _ _ _ _ _....:.H...L.~:>..r,_:-t-...:..._,_f..,o,<.:.. in this Owner's Report during the period /1* ~:)..5'f~ to ~~1~.qQ'J_ , and state that to the best of my knowledge and belief, the Owner has performed examinations* and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section XI. By' signing this certificate *neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspection.

   ----l-QI-L~"'-*        --=--'---=""'"'-l_{j,::::;;>"8--~~=---

1nspactor's Signature Commissions--'-'-VA.,_,S....i4.._3- - - ~ - - - National Board, State, Province, and Endorsements Date,_ _ _ _.,.,,1,,_,_..~__,,&.___19 9/

FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI

1. Owner Virginia Electric and Power Co. Date /-28-q/

Name 5000 Dominion Blvd., Glen Allen, VA Sheet _ _,_/__ of_....:../_ _ _ _ _ _ _ _ __ Addrea 23060

2. Plant Surry Power Station Unit ONE.

N11me P.O. Box 315, Surry, VA 23883 WO* 38000952.0I Address Repair Organization P.O. No., Job No., etc.

3. Work Performed by Virginia Power Type Code Symbol Stamp~N.,__/'-'A~--------

Name Authorization No. _......,_N,_,/__.A~--------- P.O. Box 315, Surry, VA 23883 Expiration Date _ _~N,.,/....A..,__ _ _ _ _ _ _ _ __ Address

4. Identification of System_--'M"'-"-A..ul.uN'---=S'--'T..,EA..._.,.,M..__ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
5. (a) Applicable Construction Code B31.1 19.fil_Edition,_....,N.......
                                                                                                       /A,._,___ _ _ Addenda,N-1,         N-7         Code Case (b) Applicable Edition of Section XI Utilized for Repairs or Replacements 19 80W80
6. Identification of Components Repaired or Replaced and Replacement Components ASME Code National Repaired, Stamped Name of Name of Manufacturer Board Other Year Replaced, (Yes Component Manufacturer Serial No. No. Identification Built or Replacement or No)

DI SC. Shutte ~ ~rlim UN"'1..IOU,IJ NIA OI -MS-RV-1018 IJNKllQI)~ RePLAc.EP tlll~WN DISC AME-rEI< (s~ K) 12.E006S\JOOZO NIA 01- M<:-Pll-1018' Jq9,7 l~P1 * - ... ~~, IHJl&:alOWM

7. Description of Work 0\JE:RHAlJL VALVE-.
8. Tests Conducted: Hydrostatic O Pneumatic O Nominal Operating Pressure 0 OtherO Pressure _ _ _ _ _ psi TestTemp. _ _ _ _ _°F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is 8% in. x 11 in., (2) informa-tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form .
  • (12/82) This Form (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017

FORM NIS-2 (Back)

9. Remarks p,sc. Po ti= SS'(- /23688 -_3_ _ _ _ _ _ _ _ _ _ _ _ __

Applicable Manufacturer's Date Reports to be attached CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this 121:PLAc.EPIENT conforms to the rules of the ASME Code, Section XI. repair or-.replacement Type Code Symbol Stamp _ _- N . . , / ~ ' A - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Certificate of Authorization No. N/ A _ _ _ _ _ Expiration Date __N_,_/.;;..A.;;...._ _ _ _ _ _ _ _ _ __

               ;;'l '" t./ I ~ _/ r s:z;-- kt; cM:!d Signed oWr or Province of VA or Own~nee, Title                    .*

Date _ _ CERTIFICATE OF INSERVICE INSPECTION A_cryz~._.l._y' ____ , 19 'l( I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State and employed by HS BI &I CO , of _______.,.H. . .a~V'_:t~n~~l"~J:'--l1'"'c=-~-r~-----------~--have inspected the components described in this Owner's Report during the period _ _ _ _ _:- /1.-21,-a"l:f to  ;>-. ~~ ... q'J- , and state that to the best of my knowledge and belief, 'the Owner has performed examinations and taken corr~ctive measures described in this . Owner's Report in accordance with t.he requirement! of the ASME Code, Section XI.

  • By signing this certificate neither the Inspector nor his employer makes any war~anty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspection.
   ----,~1--=--,-----:---==-:-*      ~tr-'--=&i-:;...;c...::'-----Commissions~V~A~S~43~---------

lnspector's Signature National Board, State, Province, and Endorsements Date,_ _ _ ~fJ.~-{J_~~-191'/

FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI

1. Owner Virginia Electric and Power Co. Date J-26-'j/

Name 5000 Dominion Blvd .* Glen Allen, VA Sheet _ _:.../_ of I Addr- 23060

2. Plant Surry Power Station Unit ONE Neme P.O. Box 315. Surry, VA Addr-23883 WO# 3800 /03055 Repair Organization P.O. No., Job No., etc.
3. Wor1t Perfonned bv Virginia Power Type Code Symbol Stamp__._N,...{....A~-------

Nem* Authorization No. _-.!.!Nu;{.LA..__________ P.O. Box 315, Surry, VA 23883 Expiration Date _ _""'N""/_._A..___ _ _ _ _ _ _ __ Addren

4. Identification of System RE-.AcroR COOLANT
5. (al Applicable Construction Code B31, 1 19...2.Z_Edition, _ _.N.,,.{uA.._____ Addenda,N-1, N-7 Code Case (bl Applicable Edition of Section XI Utilized for Repairs or Replacements 19 80W80
6. Identification of Components Repaired or Replaced and Replacement Components ASME Code National Repaired, Stamped Name of Name of Manufacturer Board Othar Year Replaced, (Yes Component Manufacturer Serial No. No. Identification Built or Replacement or Nol snms (?z..LL' Wesru.161-!00SS. UWKAIOloJN NIA 01-RC-E-IA ~lf~Utll REP* .arcn ~

STUbS {3 ~1-.,,_J I.UEST**-~.*.* ,__ UNKIJIIIAJI\I NJ~ 01- Rt: .. c:-1A 1/~IKl'JOWN --** I, 1t.11111owt,1 {-

7. Description of Work RMY / I.NSTL MA~WAY a>VERS
8. Tests Conducted: Hydrostatic O Pneumatic O Nominal Operating Pressure W Other D Pressure 2,2.J r psi Test Temp. ,'2?{7 °F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (11 size is 8% in. x 11 in., (2) *informa-tion in items 1 through 6 on this report is included on each sheet, and (31 each sheet is numbered and the number of sheets is recorded at the top of this form *
  • (12/82) This Form (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017

FORM NIS-2 (Back)

9. Remarks ?Tll05 pc,# E.T- 4(822 - I Applicable Manufacturer's Data Repom to be attached CERTIFICATE OF COMPLIANCE We cenify that the statements made in the report are correct and this ~LAcl:M§NT conforms to the rules of the ASME Code, Section XI. repair or replacement Type Code Symbol S t a m P - - - ~ - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -

Cenificate of Authorization No. _ _N~/_A___________ Expiration Date __N_._/_A____________ Signed ( ) ... / ~ Owner or ~ n e e , Title

                                      - 4.,L CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State or Province of VA                            and employed by       HSBI&I Co,                                                           of Ht1 t:T 'fot JI c..:f-
  • have inspected the components described in this Owner's Repon during the period /j.-,1~ -RI to 1;-,l i-Cf 'J... , and state that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Repon in accordance with the requirements of the ASME Code, Section XI.

By signing this cenificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Funhermore, neither .the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspection.

   -----"-~-----""---'""-'"--'£"'-._-~__,c...:=-==c.....a.---Commissions _  _,yuA.._....S:...4..,3.._________________

lnapector's Signature National Board, State, Province, and Endorsements

                            ~- ~2          19 q/

Date

        --------~---
  • FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI
1. Owner Virginia Electric and Power Co. Date 1-2.6-'jl Nam*

5000 Dominion Blvd., Glen Allen, VA Addr- 23060

2. Plant Surry Power Station Unit ONE.

Nam* P.O. Box 315, Surry, VA 23883 .IF- 3800 09754:7 WORepair Addr- Organization P.O. No., Job No., ate.

3. Work Performed by Virginia Power Type Code Symbol Stamp__._N,../c..1A~-------

Nam* Authorization No. ---'-'N'-"/.._A..___________ P.O. Box 315, Surry, VA 23883 Expiration Date _ _""'N,./.._A..___ _ _ _ _ _ _.......;._ Addrea

4. Identification of System~R~EA~C~l}~Q=R~--C.OO~~LA~-N~T~-----------------------
5. (al ApplicableConstructionCode B31.1 19~Edition,-~N...{~A~___ Addenda,N-1, N-7 Code Case (bl Applicable Edition of Section XI Utilized for Repairs or Replacemenu 19 80W80
6. Identification of Components Repaired or Replaced and Replacement Components
  • Name of Component Name of Manufacturer Manufacturer Serial No.

National Board No. Other lden,tlfication Year Built Repaired, Replaced, or Replacement or Nol ASME Code Stamped (Yes (14-~} sn,ns,- Nu.~( WSS1Ul61-!0usE.. UWK~OIIJN Nb\ 01-RC-E- IC ~k'Allll,U,. REP~ ~ (6tf-A) STUbS 1-uut"' 1.UEST1**~ ****-- UNl(NowtJ NIA 01- R.L .. ~- IC \JN l<lJoUJN ........... "-".MFtJT" ....vuou,lf,I

7. Description of Work RMY / !NSTL MANWAY a>YER.S
8. Tests Conducted: Hydrostatic O Pneumatic 0 Nominal Operating Pressure 0 Other O Pressure 2-,l. 3.r psi Test Temp. sLt'. 2 °F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (11 size is SY.a in. x 11 in., (21 informs.

tion in items 1 through 6 on this repon is included on each sheet, and (31 each sheet is numbened and the number of sheets is recorded at the top of this form. (12/821 This Form (E000301 may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017

FORM NIS-2 (Back)

9. Remarks STUDS po# E..T - 4{822 - I Applicable Manufacturer', Data Repom to be attachad CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this Rs>LAceM§NT conforms to the rules of the ASME Code, Section XI. repair or replacement Type Code Symbol Stamp _ _.......,......_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __

Certificate of Authorization No. _ _N--'-/_A___________ Expiration Date _...;N;.;.i./.;;..A.:......___________ S~ned cZ2~~ Owner or OwneDeslgnoe, Title h~.,d., r Date _ _.;,.,;::.~:..::;.;:...:._ _ _ _ _ , 1 9 '7 ( CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a*valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State orProvinceof VA andemployedby HSBI&I Co, of

  ---------4H.-1-o...=lr':..T..._f.L..1,o,..~..,d=-,,_*....::C.~T.L..-------=-----have inspected the components described in this Owner's Report during the perio~                          fl-~  }-5{9 to--~o&.::.-....~...1:z...;... _'t..__.'l.,.""'-~---, and state that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section XI.

By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examination$ and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspection.

   ----~'1-"~--'"-""'"--~f_.__~~

lnapactor'1 Slgneture

                                             . . . . .,_. . . .___ commissions_..iYuAci.......Sc::4._,3.,_________________

National Board, State, Provlnca, and Endorsament1 Date,_ _ _ _1.....,<l.c...><.K_ _19 9' I

FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provi1ion1 of the ASME Code Section XI

1. Owner Virginia Electric and Power Co. 0119 J-2.6-,,

Name 5000 Dominion Blvd., Glen Allen, VA Shtet _____ /_of_..._________________ Addr* 23060

2. P11nt_--==s~u:.::.r..:.r...Y-:..P...o.:.;.w.,._er;:._;S:.t.:;:a::a.t:.:i::.;o:.::n.::---------------

Name Unit ONE. P.O. Box 315, Surry, VA Addr* 23883 WORepair.If 3800 097553 Organization P.O. No., Job No., etc.

3. WortcPerformedbv Virginia Power Type Code Symbol Stamp__..N.,./_,,A...__ _ _ _ _ __

Name Authorization No._....,.N.._/..,A.__ _ _ _ _ _ _ ___ P.O. Box 315 1 Surry, VA 23883 Expiration om __N~/..,A,_______________ Addrea

4. Identification of System___.R.._._cACL.&.a"-"f_,,Q~R.-_C<<>="-""LAH~ T----------------------------
5. (al Applicable Construction Code 831, 1 19~Edition,_.._N....I.A......_
                                                                                                                  . . ___ Addanda,N-1,                N- 7      Code Case (bl Applicabla Edition of Section XI Utilized for Repairs or Replacements 19                             80W80
6. Identification of Components Repaired or Replaced and Replacement Componenu ASME Code National Repaired, Stamped Name of Name of Manufacturer Board Other Year Replaced, (Yes Component Manufacturer Serial No. No. Identification Built or Replacement or Nol
.S72,~
  ~, ,

Sre,,J>

         . r;,~,,,)                   WfSTUIGMOuse.                  U\JKllO ltJN                  NIA       01-RC-E-lB           *k"'-**-**     REP~.J>        Ul#llll.ftl
      /,)
  - .,- ,~,-1  0c~)                  IN--;. "          ****--        UNKNOW~                       NIA      01- Rr .. t.,.-/B U N ~
                                                                                                                                               ..,.._,~

cnrn11 ,.,.......,.IIIN

7. Description of Work RMY / !HSTL MANWA'f (.J)VER,S
8. Tests Conducted: Hydroststic D Pneumatic 0 Nominal Operating Preuure Q/"

Other D Pressure 22...J u""' psi Test Temp. J-.; 2 °F NOTE: Supplemental sheets in form of lists, sketches, or drawings rrav be used, provided (11 size is 8% In. x 11 in., (21 informa-tion in items 1 through 6 on this report is Included on each sheet, and (31 each sheet is numbered end the number of sheets is recorded at the top of this form. (12/821 This Form (E000301 may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017

FORM N1S*2 (Backl

9. Remarks -?:;..;.:'f...;;.\J=.D=5_.._,'PQ"'-*-=E.:....;.T_---J4L.Of~S...,,2=2"""-----'I'---_ _ _ _ _ _ _ _ _ _ _ _ _ __

Applicable Manufacnirer'1 Data Reporu to be attached CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this RBPU\c!Ml;Nf conforms to the rules of the ASME Code, Section XI. repair or replacement Type Code Symbol Stamp _ _ _µ..a _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ Certificate of Authorization No. _ _N_/,__A__________ Expiration Date __N_,_/_A___________ Signed ~ ~ _f ~ fs_z;-

          ~ e r o r ~ . Title CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State or Province of VA                                                   and employed by         HSB I&         I Co,                                                       of

______...H-"-'a""'___.,,._*, __* ~&-=_r...d. . . . c=--t_________. . ., . ____ J....... have in!f>ected the components described in this Owner's Report during the period _ _ _ _-4-(... ~._~...1...,~.._,~$.;.i...'l..__to 3-* ~- d* -'1 ',l.. , _and s_tat9 that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in accorclance with the requirements of the ASME Code, Section XI. By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspection. __......,._@:__~_'-~--.L-._1_*~~-~* ____ Commissions __Y....A.._..5__.4_3_ _ _ _ _ _ _ _ _ _ __ I nspec:tor'1 Signature National Board, State, Province, and Endorsement, Date_ _ _ _ ~-_ _19 ~ {

                                  'J;=----1___

FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI

1. Owner Virginia Electric and Power Co. Date /- 28-'I/

Name 5000 Dominion Blvd., Glen Allen, VA Sheet _ _ _ _ of __3 ______________ Address 23060

2. Plant Surry Power Station Unit ONE Name P.O. Box 315, Surry, VA Addrea 23883 WO# 3800104:525 Repair Organization P.O. No., Job No., etc.
3. Work Performed by Virginia Power Type Code Symbol Stamp__.N.,_,/'-'A'-'---------

Name Authorization No. _ __,_N,../...,A'-'----------- P.O. Box 315, Surry, VA 23883 Expiration Date _ _~N~/...,A~---------- Address

4. Identification of System_5_1:.R;...c...;.c~.,_IC=E.=-_W=-=-A.,_TE'-="'R.___ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
5. (al Applicable Construction Code B31. l 19..Q.Z_Edition,_..,_N,.,/_,_A..,___ _ _ Addenda,N-l, N-7 Code Case (bl* Applicable:Editiori ofSection XI Utilized for' Repairs or *Replacements 19 8 OW8 0
                  .*s.. Identification of.Components Repaired.or*Replaced and Replacement.Components
                   . - - - - - - - - - - - - - - - ~ - - - - - - . - - ~ - - - , - - - - - - - - - , - - - - ~ - - - - - , - - - - - . .. :. ,:,-j ASME.

Code National Repaired, Stamped Name of* Name of Manufacturer Board Other Year Replaced,,' * (Yes :. : - Component Manufacturer Serial No. No. Identification Built or Replacement . or No)

                                                                                                                                                                            'yd-7
  . ,,.,:            SEAL COOLE
             .. .l,.2::tl!::~~~~~~:ll:laffl..                        _ _.j..!U~N~KtJ~OIIJ~NL-4-_I:!/.1:L_~~~:,=-._!.!:~!/M.!S~l&.L-MJ:!..til..!;;l..2~~~ i>t/l .Ja.l'h1                 ~

SEAL C.OOL ~' .-. ;~ ,_" Ul\lloN 2.? wtl UNION 2." 2.16323 N PIPE. 2. N

7. Description of Work REPLACE SE.AL. COOkf.R,
8. Tests Conductectf' Hydrostatic ~PneumaticO .:.,Nominal'Operating Pressure 0 Other O Pressure I, O< ;AfV4'i1JSi, Test ,:e1T1p. ,4e,4,.t;.,r° F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is ax. in. x 11 in., (2) informa-tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form.

(12/82) This Form (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017

FORM NIS-2 (Back)

9. Remarks _:5,...EA=-"L"--'C=OO=L=E:=R_,__---'-P.-=0_#_5""'5=-'-y_-.....,2:.:..Lf..,_7-'--=2.!~/fL..>~"'---...,.l_ _ _ _ _ _ _ _ _ _ _ _ _ _ __

Applicable Manufacturer's Data Reports to be attached UNloN Po#= CS'<- 1932..23 - 3 CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this REPLACEME-JllT *

  • conforms to the rules of the ASME Code, Section XI. repair or replacement
          'Type*Code*Symbol Stamp_----'"+-.C...------------------~---------------
           .Certificate of. Authorization No. _ _N~/_A_ _ _ _ _ _ _ _ _ _ _ Expira.tion.D.ate'._....;N~/~A.c.__ _ _ _ _ _ _ _ _ __

Signed . '2£ / Owner or O w ~ e e , Title V fJ'f CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State orProvinceof VA andemployedby HSBI&I Co. of tf o,,rTFo ... d, ct have inspected the components described

         *;;in this Ownefs Report during the period _ _-,-_ _,_..,*/'-'1.,_-_.!l""!).=--..,~._.~'-to 1, :- 1 *i - en.                , and state that

.::_; '.::to the best of my knowledge and belief, the Owner has performed* examinations and:taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section XI; i . By *signing this certificate. neither the *Inspector. nor his*employer makli$car:iy.. warranty, expressed*o~..irnplied, .concernipg the

i;exami l'lations .. and,,eor(ective :*~easures. described>: in*.,thi~ *d~er(s, Repo'rt*,Furthermo~e. ;~either. the 'inspector nor his. employer.

00

       * 'shall be ii able* in*      a~y   ,;,anner for any personal inj~ry 'ar propeny d~mage or a loss of any kind arisin~ from or connected with this inspectio~                                    £        ~

Commissions _ _,VuA_._..,Sc...4w3"-------'----------- Inspector's Signature Netional Board, State, Province, and Endorsements Date_ _ _ _ . .,.~~--a.,___ S- 19 Of, I

FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI

1. Owner Virginia Electric and Power Co. Date _ _ 1-_2_8~--'l~I___________

Name 5000 Dominion Blvd., Glen Allen, VA Address 23060

2. Plant Surry Power Station Unit ONE:

Name P.O. Box 315, Surry, VA 23883 WO :i;:. 3800 l 04525 Addrea Repair Organization P.O. No., Job No., etc.

3. Work Performed by Virginia Power Type Code Symbol Stamp~N~/~A~-------

Name Authorization No. -~N_/~A_ _ _ _ _ _ _ _ __ P.O. Box 315, Surry, VA 23883 Expiration Date _ _.a..N,../....A ~ - - - - - - - - - Addren

4. Identification of System--'5c.cE::.:R'"'"Vi...,.,ICE.""""~Wc.::.Aa..,..,J...:E.:.R:....i.._ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
5. (al Applicable Construction Code B31, 1 19__g_I__ Edition,_~N..,_/~A~_ _ _ Addenda,N-1 , N- 7 Code Case (b) Applicable Edition of Section XI Utilized for Repairs or Replacements 19 80W80
6. Identification of Components Repaired or Replaced and Replacement Components ASME Code National Repaired, Stamped Name of Name of Manufacturer Board Other Year Replaced, (Yes Component Manufacturer Serial No. No. Identification Built or Replacement or Nol PIPE:. 2 FRISCHKORN 332.636 NIA 01 -SW- E - I B Jqqo REJ'I Ar EM cN.T OtJKIJo11H,I El...BoW 2" LINKNowtJ 11/JKJJowr.J NIA 01-sw-1::.-1 B lfiJ"*"'WtJ REPLACEJ> UIJloJOWA!

a.sow 2" Fl<./5(.J.llr<()RN "322'+6S NIA 01-SW-E-JB /'190 Rc:PlJ\cS'1ENT lJMIQ,/OWt.l STUD.5 ~ NUT5  !}/JI( lll\ !>IM lJtJl::.Jo,.,,, NIA 01- 5W-E:-l B uAIKUowr..l REPL.AcEI> IJJJl(JJowtJ I STUD5 z:-13 HARDWARE:. SPEC. 305'-l-S NIA 01-sw-E-IB /'188 ~PL.AC£J\tlENT UNK/,loi,Jt,I

7. Description of Work Rf:;Pl-Ac.E Sl:AL C()OLE:R
8. Tests Conducted: Hydrostatic c::(" Pneumatic D Nominal Operating Pressure 0 Other D Pressure /. r(Jbr,,, psi Test Temp. ,d-.,lftJ :~,// OF r NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1 l size is 8% in. x 11 in., (2) informa-tion in i,tems 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the*number of sheets is recorded at the top of this form.

(12/821 This Form (E00030l may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017

FORM NIS-2 (Back)

9. Remarks-E~IP~E~-A~o_#_C_S_Y~---=3-'-17--'-=2:....,3:c....b~-~2 _ _ _ _ _ _ _ _ _ _ _ _ _ __

Applicable Manufacturer's Data Reports to be attached ELBOtAI Po~ cs)'- 3oqsi+1-5 CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this gE:PLACENlENJ conforms to the rules of the ASME Code, Section XI. repair or replacement Type Code Symbol Stamp _ _. . . . u ; . . . , . ; " - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Certificate of Authorization No. N/ A Expiration Date __N-'-'-/.c.A.;_____________ Signed Wt(;_ / ~AL.,/ Owner or Ow~;;ignee, Title _z-n:;:£v4c-v~ Date--M~-'d~~~~~~----, 19 ~ / CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State orProvinceof VA andemployedby HSBI&I Co. of tl~rifo..-d., C:.-t have ins cted the components described in this Owner's Report during the period d-- 'l. a-1i._

  • and state that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section XI.

By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer Ld-L shall be liable in any manner for any personal injury or property damage or a loss of any kind aiising from or connected with this inspection.~ Commissions_~V~A~~5~4~3_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ Inspector's Signature National Board, State, Province, and Endorsements Date _ _ _ _ -1,j,_,,.,..-_i=~~-19._Cf~/-

FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI

1. Owner Virginia Electric and Power Co. Date I - 2?>- Cfl Name 5000 Dominion Blvd., Glen Allen, VA Address 23060
2. Plant Surry Power Station Unit ONE Name P.O. Box 315, Surry, VA 23883 WO-* 3800/04525 Address Repair Organization P.O. No., Job No., etc.
3. Work Performed by Virginia Power Type Code Symbol Stamp_..,N'"'-'-/A~--------

Name Authorization No. -~N~L~A~---------- P.O. Box 315, Surry, VA 23883 Expiration Date _ _. ;.N. _/'--'A,__,____ _ _ _ _ _ _ _ __ Address

4. Identification of System SERVICE WATER
5. (al Applicable Construction Code B31.1 19.fil_Edition,_...,N'"'"'"""/~A~_ _ _ Addenda,N-1, N- 7 Code Case (b) Applicable Edition of Section XI Utilized for Repairs or Replacements 19 80W80
6. Identification of Components Repaired or Replaced and Replacement Components ASME Code National Repaired, Stamped Name of Name of Manufacturer Board Other Year Replaced, (Yes Component Manufacturer Serial No. No. Identification Built or Replacement or No)

NUT.S \-15 CARDINAL INl>. t.f67B?, NIA Ol-'5W-E:-1B /'=,clO REPL.Ac.EME:N'i ,mv.low..i

7. Description of Work RE.PLACE.. SEAL COOLE;R,
8. Tests Conducted: Hydrostatic ff Pneumatic D Nominal Operating Pressure D Other D Pressure/. J",<: Afgdt&'psi Test Temp.AM/JWC°F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is 8% in. x 11 in., (21 informa-tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form.

(12/82) This Form (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017

FORM NIS-2 (Back)

9. Remarks _N,-,....aU~T~S__ Po~=l\:--~C"-'SC-..Y_---=3=2=2"--Cf-'--7-'----'7_-~2=--*---------------

Applicable Manufacturer's Data Reports to be attached CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this Rf:PLA(.E,MENT conforms to the rules of the ASME Code, Section XI. repair or replacement Type Code Symbol S t a m P - - ~ ~ ~ - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Certificate of Authorization No. _ _N~/_A____________ Expiration Date __N~/_A_____________ CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State or Province of VA and employed by HS BI &I CO . of Ha.y,fo rd: er have inspected the components described in this Owner's Report during the period-----~l_,'l=-*_,l~1~-_,Ss9~1....._to-~:l.~-~'l,~1._-_Cf~l~-----,, and state that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section XI. By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspecti{) /i

   ----1~--=~--~~~----1.,..._...,~-~~~~~~--Commissions _                      _,V'-'A_._..,.S'-4~3~----------------

lnspector's SigneMe National Board, State, Province, and Endorsements

                            /\_(\ c--

Date_ _ _ _ _sf::,.___,c;t_~-.J_ _ _19 0 J/ / e

FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI

1. Owner Virginia Electric and Power Co. Date I - 2 S - Cf I Name 5000 Dominion Blvd., Glen Allen, VA Addrea 23060
2. Plant Surry Power Station Unit ONE.

Name P.O. Box 315, Surry, VA 23883 WO # 33000 888 76 Address Repair Org11nlz11tion P.O. No., Job No., etc.

3. Work Performed by Virginia Power Type Code Symbol Stamp__,_N.,,,/'-'A..,___ _ _ _ _ __

Name Authorization No. _ __,,N"'/'""A~--------- P.O. Box 315, Surry, VA 23883 Expiration Date _ _~ N ~ / ~ A ~ - - - - - - - - - Address

4. Identification of svstem CHEMICAL AND VOLUME CONTROL
5. (al Applicable Construction Code B31. l 19..QL__Edition,_....,N~/A,_,__ _ _ Addenda,N-1. N- 7 Code Case (bl Applicable Edition of Section XI Utilized for Repairs or Replacements 19 80W80
6. Identification of Components Repaired or Replaced and Replacement Components
  • Name of Component Name of Manufacturer Manufacturer Serial No.

National Board No. Other Identification Year Built Repaired, Replaced, ASME Code Stamped (Yes or Replacement or No) STLJ/'\_<; ~ N'UTS VELAN UNKNOLUN NIA OI-CH-276 Ulll()JOWN RE.PL.AC.ED lJnlOlbWN 5iUDS t-10 A ~Ci !:.NGR 04-706 NIA O/-CH-"J.76 l<J'rO Rcf'lACEMali ~IO/OllltJ NUiS ~ -1a ICARD\f\lAL IND. Lf37'B7 NIA OI-CH-1..76 1qiq l<'J::Pl.ACEM~l IJIJ~Ol!i\l

7. Description of Work RE:PLAc,E, HAN6£.R BRACKET BQLT.S
8. Tests Conducted: Hydrostatic D Pneumatic D Nominal Operating Pressure ~

Other D Pressure Ala) psi Test Temp. PO Z: °F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is 8% in. x 11 in., (2) informa-tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form. (12/82) This Form (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017

FORM NIS-2 (Back)

9. Remarks __.,5I~U=DS=--........_,p()=-=W--=Cc,:::S=-Y.:...---=3:::...,l_.,,,G:.,::2::..,B=l--....,3=--------------------

Applicable Manufacturer's Data Reports to be attached u s PO# S'{- 2.5~2. 6-2, CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this REf'LACl:lYIEN"'f conforms to the rules of the ASME Code, Section XI. repair or replacement Type Code Symbol Stamp _ _......,_.,_._.___ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ Certificate~of Aut~;iz~ation No. _ _N.....c./_A_.-.-: _______?----.- Expiration Date _L._N_,_/_A____________ Signed ""~ ~/ Oner or O~Oeslgnee, Title

                                                             ~   > ..L    ,c;,µ4,~£..,,       Date         rz"'d. ,2 2-.            , 19 'zl CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State or Province of VA
  • and employed by HS BI &I Co. of

________./,f.....,a..="-r-T._,.Fo-=-_r.,.JC--J.J..:C=..f.____________~~----have inspected the components described in this Owner's Report during the period /1... a,~-}(2 to ~,'}..1.~91 ,andstatethat to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section XI. By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspection.

  ---'~11-J=--'---*_f_._~_D Inspector's Signature

_______ Commissions* VA 543 National Board, State, Province, and Endorsements Date_ _ _ _--'~'---__,J,,_~=-'"--19 ~ (

  • FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI
1. Owner Virginia Electric and Power Co. Date /-23-'U Name 5000 Dominion Blvd., Glen Allen, VA Sheet _ __;/:____ of_...!,./_ _ _ _ _ _ _ _ __

Addrea 23060

2. Plant Surry Power Station Unit ONE.

Name P.O. Box 315, Surry, VA Addr-23883 wo # 3800 09595':f Repair Organization P.O. No., Job No., etc.

3. Work Performed by Virginia Power Type Code Symbol Stamp__.N.,,./~A...__ _ _ _ _ _ __

Name Authorization No. _ __,,N._./'-'A....__ _ _ _ _ _ _ __ P.O. Box 315, Surry, VA 23883 Expiration Date _ _...._N.,_./~A"'----------- Addr-

4. Identification of System RE.GIRC.ULATIOIJ SPRAY
5. (al Applicable Construction Code B31, 1 19..Q.L_Edition, _ _,N~/A...__ _ _ Addenda,N-1, N- 7 Code Case (bl Applicable Edition of Section XI Utilized for Repairs or Replacements 19 80W80
6. Identification of Components Repaired or Replaced and Replacement Components ASME Code National Repaired, . Stamped Name of Name of Manufacturer Board Other Year Replaced, (Yes Component Manufacturer Serial No. No. Identification Built or Replacement or Nol STUl>5 Uflll(!JO,n*I U11.l l(i.)C)U)I..I tJ!A 01-RS-17 U*IKIJOUJ ij RE.Pl Ari=[:> I J/'J K>J(J.J/~
            *5 ST\JD.S,   g-11         cARDlfJA*        , ..11).      4-GS/2                 NIA           Ol-RS-17              ,qq11        REfl..tKf/YIEIJ1" UiJlo!)JouJt.
7. Description of Work RE.PLAc.E. COVER STlJD5 B.#"Tests Conducted: Hydrostatic O Pneu.matic ~niinal Operating Pressure 0 Other O Pressure ':t' r::::: psi Test Temp. ~ , ! v r ° F
                       ~ {J/>~,v      ~NJ;:f-l) ")';~.,#

NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1 I size is 8% in. x 11 in., (21 informa-tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form. (12/821 This Form (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St .. New York, N.Y. 10017

FORM NIS-2 (Back) 4'-'<f_-...,2..=-------------------------

9. Remarks _-'S""'1i..,,U'""b.,,S...__,_P=O-~---'C=5='(_.._--=3=1""6=2!.....

Applicable Manufacturer's Data Reports to be attached CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this REPL.Ac.EMEJ,IT conforms to the rules of the ASME Code, Section XI. repair or replacement Type Code Symbol Stamp _ _. . u . . 1 - L J ' - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Certifica"Authorization No. _ _N.....:./_A ____________ Expiration Date _....;;.;N;.,./..:A-=------------- Signed Ow~ar::.4.~ne:!}f 6/4,u&i,e Date_~,h-~.......,,._.~.2=?:~-----,19 CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State or Province of VA and employed by HSBI&I Co. 9/ of Ho...,.T'fo.,. dJ c:t have inspected the components described in this Owner's Report during the period I :!,-:i~*ff to I.).,':). 'l. - Cf (& , and state that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section XI. By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspection.

   ----~-'-"<-1~-.-"'-:---'--e~*:-:--*__,~-z...c=c.....             _ _ _ _ _ commissions        VA 543 Inspector's Signature                                              National Board, State, Province, and Endorsements Date
  • FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI
1. Owner Virginia Electric and Power Co. Date I - .23- j/

Name 5000 Dominion Blvd., Glen Allen, VA Sheet _ _/_ _ of__/ ~ - - - - - - - - - - Address 23060

2. Plant Surry Power Station Unit ONE..

Name P.O. Box 315, Surry, VA Address 23883 wo tt 3800 0838 73 Repair Organization P.O. No., Job No., etc.

3. Work Perfonned by Virginia Power Type Code Symbol Stamp_N.,_../~Ac:..._ _ _ _ _ _ __

Name Authorization No. - ~ N , . . / ~ A ~ - - - - - - - - - P.O. Box 315, Surry, VA 23883 Expiration Date _ _~N-L~A~---------- Address

4. Identification of System_C~H~l::-'-/Vl---'lc.A~~L~~A...,.Ai=b'--....vo~W=~M£~---'CO=N"'-'-TRQ""'-=~L~----------------
5. (al Applicable Construction Code B31, l 19...QL_Edition,_..._N,../...,.A~_ _ _ Addenda,N-1, N- 7 Code Case (bl Applicable Edition of Section XI Utilized for Repairs or Replacements 19 80W80
6. Identification of Components Repaired or Replaced and Replacement Components
  • Name of Component Name of Manufacturer Manufacturer Serial No.

National Board No. Other Identification Year Built Repaired, Replaced, ASME Code Stamped (Yes or Replacement or No) 1scc"*- STUt:>S ~ Nl>13 VFJ--.AtJ ~" 13/0-' '3lllfl?-J3f11S N/11 01-CH-2.67 Uf,l~I.) REPL.Ar£b UN~ STUDS ~-10 CARDINAL IN[). 46006 NIA OI -CH-267 1qqo REPLN;f= 111AJT 11/l)IOJOlllr.i NUTS %-lo /(f!Rf:;A Rl'>LT mt>. 'i357 NIA OI-Cl-f-267 l'no RcPL.AcEMEJ.JT UNl<tJOWN

7. Description of Work REPLACE. HA/JGE.R &'<AQ::e::r 8()LTS
8. Tests Conducted: Hydrostatic O Pneumatic 0 Nominal Operating Pressure ff Other O Pressure 11/f);) psi Test Temp. No z: °F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1 I size is BY. in. x 11 in., (2) informa-tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this fonn .
  • (12/82) This Form (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017

FORM NIS-2 (Back)

9. Remarks ~~>F-~.....;u;..::tts"'"---'-~...C..~-$-.c..;C5=..:..y_-~30....:..=:..!.::IS~J<....J7,._-__,_J_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __

Applicable Manufacturer's Data Reports to be attached NV1"5 Po:# CSY- 311/:2-J,6- ;i... CERTIFICATE OF COMl>LIANCE We certify that the statements made in the report are correct and this l?EPLAlEMEAJT conforms to the rules of the ASME Code, Section XI. repair or replacement Type Code Symbol Stamp _ _.....,._,_._...__ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ Certificate of Authorization No. N/ A Expiration Date __Nc...;.L/..:.A..:....._ _ _ _ _ _ _ _ _ __ Signed Q-zt.. ,1 Owner or O w n ~ e e , Title

.?/ ,;{S.C .£vttn:J<£,.FL Date _ _ _Mc..,..£.'A......_..,,L:..:,,.l,,.._ _ _ _, 19  ?/

CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State or Province of VA and employed by HSBI&I Co. of t( et. r-"t f:py, d) Ct" have inspected the components described in this Owner's Report during the period C'l,... ~ ~ - 8' q to ~- \. \. - 'f 1.. , and state that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section XI. By signing this certificat~ neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspection.

   -----~..lL....><..--------'----"f.'-.--M--='---='-=---

Inspector's Signature Commissions __V,.,A...__.5'-4=-<3_________________ National Board, State, Province, and Endorsements Date l - 1,~ 19,_G.__,/c.___

FORM NIS*2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI

1. Owner Virginia Electric and Power Co. Data I- 2.8- 'II Name 5000 Dominion Blvd., Glen.Allen, VA Sheet_--'/_ _ of /

Addr- 23060

2. Plant Surry Power Station Unit ON£ Name P.O. Box 315, Surry, VA 23883 WO # 3800 088fiJS Addr- Repair Organization P.O. No., Job No., ftc,
3. Work Parfonned by Virginia Power Type Code Symbol Stamp_N.,./_A _ _ _ _ _ _ __

Name Authorization No. ----"N,.../..,A...__________ P.O. Box 315, Surry. VA 23883 Expiration Data _ _..,N..,/.._A.___ _ _ _ _ _ _ __ Add....

4. Identification of System QtEM ICAL ANb VOWIIIE: ctJ~If?.OL..
5. la) Applicable Construction Codt 831, 1 19-2.LEdltion,-~N-/-A_ _ _ _ Addenda,N-1, N-7 Code Cast lb) Applicable Edition of Section XI Utilized for Repairs or Replacements 19 80W80
6. Identification of Components Repaired or Replaced and Replacement Components ASME Code National Repaired, Stamped Name of Name of Manufacturer*.: :* * * *
  • Boerd - -01har - Year _ Replaced, IYes Component Manufacturer Serial No. No, Identification Built or Replacement or Nol 511.J l).s 4 NVlS Ol~C -258 STUDS NUTS 2 -lo 7, Description of Work REPLACE: HANGER. BR(t(J(E:[ E30L:T5
8. Tests Conducted: Hydrostatic O Pneumatic O Nominal Operating Pressure 0 Other O Pressure _ _ _ _ _ psi Test Temp, _ _ _ _ _* F NOTE: Supplemental sheets in fonn of lists, sketches, or drawings may be used, provided (1) size is 8% in. x 11 in,, 121 informa-tion in items 1 through 6 on this report Is included on each sheet, and 131 each sheet is numbered and the number of sheets is recorded at the top of this fonn.

112/821 This Fonn (E00030) mey be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017

FORM NIS-2 (Back)

9. Remarks ~CD Po ,II, CSY- 30\517-1 Applicable Manufacturer', Data Reportl to be attached NUTS Po* CSY- 314:2.16-2 CERTIFICATE OF COMPLIANCE We certify that the statements made In the report are correct and this REPL,AcEMEIJT conforms to the rules of the ASME Code, Section XI. rapalr or replacement Type Code Symbol Stamp _ _. . . . . . , ' - " " - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -

_ ___,__ _ _ _ _ _ _ _ _ _ _ Expiration Date _....;N_..._/.;..A'------------- CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State or Province of VA and employed by HS BI &I Co , of ______..H.i.::et~v-1-'-'f:'-'c!>:::;..:.'l"-'.d=,,,...C...-f-.:......_ _ _ _ _ _ _ _-=--_----:-=-----have inspected the components described in this Owner's Report during the period / l. - ~ l

  • S:3 to ~ - fl. 'l-q !l , and state that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section XI.

By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspection.

  -----~.._-,-          . . . ._......,.-=_f.__.__GL                    ______ commissions_....Y....A.._,5""4......3c...._________--::-------

1nspector', Signature National Board, State, Province, and Endorsemanu Date_ _ _  ?;)._--~-~---19 q/

_-o_*_-=:~-~;;-;!~

                              . -*~ ~- --**.. .. --

FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI

1. Owner Virginia Electric and Power Co. Date I -2.~- er I Name 5000 Dominion Blvd., Glen Allen, VA Sheet _ _...;.1- __ of.......;Z...=-----------

Addrea 23060

2. Plant Surry Power Station Unit ONE:

Name P.O. Box 315, Surry, VA 23883 WO :jlf- 3WO Io 14-62 Address Repair Organization P.O. No ** Job No., etc.

3. Work Perfonned by Virginia Power Type Code Symbol Stamp__.,N~/A,_,__ _ _ _ _ _ __

Name Authorization No. _ __._N.,.,.lwA,..___ _ _ _ _ _ _ _ __ P.O. Box 315, Surry, VA 23883 Expiration Date _ __.N.,_/,..A,.,___ _ _ _ _ _ _ _ __ Address

4.
  • Identification of System GffE:NI lCAL... AAll) VOLUME- COIJ1"R.o'-
5. (al Applicable Constructio_n Code B31, 1 19..§l__Edition,_......Nu/'-!A.Ji.._ _ _ Addenda,N-l, N- 7 Code*Casa
                                    , (bl *Applicable:Edition of:Section XI Utilized for Repairu>r Replacements :19 80W8 0
. -                             6.,.ldentification of Components Repaired or Replaced and Replacement Components
                                                                                                                                                                                    '.ASME

_Code

                                                                   ;.                                         National                                                Repaired,     Stamped Name,.i:,f. ~* ".         Name of         Manufacturer       Board                      Other            Year       Replaced,        (Yes Component                   Manufacturer        Serial No.          No.             Identification            Built   or Replacement . or No) bl5C..
*:.".           ,..........';<'.nl--------+...------'+------+---'---___;-+----'------+---+-----___;+----
7. Description of Work _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __

Hydrostatic O Pneumatic O Nominal Operating Pressure 0

8. Tests Conducted:

Other O Pressure _ _ _ _ _ psi * :,.Jest Temp. _ _ _ _ _* F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1 l size is SY.. in. x 11 in., (2) informa-tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form. (12/82) This Form (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017

FORM NIS-2 (Back)

9. Remarks _J),=...,..15.,.C..~.....,P0"'-"*---"5'--'(.c--___._J=5'--Y....,,b=<-Lf_,__-_'f_,___ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __

Applicable Manufacturer's Data Reports to be attached CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this ~ o d i tcr~onforms to the rules of the ASME Code, Section XI. repair or replacement

                    '*Type"Code Symbol .Stamp ....        **-...;...i.,.._.....______________________________---'-__
:', * ="Certificate of Authorization.No. _ _N_,_/_A___________*Expiration:Oate*__N_/_A_*------------

Signed CJ-t£.s{~~u Owner or Own Designee, Title CERTIFICAT~ OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State or Province of VA and employed by HSB I &I Co. of =:~.: ** -----+H-4--'~~_T_:-*-'6_o~"'~J~.,). . c . .. . t~***.,...*

                                                                                  . . _.---'-.,...,..--*----:-----=-----have                 inspected . the components described in;this. Owner's Report during the period _ _ _ _ ___.f...,1..,,,...'..::'l;:..*'l"'"..-_.~._,~-to              Q.... i 1-9 'l,.             . and state that 1<_.         to the'best*of my knowledge and belief/the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section XI. *                                                                            .

_ . * .iBy, ~igning. thi~ certificate neither ,th.e Inspector, nor. his: emplov,er :makes any: warranty, expressed*.~r; irilpl ied; concerning. the 0

/:iiia.mltjations*:and '.corr'ective';~eas~res**desctibed;in;;'thi~tOwner,;~:,Repo~':.'. Furthermore,* neither: the .lns~~to~ :n~rJ1is :empl~yer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspection. *
                      ----'¥1r-.a"-~.._---'*
                                  ~~sSign~

c...,..-~-'-*.,_,_...~"'----------Commissions_-'V~A"'--.,.S'-4._.3"'----------------- National Board, State, Province, and Endorsements Date

                           -------~~~~--               [~'.\..2 19 'iJ J'- . .

FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI

1. Owner Virginia Electric and Power Co. Date 1-Zi-t:tJ Name 5000 Dominion Blvd., Glen Allen, VA Sheet _ _/_ _ of 1-
                                    *Addrea 23060
2. Plant Surry Power Station Unit ONE.

Name P.O. Box 315, Surry, VA Addrea 23883 WO :1r 3800 I Ol '+/-62.. Repair Organization P.O. No., Job No., etc.

3. Work Performed by Virginia Power Type Code Symbol Stamp_.N.,_,/,._,A...__ _ _ _ _ _ __

Name Authorization No. _ __,_N,.,./-=A~--------- P.O. Box 315, Surry, VA 23883 Expiration Date _ ___.N~/-=A~---------- Addrea

4. Identification of System CHEMICAL AND
  • YOWME C..QNTR.OL
5. (al Applicable Construction Code 831.1 , 19~Edition,_..._N,.,./..,.A_,___ _ _ Addenda,N-l, N- 7 Code Casa (bl Applicable Edition of Section XI Utilized for Repairs or Replacements 19 80W80
6. Identification of Components Repaired or Replaced and Replacement Components ASME Code National Repaired, Stamped Name of Name of Manufacturer Board
  • Other Year Replaced, (Yes Component Manufacturer Serial No .. No. Identification Built or Replacement . or No) 5TODS i NUTS UNl<NOIAIN 01-c.H- R.V-12.03 NUT °i" - II O't237 N 6512.

UN OJ-QI-RV-NOZZLE 8'+-101 -er NA 3 1'1~1 Rc:P

7. Description of Work R,E,MDVE. AND Te.ST ~LI f;.F VALVE
8. Tests Conducted: Hydrostatic O Pneumatic 0 Nominal Operating Pressure W' Other D Pressure /I/ of psi Test Temp.A/Qr: °F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1 l size is 8% in. x 11 in., (21 informa-tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form .
  • (12/82) This Form (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017

FORM NIS-2 (Back)

9. Remarks _..:;5.,_T:....:U"--'D=Sc....-----'-'R?"'--~----"'C=S<...JY'----=3'-!../""'6'-"'2.=-lfC/._,___--=2--------------------

Applicable Manufacturer's Data Reports to be attached NU'TS Pot1r CSY- ')...CJ't-70Cf- J Noz:z.LE. Po-F sy- -s2sos-1 CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this R.:PLAC.E:ME;NT conforms to the rules of the ASME Code, Section XI. repair or replacement Type Code Symbol Stamp _ _. . . . . . . _ ~ . _ _ - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Certificate of Authorization No. _ _N-'-/_A_ _ _ _ _ _ _ _ _ _ _ Expiration Date __N~/_A_ _ _ _ _ _ _ _ _ _ __ CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State or Province of VA and employed by HS BI &I Co, of Ht1'r t fo ... d1 ct have inspected the components described in this Owner's Report during the period /l*l:\*8<<:t to 1.-~'l-'l1.. , and state that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section XI. By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspection(,")~* ~

  -----,~1--=----'~-~~-P_________

1nspector's tgnature Commissions_~V~A~~5_4~3~---------------- National Board, State, Province, and Endorsements Date_ _ _ _..:=.d-_'--=.l.~~--19 tf; /

FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI

1. Owner Virginia Electric and Power Co. Date _ _ /-_z._g_-_1._/____________

Name 5000 Dominion Blvd., Glen Allen, VA Sheet _ _ _ _ of _ _ l _ _ _ _ _ _ _ __ Address 23060

2. Plant Surry Power Station Unit ONE..

Name P.O. Box 315, Surry, VA 23883 WO :II= 3800015167 Address Repair Organization P.O. No., Job No., etc.

3. Work Performed by Virginia Power Type Code Symbol Stamp~N,.../'-'A~--------

Name Authorization No. -~N'-J./~A-=----------- P.O. Box 315, Surry, VA 23883 Expiration Date _ _~ N ~ A ~ - - - - - - - - - Address

4. Identification of System CHEMICAL* AND VOLi/ME.. CONT~L
5. (a) Applicable Construction Code B31. l 19M_Edition,-'-'N'"'"'"""/A~_ _ _ Addenda,N-1 N- 7 Code Case (b) Applicable Edition of Section XI Utilized for Repairs or Replacements 19 80W80
6. Identification of Components Repaired or Replaced and Replacement Components ASME Code National Repaired, Stamped Name of Name of Manufacturer Board Other Year Replaced, (Yes Component Manufacturer Serial No. No. Identification Built or Replacement or No)

STUDS t NUTS VE.l.AN 1,tJv rJolAJN NIA 0/-CH-2"1/ UIJkJJowrJ REPLAc.5.b (Jll1'llll~,-.\ NVTS t-10 Ct\~DJNAL- lll!D. lf 4-5 lf'f NIA OI-CH-2..1/ Jqqo REPl.Aafr"ENf VNKNOIJJN STVDS °; -JO CARDINAL IND, Lf6006 NIA 01 -C.H-7..'JI l'f'fO ~E:PLACf;ll1'E:I\\T UNl<Now,J

7. Description of Work REPL.ACE. Covs.R SfVt>s
8. Tests Conducted: Hydrostatic D Pneumatic D Nominal Operating Pressure E:("'

Other D Pressure ,Alo,l psi Test Temp. "A/(f)C °F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is SY. in. x 11 in., (2) informa-tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of th is form .

  • (12/82) This Form (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017

FORM NIS-2 (Back)

9. Remarks -~5:C..:.:7i-"-V=Ds=-----Pcc....c?_#---=C5=-y,__-_3_0.c.l5=-c..17_-_I,___ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __

Applicable Manufacturer's Data Reports to be attached NUTS Po ,,,_. C.SY - 2.81 852. - 'f CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this RePL.A,::.§'l\i;:NT conforms to the rules of the ASME Code, Section XI. repair or replacement Type Code Symbol Stamp _ _~ ' + - ' ~ - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Certificate of Authorization No. N/ A Expiration Date __N~_A _____________ Signed /.'7 ~ ~ , IS::Z- 04r~

           >t4er or Ow;,;;;::01Jesignee, Title or Province of VA Date CERTIFICATE OF INSERVICE INSPECTION
                                                                                                          ,Md,     .it 2=--

I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State and employed by HSBI&I Co.

                                                                                                                                        , 19 fy of
  -----+fl~tt=~-T...,__~b>~_.,.._i:1--;Jt-'~C~+/-=~--------c---,--------have inspected the components                                          described in this Owner's Report during the period _____~/~1_-~j_l.l._-~8~1--to_~i~*~'J._'l._-_'i~_'l..                           ______ , and       state that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section XI.

By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and correctiv.e measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this i-n-sp_e_c_t-io_n_._t?H..--"""J.__aA~-""--"""'::-:--....c...--------Commissions __V'"'A._._...,5"-'4..,.3'------------------- l nspector's Signature National Board, State, Province, and Endorsements Date _ _ _ _ ~'i~--~a-~__ 19 q/

  • FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI
1. Owner Virginia Electric and Power Co. Date l <fl Name 5000 Dominion Blvd., Glen Allen, VA Address 23060
2. Plant Surry Power Station Unit ONE Name P.O. Box 315, Surry, VA 23883 WO tt 3800 OC/5'165 Address Repair Organization P.O. No., Job No., etc.
3. Work Performed by Virginia Power Type Code Symbol Stamp........,N"-"'-/A,_,__ _ _ _ _ _ __

Name Authorization No. _ __,_N.>.J/'-'A'-'------------ P.O. Box 315, Surry, VA 23883 Expiration Date _ _..,_N.u..cA,_,__ _ _ _ _ _ _ _ __ Address

4. Identification of System ....,,,O;~EM="-JC}r.....,,..I~...,A_,,_,Nc::D:::.......e,VO""L""'-U!.:.M.,,,E."'-...,C.O=N~~c.c::,:0::c,L==----------------------
5. (a) Applicable Construction Code 831.1 19...QL._Edition,_...,N~(A,..___ _ _ Addenda,N-1 N- 7 Code Case (b) Applicable Edition of Section XI Utilized for Repairs or Replacements 19 80W80
6. Identification of Components Repaired or Replaced and Replacement Components
  • Name of Component Name of Manufacturer Manufacturer Serial No.

National Board No. Other Identification Year Built Repaired, Replaced, or Replacement or No) ASME Code Stamped (Yes STV05 ~ NV"TS vr::1 AIJ u11v, ,,.,, .*,J NIA OI-CH-301/- L)t,)l('JJCUJ,J Ri..Pl-AelID llNllAJoUJIJ NUTS i-10 cARD!fllA-1 IND. 'fll-5'f4 NIA OI-CH-304- /'190 Ipr;.f)J_At:erv1£1Jf VAlitNOllJN STUDS ~-10 cARDINAL IIJD. 46006 NIA 01 ,rU-304- l'l'IO lr.ir::.pl Ar<:AA'°\f'T I ** I k'llOI/J~

7. Description of Work REPLACE. COVER STUDS
8. Tests Conducted: Hydrostatic D Pneumatic D Nominal Operating Pressure D Other .D Pressure _ _ _ _ _ psi Test Temp. °F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is 8% in. x 11 in., (2) informa-tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form .
  • (12/82) This Form (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017

FORM NIS-2 (Back)

9. Remarks __C_S_Y~-~3~0~/~5_/~7_-~I- - - - - - - - - - - - - - - - - - - - - -
           ~S""-'T~U=l?S~~R=O_.#=

Applicable Manufacturer's Data Reports to be attached NUTS Po.# C.SY- 2.8/852 CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this RE.PLACf;/VlfNT conforms to the rules of the ASME Code, Section XI. repair or replacement Type Code Symbol Stamp _ _~ . . _ , _ . ~ - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - __N_/_A___________ Expiration Date __N~/_A____________ CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State or Province of VA and employed by HSBI&I Co. of

                  /14-v-Tfo..-d ) Cf                                                      have inspected the components described in this Owne(s Report during the period                       J. ~ - .\.1- 0   to    i- ~ :l--g 'l...              , and state that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section XI.

By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective, measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspection.

   ----~..__-"-~~~--~J_.~~~~~-----Commissions                                 VA 543 Inspector's Signature                                    National Board, State, Province, and Endorsements

FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI

1. Owner Virginia Electric and Power Co. Date J-:z.S-"11 Name 5000 Dominion Blvd., Glen Allen, VA Sheet of _ _ _ _ _ _ _ _ _ _ _ __

Address 23060

2. Plant Surry Power Station Unit ONE-Name P.O. Box 315, Surry, VA 23883 WO "" 3800 088e23 Address Repair Organization P.O. No., Job No., etc.
3. Work Performed by Virginia Power Type Code Symbol Stamp____,N"--'-/"'"'A.___ _ _ _ _ _ __

Name Authorization No. _ __._N,.../'-'A'-'------------- P.O. Box 315, Surry, VA 23883 Expiration Date _ _....,N-'-'--'A'-'------------- Address

4. Identification of System SAFETY INJEC.TIC>N
5. (a) Applicable Construction Code B 31 , 1 19..QL__ Edition, _ _.N,..,/c.;A-'--_ _ _ Addenda,N-1 N- 7 Code Case (bl Applicable Edition of Section XI Utilized for Repairs or Replacements 19 80W80
6. Identification of Components Repaired or Replaced and Replacement Components
  • Name of Component Name of Manufacturer Manufacturer Serial No.

National Board No. Other Identification Year Built Repaired, Replaced, ASME Code Stamped (Yes or Replacement . or No) Fl&~ S"T\.l[>.S ~ N\JT.S \IELAN ~I 6I0-3111f-B-l'3MS NIA OI - S!-'2-25 UM1e,1owfll RsPL11c£D U/IIKtJ0111tJ STUDS l-10 CARDINAL INI:>. 46D06 ~IA 01- S!.- 2.25 ICf'IO IRE.Pl AcEMeJl cJJJl<NOIAJN NUT.5 ,t-10 IKORE.A BoJ....T IND. q357 NIA 01- SI-:llS 1q90 R.ePLACEMENT U"'IOJOWN

7. Description of Work REl>LAc.E HANGER BBAa<c::r i3,0LT5
8. Tests Conducted: Hydrostatic D Pneumatic D Nominal Operating Pressure ~

Other D Pressure ~;:> psi TestTemp. tlor" °F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is 8% in. x 11 in., (2) informa-tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form .

  • (12/82) This Form (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017

FORM NIS-2 (Back)

9. Remarks _.,::,5<...:.:T..:=..U.><.D=5_...:..Pi-=r>_#--"-CS....:.....:Y_-....;3=:....::.0.:..:15=/:...:7_-...:/'----------------------

Applicable Manufacturer's Data Reports to be attached NUTS Po """ CSY- 3/'l-216-J... CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this REl'LAcEIAENT conforms to the rules of the ASME Code, Section XI. repair or replacement Type Code Symbol Stamp _ ___...,'--1--'.,_----------------------------------- Certificate of Authorization No. ___ N-'-/_A____________ Expiration Date _ _N_,_/-'A-'-------------- Signed Q.~t;w~~itle CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State or Province of VA and employed by HSBI&I Co. of ______,fJ~=tL~lr_(_,_.L'fo__..'-'-r_J='-+'-C=--'__________________ T have inspected the components described in this Owner's Report during !he period _ _ _ _ _~,1-/-=1.::..*_.cf._i=-*--'8'.~'t..,__to _ __..l,.,,__--':l=:!-_-_q_,_t._c.=-_____ , and state that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section XI. By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspection.~/. /D (\ ,

   ----~1-----;~~--~-~-~-~~-----Commissions _                                       _,V~A_,__,.S'-4..,3~----------------

1nspector's Signature National Board, State, Province, and Endorsements Date _ ______.~~ ... ~d-~~-19 '1(

  • FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI
1. Owner Virginia Electric and Power Co. Date I - 2<3 - Cf f Name 5000 Dominion Blvd., Glen Allen, VA Address 23060
2. Plant Surry Power Station Unit ONE-Name P.O. Box 315, Surry, VA 23883 WO <F 3800 o~~iOLf-Address Repair Organization P.O. No., Job No., etc.
3. Work Performed by Virginia Power Type Code Symbol Stamp___.N~/A,_,__ _ _ _ _ _ __

Name Authorization No. _ ......N'--/-'A'-'------------ P.O. Box 315, Surry, VA 23883 Expiration Date _ _~ N ~ A ~ - - - - - - - - - - Address

4. Identification of System .SAFE-TY /tJJECTION
5. (a) Applicable Construction Code B31.1 19_hl_Edition,_...,N'"'""""/~A~_ _ _ Addenda,N-1 N-7 Code Case (b) Applicable Edition of Section XI Utilized for Repairs or Replacements 19 80W80
6. Identification of Components Repaired or Replaced and Replacement Components ASME Code National Repaired, Stamped Name of Name of Manufacturer Board Other Year Replaced, (Yes Component Manufacturer Serial No. No. Identification Built or Replacement or No)
                                                ,:1r, #

s,uDS ~ NtrfS Vf..LAN 3" 1B/0-3ll1f8-/.3NIS NIA 0/-SI.-~7 (I.) l'AV>I, 1,J R~PJ"/"",., ,h11{ tJaw~ N1l1S \-10 cARDlt-11!\L IND. 4-t..72,.c., NIA 01-.SI.- 2.27 /CfC/0 IRE.PLACEMENT VNK/\.brH.J STUDS .a. 't

                -10      CAP.DIii/AL IND.          4-6006               NIA            01-SI-2.27                1'1'10        REPLAC.EMENT VtJ l<IJOWN
7. Description of Work REPLA-c.E. HAN6ER 8BN.J<&T "/30LT.5
8. Tests Conducted: Hydrostatic O Pneumatic 0 Nominal Operating Pressure W Other O Pressure t,lfJ? psi Test Temp. Alar: °F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is 811:z in. x 11 in., (2) informa-tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form .
  • (12/82) This Form (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017

FORM NIS-2 (Back)

9. Remarks 5TVPS fO # CSY - 30} 517- I Applicable Manufacturer's Data Reports to be attached Nl/TS PO 'IF CSY- 32/ 5 - 2..

CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this Rl=Pt.Ac.JE/1!3!1rT conforms to the rules of the ASME Code, Section XI. repair or replacement Type Code Symbol Stamp _ _~c.,..;.....___ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ Certificate of Authorization No. ___ N~/_A____________ Expiration Date _ _N~A_____________ Signed 0~ ~ * ~ Owner or O~signee, Title or Province of VA pf Date _ CERTIFICATE OF INSERVICE INSPECTION _,,_M---~""'-_z.._2--- _____ , 19 $;! I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State and employed by HSBI&I Co. of ________.H'"--'-'a~c~T~A~Z>~Y'~c:l"'---,7-;-->,c_+/- ________________ tiave inspected the components described in this Owner's Report during the period / 1 ~ 1.)

  • 8 9 to-~.i~-=j.~!l..~-~Cf_'L~----, and state that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance yvith the requirements of the ASME Code, Section XI.

By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspection.~///) /1

   ----.JJ~-=!<.....---:----'--c~':--~-=----"---=-='----Commissions _            _,V'-'-A_,__.,,Sc:.4c.,3"-------------------

I nspector's Signature National Board, State, Province, and Endorsements Date

       ---------~~--         !l_ - ~ 'J- 19 'f f

FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI

1. Owner Virginia Electric and Power Co. Date 1-28-'II Name 5000 Dominion Blvd., Glen Allen, VA Address 23060
2. Plant Surry Power Station Unit ONE:

Name P.O. Box 315, Surry, VA 23883 U.JO #=- 3800 I 02 3C/'1 Addrasa Repair Organization P.O. No., Job No., etc.

3. Work Performed by Virginia Power Type Code Symbol Stamp___,_N.,_./'-'A_,__ _ _ _ _ _ __

Name Authorization No. --'-'N'"'"/_,_A.,___ _ _ _ _ _ _ __ P.O. Box 315, Surry, VA 23883 Expiration Date _ _~N~/_,_A~--------- Address

4. Identification of System SER\JIGE. IAJAT/E.R.
5. (al Applicable Construction Code B31.1 19-2L_Edition,_....,N..,_,_/A,...,__ _ _ Addenda,N-1, N-7 Coda Case (bl Applicable.Edition of Section XI .Utilized'for Repairs or Replacements 19 ffOWBO
  . 6. Identification of Components Repaired _or Replaced and RepJacementComponerits ASME
                    . -  ._-.                                                                                                                           Code National                                                   Repai,-ed,     Stamped Name o!_ .*                 Name of       Manufacturer         Board                     Other              Year         Replaced,         (Yes Comporient                   Manufacturer      Serial No.           No.               Identification            Built    or Replacement . or No.,
           .,~ ...                                        .*

VAI\IE. STOCk/.lAM UhFl2.. l\,)A,. 01-srv- 2.1-11 111114/nml\l Or-PJ AC,F.l'I IJ~l<>J()IA.I I VllL\/E. POI.All::LL '+lf277J... N/A OI-SW-2.'il l'1'B'i E?.E:P!./ --* --., u,JWoiuN C

7. Description of Work REPLACE. VALVE:
8. Tests Conducted: Hydrostatic O Pneumatic 0 Nominal Operating Pressu~

Other O Pressure AIO). psi Test Temp. NQ/ °F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1 I size is 8% in. x 11 in., (2) informa-tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form .

  • (12/821 This Form (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017

FORM NIS-2 (Back)

9. Remarks ~Vi. .A.....L,.,._V..,,.E,__.....L...;Po~*-*_C=S..!..Y_-_.2=2-=2,_LfL.C6=8--.....: : L = - - - - - - - - - - - - - - -

Applicable Manufacturer's Data Reports to be attached CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this ef:PLAC.EMENTconforms to the rules of the ASME Code, Section XI. repair or replacement Type Code Symbol s*tamp _ __ . . . . , _ . _ " - - " - - - - - - - - - - - - - - - - ~ - - - - - - - - - - - - - - - - - Certificate of. Authorization. No. N/ A *Expiration .Date --'N""'-/.;.A;..____________ Signed Q ~ jj  ::..CALL

                 '* *owner ~ ~ s i g n e e , Title.-
                                                                     ~ l f E<&~                           Date-~~""'5i'..__..tt,""':Z..,."""-----, 19 2t CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State orProvinceof              VA                               a~demployedby           HSBI&I Co.                                                           of Ha..v-T fo.,.. c::\..            , ct: -,._. -          .                              have inspected the compone*nts described
   .'in this *Owner's Report during the ?eriod                                         Ii-a~-~             to     ~ .. 1_'l_-q !L               .-~nd state that
  • to the_ best of my knowle~ge *and belief, the O_wner has p~rforme*d examinations and taken corrective m~asures described in this Owner's Report in accordance with the requirements o*f the ASME.Code, Section XI.
   /*.,......By signing _this certificate:neither the -lnspector-.nor.,his-employer :makes ariy..warranty;. expressed.or implied,: concerning the
' , *:'~xami na~ions :and:'corre~tive *.measures >describedJn'!-this'" Qwner*s* 'Report.'.;Furthermore;, neith~r-*-~he.*1nspector nor his *employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspection.
       ----~,...=....~-~-----f-*~~~~---Commissions                                                      VA 543 Inspector's Signature                                                National Board, State, Province, and Endorsements Date_ _ _ _ _1..._-=~~~~-19                                °t)

FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI

1. Owner Virginia Electric and Power Co. Date I - 2.3 - j I Name 5000 Dominion Blvd., Glen Allen, VA Addr- 23060
2. Plant Surry Power Station Unit ONE.

Name P.O. Box 315, Surry, VA Address 23883 wo # 3800 O99927 Repair Organization P.O. No., Job No., etc.

3. Work Performed by Virginia Power Type Code Symbol Stamp~N~L-A~--------

Name Authorization No. -~N,../'-'A~--------- P.O. Box 315, Surry, VA 23883 Expiration Date _ _.....N.,../...,A~---------- Addnm

4. Identification of System SAFETY INJE.C.T/QN
5. (a) Applicable Construction Code B31.1 19...Q.L_Edition,_~N.,./-A~_ _ _ Addenda,N-l, N- 7 Code Case (bl Applicable Edition of Section XI Utilized for Repairs or Replacements 19 80W80
6. Identification of Components Repaired or Replaced and Replacement Components ASME Code National Repaired, Stamped Name of Name of Manufacturer Board Other Year Replaced, (Yes Component Manufacturer Serial No.
  • No. Identification Built or Replacement or No) s NA Of-SI.- G STUl>S 1-8 %2.50 N 01-sr- UtJKNOWN STU I-~ 0 -SI-56.
7. Description of Work OPEtJ / ltJSPEC.T CHECK VALVE.
8. Tests Conducted: Hydrostatic O Pneumatic 0 Nominal Operating Pressure ~

Other (J Pressure )/ti:.)> psi Test Temp. NCI 'f' °F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1 l size is 8% in. x 11 in., (2) informa-tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form. (12/82) This Form (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017

FORM NIS-2 (Back) PO:ft.

9. Remarks STUbS CBY - 308 557 - I Applicable Manufacturer's Data Reports to be attached
               .s-rubS Po        41=' CS'1'- 3l<f1D6- I CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this RE.f'LA<:.E.ME.NT conforms to the rules of the ASME Code, Section XI.                                                           repair or replacement Type Code Symbol Stamp _ _~ , . . . . ~ - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -

Certificate of Authorization No. _ _N~/_A___________ Expiration Date __N....._/_A____________ Signed f2.~~~tle CZ:Sf ~ Date bd', ?2=

  • 19 %I CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State or Province of VA and employed by HSBI&I Co. of Ha. r: 1 &. . J > er . have inspected the components described in this Owner's Report during,the period /).;-~i-fJl!.J to ~-11-q 'l.. , and state that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this ,

Owner's Report in accordance with the requirements of the ASME Code, Section XI. By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspectionn~ f /j) (\

   ---....lJ~c;:..:e......><..=-'--..:....-"":-"--~=-=--=------Commissions_~V~A~~S~4~3~----------------

I nspector's Signature National Board, State, Province, and Endorsements Date, _ _ _.....,.~ __'_,,,clill'-~~-19 Cf/

FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI

1. Owner Virginia Electric and Power Co. Date I - 2.8 - 'lf Name 5000 Dominion Blvd., Glen Allen, VA ShNt _ __:./_ _ of /

Addr- 23060

2. P11nt_--=sa.;::u:.::r...:ry_..:.P...:o;.:;wa.;::ea.;::r:......:Sa...at:;:a"-'t:.:i::.;o:.:n::....._______ Unit ONE Neme P.O. Box 315, Surry, VA 23883 lUo 11 3800 OS/508 Repair Organization P.O. No., Job No., etc.
3. Work Perfonnedby Virginia Power Type Code Symbol Stamp__.,N._./..,,A......__ _ _ _ _ __

Name Authorization No._........,N"/""A,___ _ _ _ _ _ __ P.O. Box 315, Surry, VA 23883 Expiration Dote _ _.L:!N'J./"'A~-------- Add,-

4. Identification of System COMPQNE-/\IT COOLING
5. lol Applicable Construction Cod* 831, 1 19.9.L_Edltion,_...,N'J./""A.___ _ Addende,N-l, N-7 Code Case lb) Applicable Edition of Section XI Utilized for Repeirs or Replacements 19 80W80
6. Identification of Components Repaired or Replaced and Replacement Components ASME Code National Repaired, Stamped Nome of Name of Manufacturer Board Other -- Veer Replaced, (Yes Component Manufacturer Serlel No: - ----- No.

ldentificatio~ Built or Replacement or Nol VALVE UNIGJ6WN UNV~IOWN NIA 01-CL.-6'15 U/1.\)iWOIAII RE.PLACEb UIJl<>JCIUl~ VALVE. VDC:rT MAC.ltlNE a, 2.16100 NIA 01-a:-6'15 /CfCfO REP/ Al""'-M~T UNlt'"'"""N PIPE UNk'.}Jol.U\I LlNKNOWN NIA 01-cc..- 6ct5 Vfllk1'1otiJI\.\ t:.>~PI.ACE.f) UIJkJll.aWij PIPE= FRISCH!/nPN 32.2.%5 NIA 01 -cc-6'15 /Cf'IO REPI..ACEMBJr u..itotuW

7. Description of Work RGPUt<;..E. VALVE
8. Tests Conducted: Hydrostatic ~ Pneumatic D Nominal Operating Pressure D Other D Pressure /,5',tMS:tW psi Test Temp. 46$.5-<1r'°F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is 8% in. x 11 in., 121 informa-tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet Is numbered and the number of sheets is recorded at the top of this form.

112/821 This Fonn IE000301 may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017

FORM NIS-2 (Back)

9. Remarks _ve.. .w_v_1;,_~po_=11=_ss=-Y....-____~....q=o__8__'t__4:.___-.....l___________________

Appllcable Manufacturer's Data Reports to be attached

               ?lPE.                    PO <l        C.SY - 30Cf5Lfl - 'f CERTIFICATE OF COMPLIANCE We cenify that the statements made in the repon are correct and this REPL4CEMENT conforms to the rules of the ASME Code, Section XI.                                                                                     repair or replacement Type Code Symbol Stamp _ _~ , . . . . . . . . _ - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -

__N"""/.....A __________ Expiration Date __N_/.._A ____________ CERTIFICATE OF INSERVICE INSPECTION I, the*undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State or Province of VA and employed by HSB I &I Co. of ______ f.... c""f_________-_....,..___ t/...,:;.A;:;.;'l':..T..._... 2S._r~.i=-,i...... have inspected the components described in this Owner's Repon during the period 11* :J. !l.- ,5'2 to _ __..i._-_,1."'-'-' J."'---G'._a,_...______ , and state that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Repon in accordance with the.requirements of the ASME Code, Section XI. By signing this cenificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and .corrective measures described in this Owner's Report. Funhermore, neither the Inspector nor his *employer shall be liable in any manner for any personal injury or propeny damage or a loss of any kind arising from or connected with this inspecti~n(~ /J _ + .I)_ /l) /)

  ----~+-'"""---=-----'~-=-------=~a.---------Commissions_...Y                                         ..A..__..S...,4..3.._________________
                             ~1Slgnatul'9                                                              National Board, State, Province, and Endorsements
  • FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI
1. Owner Virginia Electric and Power Co. Date l-23-<f/

Name 5000 Dominion Blvd., Glen Allen, VA Address 23060

2. Plant Surry Power Station Unit ONE Name P.O. Box 315, Surry, VA 23883 WO ~ 3300 0~8'.i'.> 24:

Address Repair Organization P.O. No., Job No., etc.

3. Work Performed by Virginia Power Type Code Symbol Stamp__,N~/._,A'----------

Name Authorization No. _ __,_N.,_.,/c...:Ac.,___ _ _ _ _ _ _ _ __ P.O. Box 315, Surry, VA 23883 Expiration Date _ __,.N:!.J....,A'-'------------ Address

4. Identification of System 5AFE:TY /,NJECTION
5. (a) Applicable Construction Code B31. 1 1s__Q]_Edition,_--'N,_,__,_/.,_A,___ _ _ Addenda,N- l N- 7 Code Case (bl Applicable Edition of Section XI Utilized for Repairs or Replacements 19 80W80
6. Identification of Components Repaired or Replaced and Replacement Components ASME Code National Repaired, Stamped Name of Name of Manufacturer Board Other Year Replaced, (Yes Component Manufacturer Serial No. No. Identification Built or Replacement or No)

F/6"1 STUD.S ~ NUT.5 VEL.AN 3 BJ0-3114-B-r~M:S NIA 01-51-2.26 UNrNOWN RePLAc&D \)~~()ui,J NVTS \-10 IrAP,.D1NAL. IND. 'tb7?.C.. NIA 01 :2.26 1q10 REPI.A(e.MENT IJN~o""tl STUl)S i-10 CARDINAL 11.10. l/6006 NIA OI - SI. - 2.26 1qqo it1J:.PLJ\CEMctJT VNKNOWN

7. Description of Work R~PL.4(£ HNJ6f.R.. BR[Ck.r;_r &>OLTS
8. Tests Conducted: Hydrostatic O Pneumatic 0 Nominal Operating Pressure ~

Other O Pressure tYll/ > psi TestTemp. tvor °F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is 8% in. x 11 in., (2) informa-tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form. (12/82) This Form (E00030) may be obtained from the Order.Dept., ASME, 345 E. 47th St., New York, N.Y. 10017

FORM NIS-2 (Back)

9. Remarks -----.:S;:..T1'-'Ue..,D=$"------------'--f'c--=-~-*--=C'-'S:...;Y:.....-_3=--=-0..:..I5.=....c...17'-------'1'----_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __

Applicable Manufacturer's Data Reports to be attached NUTS Po~ CSY- 321'+<?5-Z. CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this REPLACEMENT conforms to the rules of the ASME Code, Section XI.

  • repair or replacement Type Code Symbol Stamp _ __._,_.µ...._ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __

Certificate of Authorization No. ___N...c./_A _ _ _ _ _ _ _ _ _ _ _ _ Expiration Date _ _ N..,__A Signed 0-~/

         , ~ner or Owr(!!)'s Oesignee, Title fS'L                           .,!"~/~Ml            Date _    _,_Ma'--=-c.o..*-=e,2..,,=----,19   97 CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State orProvinceof VA                                                                  andemployedby                             HSBI&I Co.                                                       of H4.v- rfo. . d . Ct                                                                                                       have inspected the components described in this Owner's Report during ;he period                                                                               J:J- 4.1-R~    to       1-1..B--1!l-                 , and  state that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report.in accordance with the requirements of the ASME Code, Section XI.

By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a Joss of any kind arising from or connected with this

  ;,.,ec,;oo~l                                                          &-4--

Commissions_~V~A~=5_4~3~---------------- 1nspector's Signature National Board, State, Province, and Endorsements Date_ _ _ _...,~~-~Q..~d--- _ _19 Cf/

FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI

1. Owner Virginia Electric and Power Co. Date J-z~-ql Name 5000 Dominion Blvd., Glen Allen, VA Address 23060
2. Plant Surry Power Station Unit ONE.

N111me P.O. Box 315, Surry, VA 23883 I/Jo #= 3<3'CO 1036'83 Address Repair Organization P.O. No., Job No., etc.

3. Work Performed by Virginia Power Type Code Symbol Stamp~N_/~A~-------

Name Authorization No. _ __:.N.,_./'-'A~--------- P.O. Box 315, Surry, VA 23883 Expiration Date _ _...,_N.,_./...,A~---------- Address

4. Identification of System C.HE:.M /CAL Atvt:> v'OLUME: C.OtJT~OL-
5. (a) Applicable Construction Code B31.1 19..Q.L__Edition,_.....N_/~A~---Addenda,N-1, N- 7 Code Casa
                       .(bl .Applicable Edition of Section XI Utilized for Repairs :or Replacements 19 80W8 0
6. . Identification of Components Repaired or Replaced and.Replacement.Components
1. --
                                . '                                                                                                                       -*  ASME
                                                                                                                                                           -    Code National                                        Repaired,       Stamped Name'of                Name*of          Manufacturer             Board               Other           Year      Replaced,            (Yes Component
  • Manufacturer Serial No. No. Identification Built or Replacement . or No)
    ,,,_*.' r ,,.

VAL..Vf;. Vf\l IOJCtAhJ UII) 10J1) 1\/ ~ NIA 01 a-l-R:V.-1 u:q UIJk.lJbWN RcPI-ALEC> UtJ.1:111 owiJ t,J6qqe,3-01-: I

                   \JAi.Ji~                   C.K'()Sf:':Y                   0006             NIA        Ol-a1-R\/-1Ul'1        /'1'8'1 IQE:PI ArEf,'IENT vtJmowrJ
7. Description of Work TEST RELIEF VAL\Jc (INSTALL.El> NEW IIALV6j
8. Tests Conducted: Hydrostatic O .: *Pneumatic O. Nominal Operating Pressure w' Other O .Pressure Ale, ? psi Test Temp. NO C °F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1 I size is 8% in. x 11 in., (2) informa-tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form.

(12/82) This Form (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N. Y. 10017

FORM NIS-2 (Back)

9. Remarks __.'vµALY==E:.__-'Po'-=---41:_..;::CS::.......1.Y_-__,_/q-"6~lB::::.2=--_,j.___ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __

Applicable Manufacturer's Data Reports to be attached CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this ~I conforms to the rules of the ASME Code, Section XI. repair or replacement

                      -,'ype*Code;SyrnborStamp_*......_ _......_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _- ' - - - - - - - ~ - - ~ - -

Certificatn0:;~r'.zatjon _No ___N ___/_A_ _ _ _ _ _ _ _ _ _ _. Expiration.pate___....,...N_._/_A______________

                      *signed         ~ , ' ( ;..~./

Ownarn OwsDesignee, Title

t. . .'*. ____ ,19 Date-~Oc...:~~,,,_..-....f ... 9/

CERTIFICATE OF*INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State or Province of VA an2 if!Ployed by HSB I &I Co. of Ha..'rT fo't'd . ~ c.T have *inspected the components described >' in~ this))wner's Report ,during .th.e period. I ~. ~~- s, to 1* ~ 'l.-91.  ;-and state that

                       *to the best of my knowledge and *belief;the Owner has performed. examjn~tions and taken corrective measures described in this*
           .. .. . Owner's Report in accordance with the requirements of the ASME Code, Sectio~:*x1.

l .. ' . . -* ,, .

 ~ ;: __ ' .'.         .* ,. :, By!signing. t_his c,enificate,,neJther.. th_e *lnspector,nor)1is.,empl~y.er.:makes any, ..warrantv,::expressed_or i,t,plied; concerning the

, :*,':*'c- ..,._. .,<<*,,exar:ninations;,and **cdrfect.hte.irneasures '.desc:dbec:f* in :this.,Owner!s* Aeport:.,Furthermore~':neither:.the*.:ln.spector, nor his*ernployer

                   *:* snall .. be   liable i~ ~ny-*~an~~ttor any perso~al .injury or property damage or a l~;s                 ~f any.kind arising from *o,corinected with this
                      ~           .

inspection. nLJ ....p* ~

                          ----~~l-""~...,..-----fL~;:__..c~.....::..:;...              _____ Commissions_~V~A~=S~4-3~----------------
                                                 ,ln_spactor's Signature                                                National  Board, Stat,e,.Province, and Endorsements Date_ _ _ _ _*-'iiiF~~'~_d,'"""0_19                          q/ *
y

FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI

1. Owner Virginia Electric and Power Co. Date_--=../_-..;.2.:._'o_-_C/..!.L./_ _ _ _ _ _ _ _ _ __

Name 5000 Dominion Blvd., Glen Allen, VA Sheet _ _""""/__ of I Address 23060

2. Plant Surry Power Station Unit ONE.

Name P.O. Box 315, Surry, VA 23883 WO -JI= 3800 I 0/ 835 Addrea Repair Organization P.O. No., Job No., etc.

3. Work Performed by Virginia Power Type Code Symbol Stamp~N...,../A~--------

Name Authorization No. _ _e.N..,/_.A...__ _ _ _ _ _ _ __ P.O. Box 315, Surry, VA 23883 Expiration Date _ _-=-N...I_.A'-'------------ Address

4. Identification of System CHl:/t)l cAL AND *\/OUJME CQNTROL
5. (al Applicable Construction Code 831.1 19..QL_Edition,_""N.,_./...:A..:...._ _ _ Addenda,N-1, N-7 Code Case (bl Applicable Edition of Section XI Utilized for Repairs or Replacements 19 80W80
6. Identification of Components Repaired or Replaced and Replacement Components ASME Code National Repaired, Stamped Name of Name of Manufacturer Board Other *Year* Replaced, (Yes Component Manufacturer Serial No. No. Identification Built or Replacement . or No)

JJU'T5 l~-8 CDP~ v,11,aiJ VMKIJOW,J NIA 01 CH- FCIJ-1160 ,.............. Qi::.p1 Ar.Et,, UMIOIIOYI" AIIJT"; ,i-8 TEXA~ SOL:T 31~2.I NIA 01-cU-t=rl/-116() , Ull,** IDIUII C,t:.1)1 * - - * * - .. llNl:NOW,J

7. Description of Work ltJVESTIGATe/ IDAIR VALVE
8. Tests Conducted: Hydrostatic O Pneuma~ 0 Nominal Operating Pressure~

Other O Pressure/Vt) psi :rest Temp. /VO'? °F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1 l size is SY.a in. x 11 in., (21 informa-tion in items 1 through 6 on this report is included on each sheet, and (31 each sheet is numbered and the number of sheets is recorded at the top of this form *

  • (12/821 This Form (E00030l may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017

FORM NIS-2 (Back)

9. Remarks _N........,,.l/-r:~J=---~pt)'--1f_...c.C5...=-,Y~-~")..h()-----8'~Lf=-2--~l-----------------

Applicable Manufacturer's Data Reports to be attached CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this &ef'LACEM6'JT conforms to the rules of the ASME Code, Section XI. repair or replacement Type Code Symbol Stamp _ _......,,_,_,_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ N/ A Expiration Date __N_,_/_A"------------ Certificate of Authorization No. Signed Cl~L,L/

           ~e~esignee,
                                              ..XS.Z-&6/Uc~ Date Title k-t, . .tf              ,19__,2....i~-

CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State or Province of VA and employed by HSBI &I Co. of

                       #o,.v:'T ffl ,._J      c:.r                                        have inspected the components described in this Owner's Report during the pe~od                         l'l*~~-~~      to      b-(1~Cf1.,.                 , and state that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section XI.

By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspection. ~ ;f. . 1 Inspector's Signature

                                               ~              Commissions_...,V'"'A..._.,.5'""'4..,3"------------------

National Board, State, Province, and Endorsements Date_ _ _ _ _ ~-....~~~()_ _19 q{

  • FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI
1. Owner Virginia Electric and Power Co. Date I Cf I Name 5000 Dominion Blvd. Glen Allen 1 VA Sheet _ _.;../_ _ of_.,..!../_ _ _ _ _ _ _ _ __

2 Address 23060

2. Plant Surry Power Station Unit ONE.

Name P.O. Box 315, Surry, VA Address 23883 wo # 3800 05Lf90! Repair Organization P.O. No., Job No., etc.

3. Work Performed by Virginia Power Type Code Symbol Stamp___.N..,_/'--'A,_,__ _ _ _ _ _ __

Name Authorization No. _ __._N:wl'--'A'-'---------- P.O. Box 315, Surry, VA 23883 Expiration Date _ _..:.N.,_./'--'A'-'------------ Address

4. Identification of System COMPO/JENI COOL..]N6
5. (a) Applicable Construction Code 831.1 19...Q.I._Edition,_..._N:w(..:.A~_ _ _ Addenda,N-l, N- 7 Code Case (bl Applicable Edition of Section XI Utilized for Repairs or Replacements 19 80W80
6. Identification of Components Repaired or Replaced and Replacement Components ASME Code National Repaired, Stamped Name of Name of Manufacturer Board Other Year Replaced, (Yes Component Manufacturer Serial No. No. Identification Built or Replacement or Nol VALVf. M1ss1otJ DUO UIJh*CJW/J NIA 01-cc- /76 I.Jt\lKtJ:,u}/J l<Ef>I AGE!> llNKIJoo.11'1
   \JALV6:.                  AC°=ICO                  A/2 C:,'3 J            NIA           01-cc..-176               fq'6Cf       REPUCEMWT            U!Jl(IJOIIJ>>

STVl>S ~ !JOTS 0Nltllt>W.N UIJKtJOW1'.l NIA o I- CL.-- 176 UrJ~Ol,OJj REPLACED VN~tJ Nurs it-~ "ft:)(AS RDCT' 3162.1 NIA OJ -<X-176 /'fd'j REP! M"'N1i:.t.t'I uNk:1.10 !NII STUDS 1i-~ c.ARDll'JAL 1tJD. 1./6367 NIA 01-cc..-l?b 1190 R.E:P~r Vt.Jl(1'XJW,J

7. Description of Work RffLACE CJl£CJL VALVE
8. Tests Conducted: Hydrostatic D Pneumatic D Nominal Operating Pressure ~

Other D Pressure N('J )> psi Test Temp. PP r °F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is 8% in. x 11 in., (2) informa-tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form. (12/82) This Form (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017

FORM NIS-2 (Back)

9. Remarks _'/J,._~=Di=E=--__,_PO=--*--=Cc.c..N""'T'---.....,23=-9'--'6=-]...,.h.._--'-/- - - - - - - - - - - - - - - - - - - -

Applicable Manufacturer's Data Reports to be attached STU.I>$ Po ;t:. C.5'1' - 311 ~5R - I NUTS Po~ CSY - uoi42- I CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this 'l?Ff/..AC£ME::NT conforms to the rules of the ASME Code, Section XI. repair or replacement Type Code Symbol Stamp _ _~ , - . . ~ - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Certificate of Authorization No. _ _N_.:_/_A___________ Expiration Date __N:.:.L/..:.A.:.....----------- CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State or Province of VA and employed by HSBI&I Co. of

    -------1-f~/-e;;:_,~Y-T...__.f,,....    ~6~1/'~d-..,,  . .;C=-..,-f:~______________ have inspected the components described in this Owner's Report during the period                                               /l* ~~-sci   t0--~-----1~~--~~~)..~----, and state that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section XI.

By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the

  . examinations and corrective measures described in this Owner's Report. Furthermore, neith'er the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspection. n        I\     -A-    !.      fi)           /)
     -----'~'-'-       ~.:--"----:::---'~=-------Commissions                                          VA 543 Inspector's Signature                                                     National Boe rd, State, Province, and Endorsements Date                            ~-~ 0            19._4_/_
                                                                                                                                                                                           . .-;::_---. ~ -

FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI

1. Owner Virginia Electric and Power Co. Date /- z-z-q/

Name 5000 Dominion Blvd., Glen Allen, VA Sheet of_ _.__ _ _ _ _ _ _ _ __ Addrea 23060

2. Plant Surry Power Station Unit ONe Name P.O. Box 315, Surry, VA 23883 WO # 3'i500 095962-Addrea Repair Organization P.O. No., Job No., etc.
3. Work Performed by Virginia Power Type Code Symbol Stamp__,_N,_,/....A...,__ _ _ _ _ __

Name Authorization No. ---=-N,../_.A...,__ _ _ _ _ _ _ __ P.O. Box 315, Surry, VA 23883 Expiration Date _ _~N,../_.A~--------- Address

4. Identification of System :SAFt=TY INJEC..:Oo.,J
5. (al Applicable Construction Code B31 1 19...Ql__Edition, _ _,_N.,../....A...,____ Addenda,N- l, N-7 Code Casa (bl -Applicable Edition of Section XI Utilized for Repairs or*Replacements 19 8 OW8 0
6. Identification of Components Repaired or Replaced and Replacement Components
                   *- *~*.

ASME

                    ;                                                                                                                                                          Code National                                                          Repaired,                Stamped
                         **:*lt*

Name of Name of Manufacturer Board Other Year Replaced, (Yes Component Manufacturer Serial No. No. Identification Built or Replacement . or No) SiVD5 f Nr!T:5 IA-k!UfoR - ~H"., V~KtJOvJtJ NIA

                                                                                    .. - . Ot-SL-Mn\J-/W;t(.,             UIJllLLllwl,J   RGf>J      ArFl'I               *klVLlll!AJ/j a

5T\JbS I~ -,g. CARbl1'1Al 11vt>. lfl+54 .. NIA 01-sr-Moll-/'i!67C.. 1qqo Rc:P1Ac£(v1&11 U~l::NOWN Nurs. 1}-53 UAROWA-D r::- SPl:C. 30431 . .. N/A . 01.:..sr.:.Mov-iu1c. \q<gq I OF'-:f.>1 ,.,, ;:-,,;.:.._;,;j- VAIIOIO"'N

7. Description of Work RE.PLACE. C.OVC:'.:-R STl,)DS
8. Tests Cond!,!cted: flydrostatic O Pneumatic O Nominal Operating Pressure~

Other O Pressure /110 ~ psi Test TempA-"'&;_vt::'. ° F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is 8% in. x 11 in., (2) informa-tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form. (12/82) This Form (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017

FORM NIS-2 (Back)

9. Remarks _ _ s_T_UD~__,R....,,t>'-~-->CS=-Y ....-___.2=<Z=<..:.->IS.....5..c.o,:Z.:....-_,I.__ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __

Applicable Manufacturer's Date Reports to be attached NUT po:11< est- 231327-7 CERTIFICATE OF COMPLIANCE We certify that the statements made in the report a*re correct and this ta::fl.ACEMEN:T conforms to the rules of the ASME Code, Section XI. repair or replacement

                 ***-Type Code Svmbol 'Stamp _ _.....,,,µ:, __-'-'----.. . . . .-"'-.C....,-"------'----------'-~----'-'""-"'---~-----
                                                                      --N-=/'-A----------**Expiration .Oate_....;N./'-'A'-'-----------

CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State or Province ot VA and employed by HSIH &I Co. of _____.._.*.JB.....,etc.1.X:""t~fi-'(j.._.,_r~c'.!:c..._.,C..._.-f: _________________ have inspected the components described*.

                                                      .               1 irl'"t~is .Owner's Report during the period ___ _ _ _.....;.*,1.(..,>,.,._:"_..:).,..1t.;*_.('L....,'---to t9<j
a. .. i !l, .. ~ ',).. , and state that

.,':<*. _* .. to the best-of my knowledge and belief, the Owner has performed examinatior:i.s and taken corrective measures described in this

              .      Ow$er's Report in accordance with the requirements of the ASME Code, Se~tion XI.                                                        .      .        , $_        .       __:_.*
               .* . ,_-:*' lkv signing this.~ertificate :rieither. the lnspector-.,nor hi~-:employer *.makes*:a~-.rwa_rranty;~expressed orlimplied,: concerning the
  • ,;;,
    .exaAiinations*,and;:corrective:measures -described' in .. this'* Owiler'~ Reporti,F urthermor~/~eithertti~ ':l~~toi* nor* hiS employer:

shall be liable in any manner for any personal injury or property damage o_r a loss of any kind arising from or connected with this inspection.

                      -----4            ......-=---'
                                           ~-""     ----f....._*-'-~--~=.."'-"'-=_._--'--commissions                                         VA 543                                                       .
                                   ,           Inspector's Signature                                                                         National Board, State, Province, and Endorsements Date,_ _ _ _-'~,._'-__,_,:.../~..___19                                qI
  • FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS A1 Required by the Provi1ion1 of the ASME Code Section XI Virginia Electric and Power Co. I - 2.8 - 'ti
1. Owner Date Name 5000 Dominion Blvd., Glen Allen, VA Sheet _ _/ _ _ of I Addr-23060
2. Plant Surry Power Station Unit ON£ Name P.O. Box 315, Surry, VA 23883 Wo Repel,
                                                                                                                                  # 3800 09596/

Organization P.O. No., Job No., etc. Addr-

3. Work Parfonned by Virginia Power Type Code Symbol Stamp .........N""/....A......__ _ _ _ _ __

Neme Authorization No._""'N...,/A=---------- P.O. Box 315 1 Surry, VA 23883 Expiration Date_--'N...._/A=---------- Addret1

4. Identification of System_=S,_,A.._F..:;;:e""'T_Y____.,_N.;..;:.J:;.;;EC=T.t..:.:Jo ....Ni._ ____________________;,___
5. (al Applicable Construction Code 831. 1 19 ...61_ Edition,_...,N..,_/,LJA.___ _ Addenda,N-1 , N- 7 Code Case (bl Applicable Edition of Section XI Utilized for Repairs or Replacements 19 80W80
6. Identification of Components Repaired or Replaced and Replacement Components ASME Code National Repaired, Stamped Name of Name of Manufacturer Board Other Year Replaced, (Yes Component Manufacturer Serial No. No, Identification Built or Replacement or Nol S1\J~S 01-s:c.-

STU 01-sr-l'l\oV-1861 01-sr-Moll-1g(;J

7. Description of Work___.R'-""'EP::L.loJ.ACLU,,.,,,,e,[)....__ _Ci:>=..,\l-"ER,:i::,,,..__,S~T..1..1o<U.:::t:6=.._ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
8. Tests Conducted: Hydrostatic D Pneumatic D Nominal Operating Pressure 0 Other D Pressure_.M:)=-,_i>_ _ _ psi Test Temp. A/() r* °F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (11 size is B% in. x 11 in., (21 Informa-tion in items 1 through 6 on this report Is included on each sheet, and (31 each sheet is numbered and the number of sheets is recorded at the top of this fonn.

(12/821 This Form (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017

                                                                                                                    ~~   ------~--~---

FORM NIS-2 (Back)

9. Remarks $:DJ D5 Po 1t: G5 Y - zgJ 8'52 - I Applicable Manufacturer', Data Reports to be attached Nl)JS EP 1'= cs::<- 231327-7 CERTIFICATE OF COMPLIANCE We cenify that the statements made In the repon are correct and this REPLAc:.EMEAITconforms to the rules of the ASME Code, Section XI. repair or replacement Type Code Symbol Stamp _ _......,....,._ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __

_ _N....:c/_A_ _ _ _ _ _ _ _ _ _ Expiration Date_...:.N""'/'"'A..;.__ _ _ _ _ _ _ _ __ CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State or Province of VA and employed by HSBI&I Co, of Ha1c::tf:or- & < Cf in this Owner's Repon during the period

                                          -                          I\,~ 1*f1to ,.                                                                                              have inspected the components described f 'l....           , and state that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Repon in accordance with the requirements of the ASME Code, Section XI.

By signing this cenificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Funhermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspection. __t(....,~,____~~i"r----. -~~~=----Commissions~Y-A~S~4~3_ _ _ _ _ _ _ _ __ lnspactor'1 Signature National Board, State, Province, and Endorsement, Date_ _ _ ___..*~=-------'-'-'f_ _19 'I /

FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI

1. Owner Virginia Electric and Power Co. Date I - 2.8 - Cf I Name 5000 Dominion Blvd., Glen Allen, VA Sheet_.....:./_ _ of I Addr- 23060
2. Plant Surry Power Station Unit ON£ Neme P.O. Box 315, Surry, VA 23883 Addr-wo # 3800 0'15'-/60 Repair Organization P.O. No., Job No., etc.
3. Work Parfonnad by Virginia Power Type Code Symbol Stamp__.,N.,./...,A...__ _ _ _ _ __

Neme Authorization No._.....,,.N.,_/,.,A..___ _ _ _ _ _ __ P.O. Box 315, Surry, VA 23883 Expiration Date _ _N:..:..r../..,A..___ _ _ _ _ _ __ Add,...

4. Identification of System SAFETY !NJ §'CT I Oi\l
5. (al Applicable Construction Code B31.1 19..il_Edltion,_...,N...I....A~_ _ _ Addenda,N-l, N-7 Code Case (bl Applicable Edition of Section XI Utilized for Repairs or Replacements 19 80W80
6. Identification of Components Repaired or Replaced and Replacement Components ASME Code National Repaired, Stamped Name of Name of Manufacturer Board Other Year Replaced, * (Yes Component Manufacturer Serial No. No. Identification Built or Replacement or Nol J<J6'/A 5TVb5 t ~u OI-S'I.-MOI/-

5TUD5 I °i - '$ NA

  \.ITS    I i-s                                 301.f-37           N          Ol-fil-MOV-
7. Description of Work REPJ..Ac.E CQ\/E&. STIJbS
8. Tests Conducted: Hydrostatic O Pneumatic 0 Nominal Operating Pressure [3/'

Other O Pressure Alol psi Test Temp. kf2 Z:: °F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (11 size is 8~ in. x 11 in., (21 lnforma-tlon in items 1 through 6 on this report Is included on each sheet, and (31 each sheet is numbered and the number of sheets is recorded at the top of this form. (12/821 This Form (E000301 may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017

FORM NIS-2 (Back)

9. Remarks __s.._-ru.:...=.,1>=--.....P...,o..__:11=---'c=s..... 2....8'"/....8'..,.5=2=--.....' - - - - - - - - - - - - - - - - -

Y_-..... Appllcable Manufacturer', Data Reporu to be attached NUT Po :Ill= CSY- 23132.7-7 CERTIFICATE OF COMPLIANCE We certify that the statemenu made In the report are correct and this ~E.PLAcevlENT conforms to the rules of the ASME Code, Section XI. repair or replacement Type Code Symbol Stamp _ _ ..,,.u...-------------------------------- Certificate of Authorization No. _ _N ___/_A___________ Expiration Data __N'"""'"/.;;.A.:-___________ Signed GJ ~ _/ ~J Owne~deslgnH, Tltle

                                                                                                                   ~~f Date-~_,/..L.......~ - - - - - - - - - -
  • 1 9 q /

CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State or Province of VA and employed by HSB I &I Co, of HtJ.r""t fe.r d, C.+/- have inspected the components described in this Owner's Report during the period l'l.-:J,\.-f3 to ~-1'l.-~'J.... , and state that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section XI. By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspection. __....._~....,,..__=--;---...£"'-.,,..,...-=~=-"----'-----Commissions_.iY....A"--'S"-4;;i. . .,.3'------------::-------

                        . I n11>ector'1 Signature                                                         National Board, State, Province, and Endonemanu

FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI

1. Owner Virginia Electric and Power Co. Date /-23-9/

Name 5000 Dominion Blvd. , Glen Allen, VA Addrea 23060

2. Plant Surry Power Station Unit ON£ Nama P.O. Box 315, Surry, VA Address 23883 wo # 3800 0Cf4- 7 /0 Repair Org11niz11tlon P.O. No., Job No., etc.
3. Work Performed by Virginia Power Type Code Symbol Stamp___,_N.,_,/'-'A_,___ _ _ _ _ __

Name Authorization No. _.....e;Nu;/_._A_,___ _ _ _ _ _ _ __ P.O. Box 315, Surry, VA 23883 Expiration Date _ _. ._N,_,/. .,_A..,____ _ _ _ _ _ _ __ Address

4. Identification of System COt.JTAINMENT ';;PRAY
5. (a) Applicable Construction Code 831
  • 1 19..Q.L.__ Edition,_...;N-u../...,A,..___ _ _ Addenda,N-1 , N- 7 Code Case (bl Applicable Edition of Section XI Utilized for Repairs or Replacements 19 80W80
6. Identification of Components Repaired or Replaced and Replacement Components
  • Name of Component Name of Manufacturer Manufacturer Serial No.

National Board No. Other Identification Year Built Repaired, Replaced, or Replacement or No) ASME Code Stamped (Yes Si,(lt)S ~ NUTS VELAN 01q N/A O/-C.S-/05 /97'1 ReP1 arEO '(1=5 N\)15 ,~-ig 3 cARblk!A1 INC>. "t6576 NIA 01-6 -/05 l'1'1D RJ::/>lACcMBII ,J/'J/:J)OIW STvbS ,t-<B c.AR'DINAL 1.. 11), lf4-5'1-4 NIA 01-cs-105 /'j'fO I D.C:..lll "~- ,.-v, l)i,J/0.11,w,J

7. Description of Work OPEN /JNsPt:<,T IAW CHEC!<. 1/At\/e PM PR06RAM RE.PLACEQ S1JJ().S ~ NVT.S
   ¥,-
8. Tests Conducted: Hydrostatic O Pneumatic O Nominal Operating Pressure 0 Other O Pressure psi Test Temp. °F
     'NOTE:
  • Ord'""Supplemental

_,,.,,)~J l. '°,;t!-. sheets in form of lists, sketches, or drawings may be used, provided (1) size is 8% in. x 11 in., (2) informa-tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form .

  • (12/82) This Form (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017

FORM NIS-2 (Back) csY-

s. Remarks __,S..,..,T'-O""'"t>.~~-----'-PD~:ft-~6...c..8"""'1"""~-=5=2=------' - - - - - - - - - - - - - - - - - - - - - -

Applicable Manufacturer's Data Reports to be attached NOTS f>O ff CS'(-317574:-- 1 CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this @l.AceMENT conforms to the rules of the ASME Code, Section XI. repair or replacement Type Code Symbol Stamp _ _~.......~ - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Certificate of Authorization No. _ _N.. . :. ./_A___________ Expiration Date __N~/_A____________ Signed 0~/ o/w;eror~Oesignee, Title

                                           "'l/                 fC                                   Date_~h~,c;=~A ........"'-4,.~_,,$'--_ _ _ _ , 19 ?/

CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State or Province of VA and employed by HSBI&I Co. of {daYT h.rcl; Cf: have inspected the components described in this Owner's ,Report during the period / l-1\- R'9 to ~-:}. j.- 1 :J... , and state that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section XI. By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer inspection~. u* shall be iiable in any manner for any personal injury or property damage or a l~ss of any kind arising from or connected with this j ,Q:-n

   ----'---'-----c----c----:-'=:-:-.....,,--..-0"""'_......,r*~=-=----Commissions                   VA 543 Inspector's Signature                                                  National Board, State, Province, and Endorsements
                                ~-llf Date_ _ _ _ _~d:__ _ _ _ _19 -, ,__                              a,

FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI

1. Owner Virginia Electric and Power Co. Date /-23-Cf/

Name 5000 Dominion Blvd., Glen Allen, VA Address 23060

2. Plant Surry Power Station Unit ONE Name P.O. Box 315, Surry, VA 23883 WO :ti= 3300 096036 Address Repair Org11nlz11tion P.O. No., Job No., etc.
3. Work Perfonned by Virginia Power Type Code Symbol Stamp~N.a,/~A~--------

Name Authorization No. _.....:.aN,.,_/_,_A.,___ _ _ _ _ _ _ __ P.O. Box 315, Surry, VA 23883 Expiration Date _ _..,_N""'/_,_A..e..__ _ _ _ _ _ _ __ Address

4. Identification of System C.ON"fAIN N\ EN,: Sf?RA:t
5. (a) Applicable Construction Code B31.1 19...Q]__Edition,-~N~LA~_ _ _ Addenda,N-1, N-7 Code Case (bl Applicable Edition of Section XI Utilized for Repairs or Replacements 19 8 OW80
6. Identification of Components Repaired or Replaced and Replacement Components
  • Name of Component Name of Manufacturer Manufacturer Serial No.

National Board No. Other Identification Year Built Repaired, Replaced, ASME Code Stamped (Yes or Replacement . or No) A 01-cs-5/

7. Description of Work ~6.F>LACE: \/AU/f;;
8. Tests Conducted: Hydrostatic ~eumatic q Nominal Operating Pressu~e 0 Other O Pressure t,a MJ:t""!Jsi Test Temp. Mt!kfll" ° F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1 l size is 8% in. x 11 in., (2) informa-tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this fonn .
  • (12/82) This Fann (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017

FORM NIS-2 (Back)

9. Remarks ----LIY8 E:~_'Po-'--~--"S'-'-Y_-_O:....o.<5....3...,7,.....7...____ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
                ....~=V....

Applicable Manufacturer's Data Reports to be attached CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and thisire:P/f\:C_Ef\1E.NT conforms to the rules of the ASME Code, Section XI. repair or replacement Type Code Symbol Stamp _ _......,_,_,_,..___ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __

                                           ---"-------------Expiration Date __N~/_A____________

CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State or Province of VA and employed by HSBI&I Co. of tf4-'r1' fo d V' J CT have inspected the components described in this Owner's Report during the period /_1.* ,.1..-.i'.? to 9--1~-qi_ , and state that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the A~ME Code, Section XI: By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and ,cqrrective measures described in this Owner's Report. Furthermore, neither'th-e Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspection.!, ~ _ _ ___,,~1---=------"~----------Commissions _ _,V..,A..._.,.S,_4~3"'----------------- Jnspector's Signature National Board, State, Province, and Endorsements Date,_*- - - -.....~...-_,_[~_,.___19 'f/

  • FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI
1. Owner Virginia Electric and Power Co. Date_..:/_-_,2,:.::::'23_-....,Cfc..:./_ _ _ _ _ _ _ _ _ __

Name 5000 Dominion Blvd., Glen Allen, VA Sheet _ __..2==--_of_~7-_ _ _ _ _ _ _ _ __ Address 23060

2. Plant Surry Power Station Unit ONE Name P.O. Box 315, Surry, VA 23883 WO # 3800 0 '16086 Address Repair Organization P.O. No., Job No., etc.
3. Work Performed by Virginia Power Type Code Symbol Stamp__._N'-J./c.,_A.,___ _ _ _ _ __

Name Authorization No. _ __._N,../c.,_A..,__ _ _ _ _ _ _ __ P.O. Box 315, Surry, VA 23883 Expiration Date _ __._N.,_./'-'A'"'"----------- Address

4. Identification of System c.ptJTAINMENT .SPRAY
5. (a) Applicable Construction Code B31, l 19..Q.l._Edition, _ _,N~/A,..__ _ _ Addenda,N-l, N- 7 Code Case (b) Applicable Edition of Section XI Utilized for Repairs or Replacements 19 80W80
6. Identification of Components Repaired or Replaced and Replacement Components ASME Code National Repaired, Stamped Name of Name of Manufacturer Board Other Year Replaced, (Yes Component Manufacturer Serial No. No. Identification Built or Replacement or No)

STUI'>", "i-13 C.AROINA1 IND. 451/G NIA OI-C.S-51 1qqo RePL/tCEME/llT U>Jl:tJOIV,J

  >JUTS     ~ -13         CARblJ.IAL l**n.            /fb576             NIA            OI-C.5-51                          Jqqo    RE:f'I.Ac.E A,11:...T utJ1<.~owlJ Plf'E,   2"             MULTI METAL5               1-4qc,              NIA            Ol -C5-S1                          l'l~1 Rl:.P.' .iri:MEA!T      l}llllt'UOW,J AJ.J.c>Y ELL. 2"                   STAIIJU:SS PRO[). PIL   '*l't74'l        NIA            OI-C.S-51                          1qg1 It>f<.Dl./iCcMEtJT       UN~OWlll
7. Description of Work Rc:PW\CE.. VALVE
8. Tests Conducted: Hydrostatic ~Pneumatic O Nominal Operating Pressure 0 Other D Pressure /, .r..,r).6"1~si Test Temp. /),yl),,!,vr' °F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is 8% in. x 11 in., (2) informa-tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form.

(12/82) This Form (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017

FORM NIS-2 (Back) 9 .. Remarks -,.;;.~1i-=-U=£)5=-....:..:R:)e...:tf----=CS=*_._Y_---""~""'-':f_..lf=6~~'-"'7.__-=3::......____________________ Applicable Manufacturer's Data Reports to be attached N\)TS pa# CSY- 317574: - 2. PIPE ea 41'- c.s'( - , ¥6'166 - , E:.LL q5731 - ' CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this RcPL.ltGEME.N"T' conforms to the rules of the ASME Code, Section XI. repair or replacement Type Code Symbol Stamp _ _.....,_,_._.___ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __

~:cat7J;;todo*-~--N"""'/_A __J-_--==_s ___ ,--

___~-~-~-----Expi:a:::_n_D.L.h_te-=~~'rJ'-,...-.....N~/._/._A~r~~~~~~~~~~~-.-,--f_'/__ 9

                    ~orOwn~gnee,Tltle CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State or Province of VA                                                 and employed by                    HSB I &I Co.                                                             of t/4r"TftirdJ                        C.t                                                     have inspecled the components described in .this .Owner's _Report during the period                                                                            1-~.~-q ~                       *       , and state that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this *
        .Owner's Report in accordance with the requirements of the ASME Code, Section XI.

By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither" the Inspector nor his employer* shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this .

  • inspectioh~ i. ~(\ *
         - - - - ' 1 ~ 1 - - " ' " " - - " - - ~ - - -.....         -~  -='--'-----Commissions
                                                                           ~.-c                                       VA 543 Inspector's Signature                                                                 National Board, State, Province, and Endorsements D a t e - - - - - - ~ - -....               /q...__19 '1 /

L__

FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI

1. Owner Virginia Electric and Power Co. Date I - 2.'i3 - Cf/

Name 5000 Dominion Blvd. , Glen Allen, VA Sheet _ _/;...__ of __/ ~ - - - - - - - - - - Addrea 23060

2. Plant Surry Power Station Unit ONE.

Name P.O. Box 315, Surry, VA 23883 WO # 3800 OC/C/755 Address Repair Organization P.O. No., Job No., etc.

3. Work Performed by Virginia Power Type Code Symbol Stamp___.N~LA~--------

Name Authorization No. - ~ N ' " ' / ~ A ~ - - - - - - - - - P.O. Box 315, Surry, VA 23883 Expiration Date _ __._N.,_../'-'A'-'------------- Addrea

4. Identification of System CO/JTAl~MENT sPRA'(
5. (a) Applicable Construction Code B31.1 19.Q]___Edition,_~N'--'/~A~_ _ _ Addenda,N-1, N- 7 Code Case (b) Applicable Edition of Section XI Utilized for Repairs or Replacements 19 80W80
6. Identification of Components Repaired or Replaced and Replacement Components ASME Code National Repaired, Stamped Name of Name of Manufacturer Board Other Year Replaced, (Yes Component Manufacturer Serial No. No. Identification Built or Replacement or No)

STUD5 e ij\}T5 SchilHie ~ k<<rH"l vNWovJrJ NIA OI-CS-2_lf v>Jt>Jow,J REfl./iC.E.D ,,.,11 ........ Nu,-.;  %-11 cARDINAL !MD. 4-4-q10 Nlf'r. OI-CS-ZJ /qqo 12E.PLAC£M EJ.11 IIUV*IIIWN 3 ,,

   ~   t.Jur              Sd1vtfie  #1<.oeril""'l
                                              -    U/.JIO.Jol/J,J        NIA          0/-CS-;2.'-/          U~KJJOW>J   ~f;{'L/ta:.D      u.il(J..loWJ.l NUTS.     {-10         CAROi hlhL /AJf).            '+37<"67           NIA          O/-C:S-24               l1'BCf    REl'LIIC.l:'11BNT lJNIOJOWt.J STUDS i-11              A~G EN~R.                    01.fl.f 70        NIA          01-cs-2..tf              Jqqo     REPLA<:ENleJT      UUl:IJOWIJ
7. Description of Work Offil,.l(INSPEG: rAUI Q:iEC.K, VAL\/£ PM PR06RAl'VI
8. Tests Conducted: Hydrostatic O Pneumatic ~ Nominal Operating Pressure 0 Other O Pressure 'Y,C psi Test Temp. /kdj41'. °F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is 8% in. x 11 in., (2) informa-tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form .
  • (12/82) This Form (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017

FORM NIS-2 (Back)

9. Remarks _s_:r~u_/J_S_~R_V_#~j~CS~~Y_-~30~6~~~7~/_-_J_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __

Applicable Manufacturer's Data Reports to be attached klt)TS Po.# CSY- 2'f06'f3- I CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this RePLf/CEMIENT conforms to the rules of the ASME Code, Section XI. repair or replacement Type Code Symbol Stamp _ _......,_,_,_.___ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ Certificate of Authorization No. _ _N-'-/_A___________ Expiration Date __N_,_/_A-'------------- Signed * <i2 ~ / ~4,,C./' Owner~Designee, Title

                                                                                              /Ed,     /Y Date _ _..,_:....:::.=..::..L.------,    19 :J/

CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State or Province of VA and employed by HSBI&I Co. of flt1.. r't ford ) C.1: have inspected the components described in this Owner's Report during the period /1.-1'.l.-.&'j to 1.*';lQ.-q'- , and state that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section XI. By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or prop~rty damage or a loss of any kind arising from or connected with this i_n_sp_e_c_t-io-n~-\---~----f_._~~~-------Commissions VA 543 Inspector's Signature National *eoard, State, Province, and Endorsements Date _ _ _ _,.,.~_--'/'-Cf~_19 4/

  • FORM NIS-2.0WNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI
1. Owner Virginia Electric and Power Co. Date f-~-q /

Name 5000 Dominion Blvd., Glen Allen, VA Addrea 23060

2. *Plant Surry Power Station Unit ONE-Name P.O. Box 315, Surry, VA 23883 Address Repair Organization P.O. No., Job No., etc.
3. Work Performed by Virginia Power Type Code Symbol Stamp~N~L-A~--------

Name Authorization No. _ __,_N,.,/_.A_,__ _ _ _ _ _ _ __ P.O. Box 315, Surry, VA 23883 Expiration Date _ _-=-N'--'-/--=A-=----------- Address

4. Identification of System COMPONE.N'[ COOLING
5. (a) Applicable Construction Code B 31
  • 1 19 ..§1_ Edition,_....,N_,_/,..,A:.>.-_ _ _ Addenda,N-1 , N- 7 Code Case (b) Applicable Edition of Section XI Utilized for Repairs or Repiacements 19 80W80
6. Identification of Components Repaired or Replaced and Replacement Components
  • Name of Component Name of Manufacturer Manufacturer Serial No:
  • National Board No.
                                                                                               "Other Identification Year Built Repaired,
                                                                                                                         . Replaced, ASME Code Stamped (Yes or Replacement . or No)
7. Description of Work QE.P'LACE R..E:LLE.F VALVE:.
8. Tests Conducted: Hydrostatic D Pneumatic *o Nominal Operating Pressure ~

Other O Pressure JJO!'. psi Test Temp. peC: °F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1 I size is 8% in. x 11 in., (2) informa-tion in items 1 through 6 on this repon is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form. (12/82) This Form (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017

FORM NIS-2 (Back)

9. Remarks VAL\J E:. PO 'It- S5Y- /25962. -3 Applicable Manufacturer's Data Reports to be attached STVD;s PO w C;JY - 2/106 37 - /

NVIs fb

  • C.S'f - 2Cflf701- I CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this f?la>LA@eJT conforms to the rules of the ASME Code, Section XI. repair or replacement TypeCodeSymbolStamp _ _.......,_1-J,..J..__---------------------------------

Certificate of Authorization No. _ _N--'-/_A_ _ _ _ _ _ _ _ _ _ _ Expiration Date __N....L./.:..A;:.__ _ _ _ _ _ _ _ _ __ Signed _ _ _Q"'-,!,...<C...~-4,£-~*

                                  "-4~_,,j?'-,4--'
                                                   -     .,._=...z-.._=--s,_,,:.t.,,,_-__..&,,,~'4fil.,---Date_~h-tt""""-*._./._.Y,..__ _ _ _ , 19 7/
                                                      "=--

OwnerorOw~ CERTIFICATE OF INSERVICE INSPECTION -*---------- --- --------- 1, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State orProvinceof VA andemployedby HSBI&I Co. of f/4,r-T'fpy,J J Ct- have inspected the components described in this Owner's Report during the period 0,'" i 1- 8i to *~- ~!), - 'l'J... , and state that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section XI. By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspection. /\ _a_ __f)* If) f"\ 0

   ----~"*-""'~""-'----=-----'-'---=--L"--'--"~'---------Commissions Inspector's Signature VA 543 National Board, State, Province, and Endorsements

_J

FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI

1. Owner Virginia Electric and Power Co. Date I - :Z~ - Cf/

Name 5000 Dominion Blvd. z Glen Allen 2 VA Sheet _ _ 2__ of_.....::;;2.-'----------- Addrea 23060*

2. Plant Surry Power Station Unit ONE.

Name P.O. Box 315 2 Surry 2 VA 23883 WO :ir 38000 Cfq1 / 2 Addrea Repair Organization P.O. No.,Job No., etc.

3. Work Performed by Virginia Power Type Code Symbol Stamp____,.N.,../,_,A.....__ _ _ _ _ _ __

Name Authorization No. --=-NaJ./~A~--------- P.O. Box 315, Surry, VA 23883 Expiration Date _ _~N,_,/_,A..,.__ _ _ _ _ _ _ _ __ Address

4. Identification of System C:0Mf>O~£NT COOLING
5. (al Applicable Construction Code B31, 1 19-2Z_Edition, _ _.N,../..:A_,_____ Addenda,N-1, N-7 Code Case (bl Applicable Edition of Section XI Utilized for Repairs or Replacements 19 80W80
6. Identification of Components Repaired or Replaced and Replacement Components ASME Code National Repaired, Stamped Name of Name of Manufacturer Board Other Year Replaced, (Yes Component Manufacturer Serial No. No. Identification Built or Replacement . or No) 51"U0S ~ - I~ CAROlllAL IND. 4-51/h NIA 01-CC-RV-ll'fA /'iCfO RePLAc.EMENf UIJIOJowri NVT5 \-13 CARDINAL IN I>. 1./6576 NIA 01-i:.t-.-R\J-11qA [Cf'IO R&LAc.FMEN1 lb.. lOJOI\I~
7. Description of Work........,R=EP=--=l.A=-=C.E=---'-R.E=U=E."-'F---'V.,....4....,l""'V,..E~,..___..,(co=11.:.:.f_,_.).,__ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _....,..._
8. Tests Conducted: Hydrostatic O Pneumatic 0 Nominal Operating Pressure g/

Other O Pressure .,v,,) psi Test Temp. NOT °F NOTE: Supplemental she~s in form of lists, sketches, or drawings may be used, provided (1 I size is 8% in. x 11 in., (2) informa-tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form. (12/82) This Form (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017

FORM NIS-2 (Back)

9. Remarks _s~T_U_D_:S_~f~Oc....*-~c.5"--(_-......);C-.. q.,_4:.._Ga.<. .&.Cf....

7_--'3_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ Applicable Manufacturer's Data Reports to be attached NUTS Po# GS'(_. 31757lf: - :2-CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this lcS'I.ACEMf:tJ"f' conforms to the rules of the ASME Code, Section XI. repair or replacement Type Code Symbol Stamp _ _~.....~ - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Certificate of Authorization No. _ _N~/_A___________ Expiration Date __N~/_A____________ Signed [! ( 1 ~

           ¥nar or ~ e a , Title 1s.Z-CERTIFICATE OF INSERVICE INSPECTION
                                                                                   ~"1£          Date _ _      -+-h.__.._&~*--'~C...____, 19 I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State j'/

or Province of VA and employed by HSBI &I Co. of H4v-i'.J:ord t Ct, ~ave i:Sj?,ected the components described in,this Owner's. Report during the period i 11 '1 ~ * * * , and state that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in thi~ Owner's f!eport. in.accordance with,the requirements of the ASME Code, Section XI. By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspection.

  ---~-....,~---~-f._.=-*            -~---------Commissions_..,V~A~~5~4~3-*- - - - - - - - - - - - - - - -
                      !nsp&t;,:;;Signature                                                      National Board, State, Province, and E ndorsaments Date_ _ _ ___.g_~-_/'--'1~_19               q/

FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI

1. Owner Virginia Electric and Power Co. Date I Cf I Name 5000 Dominion Blvd., Glen Allen, VA Address 23060
2. Plant Surry Power Station Unit ONE.

Name P.O. Box 315, Surry, VA Address 23883 wo # 3800 Repair Organization 0&83/0 P.O. No., Job No., etc.

3. Work Performed by Virginia Power Type Code Symbol Stamp~N~/~A~--------

Name Authorization No. _ __._N...,/_,_A-=---------- P.O. Box 315, Surry, VA 23883 Expiration Date _ _.....N""/....,A_,__ _ _ _ _ _ _ _ __ Address

4. Identification of System SAFETY 111/JE.GT/ON
5. (a) Applicable Construction Code B31. l 19..Ql__Edition, _ _.,N,.,/....,,A_,___ _ _ Addenda,N-1, N- 7 Code Case (b) Applicable Edition of Section XI Utilized for Repairs or Replacements 19 80W80
6. Identification of Components Repaired or Replaced and Replacement Components ASME Code National Repaired, Stamped Name of Name of Manufacturer Board Other Year Replaced, (Yes Component Manufacturer Serial No. No. Identification Built or Replacement or No)

FJfz# STUDS IJELAAJ 6" B/11- ',J/'f B- /3M MIA OJ-SL-2'f() VNl<NdllJN Rcf)UlcE.J) lllll~N

<;T'UDS
         . 1t-s        rAR.blNAL     trJb.       %1~f.                 NIA           OI-Sl-2.'10                  1'190     ~LACEN\E.NT It1il1'M:IUJIJ
7. Description of Work IN$C..T HAtJ6rER l?RAa[ BoLTS
8. Tests Conducted: Hydrostatic D Pneumatic D Nominal Operating Pressure~

Other D Pressure IV' f psi Test Temp, ,A) D r OF NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is 8% in. x 11 in., (21 informa-tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form. (12/82) This Form (E00030) may be obtained from the Order Dept,, ASME, 345 E. 47th St., New York, N.Y. 10017

FORM NIS-2 (Back)

9. Remarks _5..,_T.Ltl"-'t>S"'-=-___,P...,o'-.'lt_C_=-<S...,_Y_---=3:....o_b:...:'8-=bc.=~:;....-.....,_/_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __

Applicable Manufacturer's Data Reports to be attached CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this Rl:fLACEMEJJT conforms to the rules of the ASME Code, Section XI. repair or replacement Type Code Symbol Stamp _ _....,+.-~----------------------------------- _ _.....:._ _ _ _ _ _ _ _ _ _ _ _ Expiration Date __N~/_A____________ CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State or Province of VA and employed by HSBI&I Co. of

  ---------1-1..,..=~~~-J:,___,_f""'6.,.v::....,cl.._,3f---'C""-'r,________=-_--=_=-,,_--have                                         inspected the components described in this Owner's Report during the period                                                                   /l-a.i-21to     ~-l'J-,q/                      , and state that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section XI.

By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspection.

   -------'~l-=-><-,----,,--=l_.__~......::_.;;._.....;...;;.__Commissions_...,V._.A..._..,Sc;.4u3"-----------------

I nspector's Signature National Board, State, Province, and Endorsements Date_ _ _ _ ~~~--{~q__19 q /

FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI

1. Owner Virginia Electric and Power Co. Date I 'V Name 5000 Dominion Blvd., Glen Allen, VA Sheet ____/,___ of /

Addrea 23060

2. Plant Surry Power Station Unit ONE.

Name P.O. Box 315, Surry, VA 23883 WO # 3800 076577 Addrea Repair Organization P.O. No., Job No., etc. 3~ Work Performed by Virginia Power Type Code Symbol Stamp_.N.,_,/...,A...__ _ _ _ _ __ Name Authorization No. _.....,!,;N!.L/..,_A.)__ _ _ _ _ _ _ __ P.O. Box 315, Surry, VA 23883 Expiration Date _ _-"N!.L/...._A..__ _ _ _ _ _ _ __ Addrea

4. Identification of System se:Rv1C£ WA1E.R
5. (al Applicable Construction Code B31, 1 19R_Edition,_..,_N.../..,_A..__ _ _ Addenda,N-1, N-7 Code Case lb) Applicable Edition of Section XI Utilized for Repairs or Replacements 19 80W80
6. Identification of Components Repaired or Replaced and Replacement Components ASME Code National Repaired, Stamped Name of Name of Manufacturer Board Other Year Replaced, (Yes Component Manufacturer Serial No. No. Identification Built or Replacement or Nol STIJD5 t NIIT5 ,J ~ 01-sw- FE:.-121)/!, 1//\J i4/0IAJI\I R.£:Pl.AC£J) l1111Wo1q,l rJ\JTS 3~{,6,.6 SiUbS INt>,  !.AC.f:MENi UIJ OW"1 o u=-1cs. \Jl)\'1,IOIIJ" ORIFICE. NA Ol-5W-Ft-J 5 /'f?,?, 0111114
7. Description of Work {?.f.ft..ACE. 08,!FICG- n,4-Tc / !l.GfL/fC.E. l?,OL-111'.19
8. Tests Conducted: Hydrostatic D Pneumatic D Nominal Operating Pressure W' Other D Pressure /VO)) psi Test Temp. /1/ (J L °F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (11 size is 8% in. x 11 in., 121 informa-tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form.

(12/82) This Form (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017

FORM NIS-2 (Back)

9. Remarks _ _ s~cr~v~DS~__P_O_~_~cs_Y~------'3:C..l'--C6-'Z"-'-I_C/_-_z.. _________________

Applicable Manufacturer's Data Reports to be enached NUTS ro ~ G5Y- 2q4:70C/- J 0£\FICE PtJ -:It {SY- 22.7~66 CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this @;P~*conforms to the rules of the ASME Code, Section XI. repair or replacement Type Code Symbol S t a m P - - ~ ~ ' - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Certificate of Authorization No. _ _N-'--/_A___________ Expiration Date _...;N:.c.,.../.;;.A-=------------- Signed _ _<i)o:::,;..,"----".£"---=-_.,,~=-,;q...i...A""""L..,..c'"--_::lS=-e"S'f=-=---.L,.-""-tt...:u._ _ _ _ Date _ _..<.h-=~::..:'tf.c.c.'-<-/..,.~.___ _ _ _ , 19 U Owner or Own~ignee, Title CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State or Province of VA and employed by HSBI&I Co, of

  ---------+H...<.:"--'-'-r_.7_El--"~"-'--rd=-+;-C...,,-,,,_T.,________________ have inspected the components described in this Owner's Report during the period                                                         /1- ,., _ R '1   to     '.).-1!).-'71..                        , and state that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section XI.

By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspection. _ _ _Q-'--"'~~,._____,_~/_.~~~L)~-----Commissions VA 543 Inspector's Signature National Board, State, Province, and Endorsements Date _ _ _ _ _..,,d.,:.-_,_('-_,_1_ _19 GJ /

FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI

1. Owner Virginia Electric and Power Co. Date I - 2'8 - '9 /

Name 5000 Dominion Blvd., Glen Allen, VA S.heet _ _/'--- of _ _,_/_ _ _ _ _ _ _ _ _ __ Address 23060

2. Plant Surry Power Station Unit ONE.

Name P.O. Box 315, Surry, VA Address 23883 Wo Repair # 3800 08~32H Organization P.O. No., Job No., etc.

3. Work Performed by Virginia Power Type Code Symbol Stamp__,N~/A,_,__ _ _ _ _ _ __

Name Authorization No. _ __,N"-'-'/A,_,__ _ _ _ _ _ _ _ __ P.O. Box 315, Surry, VA 23883 Expiration Date _ _-"N~(,_,A'------------ Address

4. Identification of System-=S'-'-A=F~E~T~Y-~/~N=J""E.c==JJ__,_,,()._.N-'---------------------------
5. (a) Applicable Construction Code B31. 1 19.QL__ Edition, _ _,N_,_,_,/A,_,__ _ _ Addenda,N-1 N- 7 Code Case (b) Applicable Edition of Section XI Utilized for Repairs or Replacements 19 80W80
6. Identification of Components Repaired or Replaced and Replacement Components
  • Name of Component Name of Manufacturer Manufacturer Serial No.

National Board No. Other Identification Year Built Repaired, Replaced, ASME Code Stamped (Yes or Replacement or No) f'l6 '*' 5TUD5 t;: U VE:LAr.J b". 8/i/-311'rlH3M N ol-5I-'o s 6 CJ/ -SI-~

7. Description of Work RE;f'.LAGE.. HANGiE..12. BRACKET BOLTS
8. Tests Conducted: Hydrostatic D Pneumatic D Nominal Operating Pressure W Other D Pressure /J fJ ; , psi Test Temp. ,.J~r °F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is 8Y. in. x 11 in., (2) informa-tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form.

(12/82) This Form (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017

FORM NIS-2 (Back) c..~Y-

9. Remarks -Si,.,.T-=-IJ=D-=-S_ _,_P_0_~_,,,,,,3'--'-16"""'""'21!,=-=-J_--=2=------------------------

Applicable Manufacturer's Data Reports to be attached NVTS PO~ c.sY-3162.~)-4 CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this 'R.EPLAl.EME:NT conforms to the rules of the ASME Code, Section XI. repair or replacement Type Code Symbol Stamp _ _.....u.,-,...c.___ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ Certificate of Authorization No. _ _N-'-/_A_ _ _ _ _ _ _ _ _ _ _ Expiration Date __N_,_/_A_ _ _ _ _ _ _ _ _ _ __ Signed Q~tle Date_......,ck-k.J~"'~-"I...,.,/..___ _ _ _ , 19 ~ CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State orProvinceof VA andemployedby HSBI&I Co. of

  ---------~H.~0v~\.-_,T'-'"6. . o.........c_A=-,-1-*. . .C.....,f.......____________ have                     inspected the components described in this Owner's Report during the period                                    / .)..-1'1.-f? tO-q,.j_,~i~.i~--q._{J..=-----,             and state that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section XI.

By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and -corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspection.

  ----'~t---"~~~~---~l~',---~=-~~~-----Commissions_...,V'--'A-'----"'5'-4~3~----------------

insi>ecwr'sSignature National Board, State, Province, and Endorsements Date_ _ _ _ =~~--N~--19 1/

  • FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI Virginia Electric and Power Co.
1. Owner Date I - 2.8 - 'll Name 5000 Dominion Blvd., Glen Allen, VA Sheet _ _/_ _ of I Addr- 23060
2. Plant Surry Power Station Unit ON£ Name P.O. Box 315, Surry, VA 23883 Wo # 3800 I0235Lf Addr- Repair Organization P.O. No., Job No., etc.
3. Work Performed by Virginia Power Type Code Symbol Stamp__.,Nu:I....A.._________

Name Authorization No. _ __,N...,/..._A..___ _ _ _ _ _ _ __ P.O. Box 315, Surry, VA 23883 Expiration Data _ _~N,.../..,A..___________ Addraa

4. Identification of SVstem CHEM1c.A L *AND VDWME Co~ TRol...
5. (al Applicable Construction Code B31, 1 19~Edition, _ _.N. ....,/ A..,_____ Addenda,N- l, N-7 Code Case (bl Applicable Edition of Section XI Utilized for Repair, or Replacements 19 80W80
6. Identification of Components Repaired or Replaced and Replacement Components ASME Code National Repaired, Stamped Name of Name of Manufacturer Board Other Year Replaced, (Yes Component Manufacturer Serial No. No, Identification Built or Replacement or Nol OIL CJ:,()Lt:O 8Asr.n ONIUJolAltJ NIA 01-CM-E -r;c. tJt,J~OIAl RE.Pl-Ac.ED ur.ilc(l,Jow,1 SPe<:IAL,T'/SS 011.... C.OOLER Er.I~. Cc:)Rf'. 8512.102. NIA OI -C.H-e-5C /'fg6 IllE:PJ Ar~MSN'T UMl{~II\IN
7. Description of Work RF;PLAce. W8c Ol'- CCOLE.R
8. Tests Conducted: Hydrostatic O Pneumatic O Nominal Operating Pressure W Other D Pressure Jl/ot> psi Test Temp, /VO ,.. *F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (11 size is 8% in. x 11 in., (2) informa-tion in items 1 through 6 on this report Is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form.

(12/821 This Form (E000301 may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017

FORM NIS-2 (Back)

9. Remarks --o=@,,.=.,L=-=E=R-...fo ......._:tl'-__,,5.._::(._-__,_J=D...9...(6
                                                                                't_-_.l______________________

Appllcabla Manufacturer', Data Repom to be attached CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this BEPLACF;MENT conforms to the rules of the ASME Code, Section XI. repair or replacement Type Code Symbol Stamp _ _~ ' - " " - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Certificate of Authorization No, _ _N ___/_A___________ Expiration Date _....;N;.;.L./..;;.A"------------- Signed (1 # Ownerorl&:~a jl__ -

  • A~

Date-~M-*~-- ~r_1,_:,:- _____, 19 ~ CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State or Province of VA and employed by HS BI &I CO

  • of
  -------1Hc..L.:a..==-""-t   .......Bc.. : : o-=-r.. :d=-+,_.c..,_,+....__________--:-____ have inspected the components described in this Owner's Report during the period                                              f~ ~

8', to ~ .. 3,,1..-9 'l.. , and state that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective *measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section XI. By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspectiot'\ /\ ..(i f. ~

  ----"-~L..;;~'-=-~----'-~--'~'"'""

1napector'1 Signature

                                                               .....=------Commissions_...           V""A-'-'5"4~3'-----------------

National Board, Stata, Province, and Endoraement1 Date

                         !).-1 ~                              19      C,,,J I
  • FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI
1. Owner Virginia Electric and Power Co. Date l-1..i-11 Name 5000 Dominion Blvd., Glen Allen, VA Address 23060
2. Plant Surry Power Station Unit ONE Name P.O. Box 315, Surry, VA 23883 WO #' 3BOOO 88830 Address Repair Organization P.O. No., Job No., etc.
3. Work Performed by Virginia Power Type Code Symbol Stamp~N~/~A~--------

Name Authorization No. - ~ N ~ / ~ A ~ - - - - - - - - - - P.O. Box 315, Surry, VA 23883 Expiration Date _ __,_N-'-'--'A~---------- Address

4. Identification of System SAF&1'X INtJ E(:::::n i,tJ
5. (al Applicable Construction Code B31.1 19...Q]__Edition,_~N~/~A~_ _ _ Addenda,N-1 N- 7 Code Case (bl Applicable Edition of Section XI Utilized for Repairs or Replacements 19 80W80
6. Identification of Components Repaired or Replaced and Replacement Components Name of Component Name of Manufacturer Manufacturer Serial No.

National Board No. Other Identification Year Built Repaired, Replaced, or Replacement or No) ASME Code Stamped (Yes FIG ft. STUf)S e. MOT::; VELAN 6 Sl/f-31/'I-B-13M NIA OI-SI-82. f.JNKNOIIJN REPLAc..t:.D \)~ KNOOJ.11 STUfl<; A~C:i QJG.12 NU\ 3Rh6.6 NIA 01 -S!-'32- iqqo REPt A.-" EMEt-.l"T Ut,IL'llAWN NUTS A(6 <=NoR. /llCA 3~66.6 NIA m-SL-'51- 1qqo DC:PJ .fla:MeJT . I JAi 1(/\)0i,,.l

7. Description of Work REPLAcE.. I-/AtJ6ER 6McK£I Bogs
8. Tests Conducted: Hydrostatic D Pneumatic D Nominal Operating Pressure 0' Other D Pressure htJ > psi Test Temp. NO l"'. °F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is 8% in. x 11 in., (2) informa-tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form.

(12/82) This Form (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017

FORM NIS-2 (Back)

9. Remarks STUbS PO :a= C5Y- 3/62$1-2 Applicable Manufacturer's Data Reports to be attached NUiS PD 'II= CSY- 310251- l/:

CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this REPL.ACEMEN, conforms to the rules of the ASME Code, Section XI. repair or replacement TypeCodeSymbolStamp _ _....l,.l..f....'C'------------------------------------ Certificate of Authorization No. _ _N.....:.../_A_ _ _ _ _ _ _ _ _ _ _ Expiration Date __N__,_/_A_ _ _ _ _ _ _ _ _ _ __ Signed ~ ; ~ , Title_zs-'f Date_....6'----=c-.=d....,.'---L../-""T CERTIFICATE OF INSERVICE INSPECTION _ _ _ _ _ , 19 I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State 9/ orProvinceof VA andemployedby HSBI&I Co. of f7&s 1r:J::: Fo,.d ) Ct have inspected the components described in this Owner's Report during the period f 1 ~ a.,~ -~Cf to ~ ~ .1:}. -'( IJ__ , and state that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code, Sec~ion XI. By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspection. {)_._j-_~f_.__~--~-----Commissions ____D>.f--"--- ,__~ VA 543

             ~ o r ' s Signet~                                                     National Board, State, Province, and Endorsements Date_ _ _--!l~-~(~Lj-__19                        qf

FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI

1. Owner Virginia Electric and Power Co. Date f q I Name 5000 Dominion Blvd., Glen Allen, VA Address 23060
2. Plant Surry Power Station Unit ON£ Name P.O. Box 315, Surry, VA 23883 WO # 3800 0 997 //

Address Repair Organization P.O. No., Job No., etc.

3. Work Performed by Virginia Power Type Code Symbol Stamp~N,...,/_,_A_,___ _ _ _ _ __

Name Authorization No. -~N'-J./_,_A~--------- P.O. Box 315, Surry, VA 23883 Expiration Date _ _~ N ~ A ~ - - - - - - - - - Address

4. Identification of System LC1MPONE:tvT CtOUNC:r
5. (a) Applicable Construction Code B31.1 19...QL_Edition,_~N""'"'/A~_ _ _ Addenda,N-1 N- 7 Code Case (b) Applicable Edition of Section XI Utilized for Repairs or Replacements 19 80W80
6. Identification of Components Repaired or Replaced and Replacement Components ASME Code National Repaired, Stamped Name of Name of Manufacturer Board Other Year Replaced, (Yes Component Manufacturer Serial No. No. Identification Built or Replacement . or No)

TE.LE 1>'(/JE. RELIEF VALVE.. FARRIS IIAhtuowrJ NIA 01-cc.- RV-/J,.2. [Jr,JKt.JouJN f<E:.Pl.AdJ) LIMkl,jC)w~ 1ELE DYNE Ric.LIEF VALVE FAR.RIS //35 -Ge. NIA 01-cc- R\/- /?? /'187 RcF'LAc.B'<le!l 1//\J"Nl>Wi.l STUDS ~ NVTS VfJ/C.tJow~ i./NKNOIU~ NIA 01-cc.-R\J-/'Z:)... \JNl<N<lWN IREPi..ACtm i./Nkt-lOW>I S'fUl)~ CARDll'-\AL IN{). lf4'16'1 t-JIA 01-cc.-Rv-122- /"J&fO PE:.f'l-f!tr EM6N1 UN IQ.lO\oUM NUTS ,4 ~(:j E~. Urdi'.N0"'1N NIA

                                                                         .        01-c.c.-R\l- /'22-     JC/</0    1<6.PL.Ac.eMalT     tm!WoWt.l
7. Description of Work RE:PLAc.£ RELl£F V//-LVE
8. Tests Conducted: Hydrostatic O Pneumatic 0 Nominal Operating Pressure ~

Other D Pressure A)(') e psi Test Temp. MO r °F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is 8Y:z in. x 11 in., (2) informa-tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form. (12/82) This Form (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017

FORM NIS-2 (Back)

9. Remarks _V....,_'A=L:=Y=E.~_R~V_#__ S_S~Y_-_/~Z_S~C/~6=2._-_4-_ _______1_ _ _ _ _ _ _ _ _ _ _ __

Applicable Manufacturer's Data Reports to be attached 5TV.l>S Po # CSY- Z90637- I NUT5 PO 11= C.SY- 2.984 ICf-Z CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this RsPL.AcEMl:NT conforms to the rules of the ASME Code, Section XI. repair or replacement Type Code Symbol Stamp _ _~ , - . . . ~ - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Certificate of Authorization No. _ _N_/_A___________ Expiration Date __N~/_A____________ Signed !l2 'If:~,</ Owner or Owner's D gnee, Title fTf 64, Date_~h~21=(J~~L-'f_ _ _ _, 19 7I CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State or Province of VA and employed by HSBI&I Co. of

                               #t:A.Yif:o rJ)                   CT                                                            have inspected the components described in this Owner's Report during the period                                                  I 1-;i. ~-2~        to       1-ll-- q 'J.. .                                    , and   state that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this

_Owner's _Report in accordance with the _requirements of the ASME Code, Section XI. By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a Joss of any kind arising from or connected with this i-n-sp_e_c-ti_o...,gl-*

                     ........                                                      *~---'---Commissions --'~~!~t-io""5n'-~'-'i3""s-o-a-rd-,-S-t-a-te-,-P-r-o-vi_n_c-e,-a-n_d_E-nd_o_r_s-em-e-nt_s_
                          *r4J:~~l-n-sp_e_c-to~f-,s.,..'*S-i-g~~=at""'u~rJL..,e~'-.~*

Date _ _ _ _------1~.,__-_l_t.j...___19 q/

FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI Date _ __.~'--'t.~:l-....!~~9~/------------ Sheet _ _*~'--- of_ _,* t'_*_________

                                                                                                               ...,ul!C..G/

Unit_.=C2::..* ______________ Repair Organization P.O. No., Job No., etc. Type Code Symbol Stamp _ _:_#.-'-'~'-<------- Authorization No. -----'=lfl'-'~'-"1'2=----------- Expiration Date _-4-',v<.S-!/,,;"""------------'- r Address Tl

4. Identification of System .4., ,IC, ;L,LJ(),rqdr~
5. (al Applicable Construction Code 63/. / 19~Edition, u4 Addenda p.,:f. ,.GI-/ Code Case
 * (bl Applicable Edition of Section XI Utilized for Repairs or Replacements 19                       8al()8'l)
6. Identification of Components Repaired or Replaced and Replacement Components ASME Code National Repaired, Stamped Name of Name of Manufacturer Board Other Year Replaced, (Yes Component Manufacturer Serial No. No. Identification Built or Replacement or No)
7. Description of Work._....,4c...::::;f-~-=~=--k=C=--4~~
                                                    .......""L..,dlie....l,tf.___ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __

r

8. Tests Conducted: Hydrostatic ~ Pneumatic D Nominal Operating Pressure ~

Other D Pressure/, .,-X4'P4'.tl psi Test Temp. //Nd,~l"' °F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is 8% in. x 11 in., (2) informa-tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form. (12/82) This Form (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017

                -if Ufrr.U-A,v u/tf-4.j hc.L,;~~ ,?q~r,,~""41.                                                     rJ-sr ~,.,) )o,;.vsr'44!.,p,r                . "\

Wirt.~ w~ /I y;J,u:,Tr#nc-d.u~ rtt~r~J  ?.t--4 kMj,e ,£.t-~~~r ~Alt!~4}.

FORM NIS-2 (Back) CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct arid this .&~Ji~ conforms to the rules of the ASME Code, Sectior:i XI. repai::a;:;:;;lacement Type Code Symbol Stamp _ _ _~ p - ~ ~ - ~ - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Certificate of Authorization No. ----'-'..V."--L~-~=--------------Expiration Date ----'-~---l'd,'-=-<------------ Signed ~/~~itle _z:-sz- h4 /2-Date-~--==-=-'-L...ae-=------, 19 r/ 0 CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State or Province of 1/o.. and employed by 'H S (3 .,l. -+ J:' C. ()

  • of
      . Ha._.,.~- f Ord.        J_. C:. 1".                                                   have inspected the components described in this Owner's Report during the period                         iJ;;.:).:).- if'f   to*   'l'.,;~,l-q:,..        *      , and s~ate that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report .in accordance with the requirements of the ASME Code, Section XI.

By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property_ damage or a loss of any kind arising from or connected with this inspection.


~~------,-_f_*__ Inspector's Signature d_~~--Conimissions _ _ ,J,-'4-=5~'-t_3_ _ _ _ _ __

National Board, State, Province, and Endorsements Date_ _ _ ___.d-#=--'_/_3___19 Cf I

UNITED STATES NUCLEAR REGULATORY COMMISSION WASHINGTON, D. C. 20555 January 23, 1991 Docket No. 50-280

                                                            ~1~----                CJ/-0StJ-Mr. W. L. Stewart                                        Bec'd.        f~N 2 8 1991 Senior Vice President - Nuclear Virginia Electric and Power Company                                   Nuclear Operations 5000 Dominion Blvd.                                                  !lcensing Supervisor..

Glen Allen, Virginia 23060 'JE!"'f'-. . .*,*1

Dear Mr. Stewart:

SUBJECT:

SURRY UNIT 1 - RELIEF FROM HYDROSTATIC TEST REQUIREMENTS (TAC NO. 79240) By letter dated December 10, 1990, you submitted a request for relief from the hydrostatic test requirements of the 1980 Edition through Winter 1980 Addenda of Section XI of the ASME Code for welded replacement check valve 1-FW-142 at the Surry Power Station, .Unit 1. This valve is located in the discharge line of auxiliary feedwater pump 1-FW-P-2 and was replaced because of excessive internal back leakage detected during an attempted hydrostatic test of the Auxiliary Feedwater System *

  • Based on the information you provided, we agree with your determination that it is impractical to meet the hydrostatic test requirements of Section XI for the above-cited valve, and we hereby grant the requested relief. The bases for our determination are contained in the enclosed Safety Evaluation.

This relief is authorized by law and will not endanger life or property or the conunon defense and security and is otherwise in the public interest. In granting this relief, we have given due consideration to the burden that could result if the requirements were imposed on the facility. Sincerely, rn-~ ert N. Berkow, Director reject Directorate II-2 Division of Reactor Projects - I/II Office of Nuclear Reactor Regulation

Enclosure:

As stated cc w/enclosure: See next page

Mr. W. L. Stewart Virginia Electric and Power Company Surry Power Station cc: . Michael W. Maupin, Esq. Attorney Gen~ral Hunton and Williams Supreme Court Building Post Office Box 1535 101 North 8th Street Richmond, Virginia 23212 Richmond, Virginia 23219 Mr. Michael R. Kansler, Manager Mr. E. Wayne Harrell Surry Power Station Vice President - Nuclear Operations Post Office Box 315 Virginia Electric and Power Company Surry, Virginia 23883 5000 Dominion Blvd. Glen Allen, Virginia 23060 Senior Resident Inspector Surry Power Station Mr. J. P. O'Hanlon U.S. Nuclear Regulatory Commission Vice President - Nuclear Services Post Office Box 166, Route 1 Virginia Electric and Power Company Surry, Virginia 23883 5000 Dominion Blvd. Glen Allen, Virginia 23060 Mr. Sherlock Holmes, Chairman Board of Supervisors of Surry County Mr. Martin Bolling Surry County Courthouse Manager - Nuclear Licensing Surry, Virginia 23683 Virginia Electric and Power Company 5000 Dominion Blvd. Mr. W. T. Lough Glen Allen, Virginia 23060 Virginia Corporation Commission Division of Energy Regulation Post Office Box 1197 Richmond, Virginia 23209 Regional Administrator, Region II U.S. Nuclear Regulatory Conmission 101 Marietta Street N.W., Suite 2900 Atlanta, Georgia 30323. C. M. G. Buttery, M.D., M.P.H. Department of Health 109 Governor Street Richmond, Virginia 23219

UNITED STATES NUCLEAR REGULATORY COMMISSION WASHINGTON, D. C. 20555

            ~Ar;:r:rv .. f.lJAb.UATI QN--8-V- -Tl:li--OfF-IC~--OF- *-NUChEAA--~AC+OR- RfGUb.AHQN REQUEST - J;OR-- RH..Jff - FROM--SEGTIQN- XI -lef.YDROST-ATI~ -REQYIREMfNTS VlRGJ.N-JA.. fleGTRJC---AN-D--P.Q~R- C~Y-stlRR-V-- POWER* STATION, --YN-IT--1 OOC K[l' - NO-.-.. aQ-.280.
  !lACKGROYND.

10 CFR 50.55a(g) requires examinations and tests of nuclear power facility piping and components be performed in accordance with the requirements of the applicable ASME Section XI Code edition and addenda. If it is impractical to meet a requirement; the licensee of the facility is required to notify the Conm~ssion and submit information in support of the determination that a requirement is impractical to perform. This information is evaluated by the Coirmission and, upon making the necessary findings, the Comission may grant relief from the requirement giving due consideration to the burden upon the licensee that could result if the requirement were imposed on the facility. By letter dated December 10, 1990, Virginia Electric and Power Company (the licensee) submitted to the NRC a request for relief from the hydrostatic test requirements of the 1980 Edition, Winter 1980 Addenda of Section XI of the ASME Code for a welded replacement valve in the Auxiliary Feedwater System at Surry Power Station, Unit 1. The information provided by the licensee is evaluated herein pursuant to 10 CFR 50.55a to determine if the necessary findings can be made to grant the request. REQUEST-- AND--SU~P.OR-T-ING---WORMAT-IQN. A. RELIEF REQUESTED Relief is requested from the hydrostatic test pressure requirement of the 1980 Edition, Winter 1980 Addenda of Section XI of the ASME Code for the weld on the inlet side of Class 3 check valve 1-FW-142. B. SECTION XI CODE REQUIREMENT A component repair or replacement shall be pressure tested as required by IWA-4400 and IWA-7000 prior to resumption of service. The test pressure and temperature, subsequent to component repair, shall confonn with the system test pressure and temperature specified in IWD-5000. Where a repaired or replaced component is isolable within a portion of the system, only that portion need be pressure tested. The system hydrostatic test pressure shall be at least 1.25 times the system pres-sure, Psv, for systems with design .temperature above 200°F. The system pressure, Psv, sha 11 be the .1 owest pressure setting among the number of safety or relief valves provided for overpressure protection within the boundary of the system to be tested. -

The system test temperature during a system hydrostatic test in syst~ms con-structed of ferritic steel components shall satisfy either the requirements of fracture prevention criteria, as applicable, or the test temperature determined by the owner. C. LICENSEE'S BASIS FOR REQUESTING RELIEF The licensee stated that during hydrostatic testing of recently completed modifications on the Auxiliary Feedwater System, excessive internal back leakage was identified at check valve 1-FW-142. To eliminate this back leakage, the decision was made to replace the six-inch discharge check valve for steam-driven auxiliary feedwater pump l-FW-P-2. Paragraph IWA-5214 of ASME Section XI requires that a hydrostatic test be performed with a corresponding VT-2 examination on the affected area. As no intermediate isolation exists and because the discharge piping is welded directly to the pump, the required test on the upstream weld would include 1-FW-P-2 (steam-driven auxiliary feedwater pump) and the associated suction piping within the hydrostatic test boundary. This would result in overpres-surization of these components to meet the test requirements (IWD-5223 test pressure: 1576 psig, suction piping design pressure is 30 psig). Section/Paragraph IWA-5224(d) of ASME Section XI allows the use of the pressure rating for the suction piping out to the first discharge shut-off valve in the case of centrifugal pumps during hydrostatic tests. Use of this Code paragraph in the application would eliminate the need for this relief request as test pressure would only be 33 psig for the replaced welds.* Code committee personnel have indicated that this is a Code oversight and that future Code editions will change the requirements for high pressure multi-stage centrifugal pumps. As such, it is the licensee's position that a relief request is necessary. D. LICENSEE'S PROPOSED ALTERNATIVES Alternatively, it is proposed that a volumetric examination and a surface examination be perfonned on the new upstream weld in lieu of the hydrostatic test. In addition, a system functional test (IWD-5222) and its corresponding VT-2 examination will be conducted with the normal Technical Specification required operability test for auxiliary feedwater pump l-FW-P-42. EVALUATION The information submitted by the licensee included ISi Classification Boundary Drawin9 No. 11448-CBM-068A, REV. 5, that shows the location of the replaced _ valve {1-FW-142) in the discharge piping of the steam-driven auxiliary feedwater pump l-FW-P-2. From the drawing, the low pressure suction piping to the pump cannot be isolated from the higher pressure discharge piping in which the weld required to be subjected to the hydrostatic test pressure of 1576 psig is located. It is therefore impractical to meet the hydrostatic test pressure requirements of Section XI in this situation without major modifications to the

discharge piping of the pump. Imposition of the r~quirement on the licensee would cause a burden that would not be compensated by the increase in plant safety over that provided by the licensee's proposed alternative. The volumetric and surface examinations of the weld will provide sufficient information to assess its structural integrity. t:<;) Nt b. lJ S1QN-Ba sedon the above evaluation, the staff concludes that, pursuant to 10 CFR 50.55a(g)(6)(i), the relief from the ~ydrostatic test may be granted as requested. The staff has determined that this relief is authorized by law and will not endanger life or property or the coRITion defense and security and is otherwise in the public interest. In granting this relief, the staff has given due consideration to the burden that could result if the requirements were imposed on the facility. Dated: January 23, 1991 Pt'.!iRt~l--CGRtF!~bYt-81'.!-: G. Jonson

FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI

1. Owner Virginia Electric and Power Co. Date I- 2.3 - '1 I Name 5000 Dominion Blvd., Glen Allen, VA Sheet _ ___;/:.....__ of /

Addrea 23060

2. Plant Surry Power Station Unit ONE.

Name P.O. Box 315, Surry, VA 23883 WO # 3800 I 02352 Addrea Repair Organization P.O. No., Job No., etc.

3. Work Performed by Virginia Power Type Code Symbol Stamp___.N.,./wA.._.__,_ _ _ _ _ _ __

Name Authorization No. ----'-'N,.,/..,_A..,___ _ _ _ _ _ _ __ P.O. Box 315, Surry, VA 23883 Expiration Oate _ _~N.,.,.lwA~---------- Address

4. Identification of System CHE=/\'IIC.Al AtJD VOWM£, CO!VTR.OL-
5. (a) Applicable Construction Code B31, 1 19...fi1.__Edition, _ _.N.,./'--'A,..___ _ _ Addenda,N-1, N- 7 Code Case (bl Applicable Edition of Section XI Utilized for Repairs or Replacements 19 80W80
6. Identification of Components Repaired or Replaced and Replacement Components
  • Name of Component Name of Manufacturer Manufacturer Serial No.

National Board No, Other Identification Year Built Repaired, Replaced, ASME Code Stamped (Yes or Replacement or Nol OIL <<ic:>L..ER. 6ASw UNKN"UJN tJ/A QI-CH-E--58 IIN~WIJ F::.Ef>L.Ac£D UN~JJow~ OJL COOL.ER 6A$l.O cg711SO'f-0101 NIA 01- c.H-E-S8 UN!<NOCAU REPL.Ac&ME~ .,VAJ~

7. Description of Work REF'LAGE. LUBE- OIL.. COOLER,
8. Tests Conducted: Hydrostatic O Pneumatic 0 Nominal Operating Pressure ~

Other O Pressure No,> psi Test Temp, Aft) 1"" °F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1 l size is B% in. x 11 in., (2) informa-tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form .

    • (12/82) This Form (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017

FORM NIS-2 (Back)

9. Remarks COOL£& PO :f;t CSY- 13668.5-1 Applicable Manufacturer's Data Reports to be attached CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this l?E:f'L.Ac.E.ME,.NT conforms fo the rules of the ASME Code, Section XI. repair or replacement Type Code Symbol Stamp _ _~.......- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -

Certificate of Authorization No. _ _N-"-/_A___________ Expiration Date _...;N;.;.L/.:;.A.:.____________ Signed ~'~~ nerorOer'sOesiQnee, Title flz ~~- Date _ _ h~~~'d~*6~-----, 19 ?t CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State or Province of VA and employed by HSBI&I Co. of

  -----~H~a.~r-_!~f~6~,.~d~-jr-"C~f~,________________                                                           have inspected the components described in this Owner's Report during the period                                     1.-

J 'l 'l - $c1 tO--~~.._'l..~'l~--q~'l.,_____, and state that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owne'r's Report in accordance with the requirements of the ASME Code, Section XI. By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspection.

  -~Di-=.             ......J..w.::~=-c---'::-:--J_--F-..___,...,~::x..=.....-Commissions_Y
                 ~.ector'sSignature A--"'-5...L><.43_ _ _ _ _ __

National Board, State, Province, and Endorsements Date _ _ _ _ _ ~1._-~]__19 -'i f

FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI

1. Owner Virginia Electric and Power Co. Date I - 2.8 - 'ii Name 5000 Dominion Blvd., Glen Allen, VA Sheet _ _/_ _ of /

Addr- 23060

2. Plant Surry Power Station Unit ON£ Nam*

P.O. Box 315, Surry, VA 23883 ()JO # 3800 /0097.3. Addr- Repair Organization P.O. No., Job No., ate,

3. Work Performed by Virginia Power Type Code Symbol Stamp~N... /-A~-------

Nam* Authorization No. _......,N...,/..,A..__________ P.O. Box 315, Surry, VA 23883 Expiration Date _ _.... N..,/..,A...__________ Addl'ftl

4. Identification of System CMIM1CA;&- ded t/ o 4 <<&.£
5. (al Applicable Construction Code 831, 1 19..6.Z..._Edition,-~N._/~A_ _ _ Addenda,N-1, N-7 Code Case (bl Applicable Edition of Section XI Utilized for Repairs or Replacements 19 80W80
6. Identification of Components Repaired or Replaced and Replacement Components ASME Code National Repaired, Stamped Name of Name of Manufacturer - - Board -other Year Replacad, (Yes Component Manufactun,r Serial No. No, Identification Built or Replacement or Nol OlL coo, S::I? P.ASI"'> UNI<' ~ll"lvJ/\1 NIA OI-Cli-E.-5A 01.Jlc:'JJOW..J REPLACED VIJl!.NovJ~

OIL COOLER BASCO '5111501.f -0101 NIA 01-CH-E-SA 7/-30/9,7 REP!~--* l)Nw.tl41N~

7. Description of Work mt.A(,E Lll'BE. OIL C.OOLE.R
8. Tests Conducted: Hydrostatic O Pneumatic 0 Nominal Operating Pressure ~

Other O Pressun, N(l 2 psi Test Tamp, /VO "r °F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is 8% in. x 11 in., (21 Informa-tion in items 1 throu~ 6 on this report is Included on each sheet, and (3) eech sheet Is numbered and the number of sheets is recorded at the top of this form. (12/82) This Form (E00030) may be obtained from the Order Dept,, ASME, 345 E, 47th St., New York, N.Y. 10017

FORM NIS-2 (Back)

9. Remarks COOLER PO #' CS'( - 136685 - I Applicable Manufacturer', Data Reports to be ettachecl CERTIFICATE OF COMPLIANCE We certify that the statements made In the report are correct and this l?l=PLAC.EME,NT conforms to the rules of the ASME Code, Saction XI. repair or replacement C

Type Code Symbol Stamp _ _....,_,-.,..;.___ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ Certificate of Authorization No. _ _N_.;./_A_ _ _ _ _ _ _ _ _ _ _ Expiration Date __N;;.;.,./""A.;;...._ _ _ _ _ _ _ _ _ __ Signed t/ / ,tJ - - oWror O w n e r ' ~ t l e Date-~/4-~_.f'~,_I.S___

                                                                                                            - _ _ _ _ _ _ , 19    9/

CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State orProvinceof VA andemployedby HSBI&I Co. of t/4v-Tc<>v: 1 6 t. -t have inspected the components described in this Owner's Report during the period I 'l.~ l-'J.*&'1 to 1,-1.l.-jl , and state that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section XI. By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspectio~~ /J n

   - - - - ~ ........

i--:----'r/:..:...t1-----'~=-=-----'~--Commissions_....,VuA..._..,S"'4L>3.__ I napector'1 Signature _________ -=------- National Board, State, Province, and Endornment1 Date_ _ _ _ _ _.,_ "-<' _ _.J_ _19 al 1

FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI

1. Owner Virginia Electric and Power Co.

Name 5000 Dominion Blvd., Glen Allen, VA Address 23060

2. Plant Surry Power Station Unit ONE:.

Name P.O. Box 315, Surry, VA 23883 Address Repair Organization P.O. No., Job No., etc.

3. Work Performed by Virginia Power Type Code Symbol Stamp___.N.,_,_/A"---'----------

Name Authorization No. _ __,_N-'-'--'/A,._,___ _ _ _ _ _ _ _ __ P.O. Box 315, Surry, VA 23883 Expiration Date _ _...,N~~A~---------- Address

                                                                                             ;6.....c"'--'--CLl...
4. Identification of System _.._5;,.L-C-..,cz<,>/'--'~"'-L.T___,"l'----=Tc.....c...,."'"'"---... ~'"'"'"'v"--------------------------
                                                          /
5. (a) Applicable Construction Code 831
  • 1 19 ..Q.L._ Edition,_...,N'"'-'-'/A'-"-_ _ _ Addenda,N-1 N- 7 Code Case (bl Applicable Edition of Section XI Utilized for Repairs or Replacements 19 8 OW8 0
6. Identification of Components Repaired or Replaced and Replacement Components ASME Code National Repaired, Stamped Name of Name of Manufacturer Board Other Year Replaced, (Yes Component Manufacturer Serial No. No. Identification Built or Replacement or No)

STUDS ~ NIJT'5 AWYco

  • UNKAIOWrJ NIA 0/ -SI.-25 tJNKNol/JN REPI..ACED 'U/Jl<!llowN STUDS c:ARbll\lill 11\Jl:>. lfl.f'ib"'I "1/A 01- SL-7r; 3-/0-'/0 KEPLAG!f/ViE/111 UNl<NDW/.1 NUTS rA.l?htNAL ti-JD, Jft./'110 NIA 01-sr:-25 ~-'f-CfO REfLA<E/M:JJT UI.IKNOuJN
7. Description of Work IMSPEGT IAW CV fPl)GRAM/R£PlftCF;.. 5T1/D5
8. Tests Conducted: Hydrostatic D Pneumatic D Nominal Operating Pressure ~

Other D Pressure /1/o? psi Test Temp, NO C °F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is 8% in. x 11 in., (2) informa-tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form. (12/82) This Form (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017

FORM NIS-2 (Back)

9. Remarks ~S,..11l.D~6~~fl~o~:ir- __ C_S~Y--_~_g,_0_1o_*_ 3 _ 7 _ - ~ ' - - - - - - - - - - - - - - - - - - - - - - -

Applicable Manufacturer's Data Reports to be attached NUTS fb °"' CSY- J.'1061'3- I CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this /<E.fLACEMENT conforms to the rules of the ASME Code, Section XI. repair or replacement Type Code Symbol Stamp _ _~ . , - . . . . ~ - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Certificate of Authorization No. ___ N~/_A____________ Expiration Date __N~/_A_____________ Signed __O_w,..~-e~r-o--r-(~w~!--e-r~"'"~e-si-g-ne_e_,-T-it_l_e_ _,L5'.._/~~"'£~--~~,.c1,_(~___ 0ate _ _.;;~~v~*~.J~/_______ , 19 ', / CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State or Province of VA and employed by HSBI&I Co. of

  ------~fl.~t;.._v-_i~'E~o~l"'~J-t-J_C-=*-""t~------------=-==------have inspected the components described in this Owner's Report during the period _ _ _ _ _ _(~~~--'l~~---S'~'j__ to                             1,,,~l,- q    be             , and state that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME* Code, Section XI.

By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this

  *rn--sp_e_c_t-io_n__,ft~~~~-----i~*--~---------Commissions __V,.,A..,__...,S"-4-'-"'3'------------------

lnspector's Signature National Board, State, Province, and Endorsements Date_ _ _ _ {_-~'.3~/___19 q/

FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI

1. Owner Virginia Electric and Power Co. Date 1-28-1/

Name 5000 Dominion Blvd., Glen Allen, VA Sheet of_---'------------ Address 23060

2. Plant Surry Power Station Unit ONE Name P.O. Box 315, Surry, VA 23883 WO # 3800 0765 76 Address Repair Organization P.O. No., Job No., etc.
3. Work Performed by Virginia Power Type Code Symbol Stamp__,N.,_,_/A,_,__ _ _ _ _ _ __

Name Authorization No. ----"N-'-/'--'A,_,__ _ _ _ _ _ _ _ __ P.O. Box 315, Surry, VA 23883 Expiration Date _ __,N.,_,_/A,_,__ _ _ _ _ _ _ _ __ Address

4. Identification of System S<!:4-r1,d:£ d,-.1~
5. (a) Applicable Construction Code B31. 1 19..Q]__ Edition, _ _,N'-'--'-/,.,A~--- Addenda,N-1 N- 7 Code Case (bl Applicable Edition of Section XI Utilized for Repairs or Replacements 19 80W80
6. Identification of Components Repaired or Replaced and Replacement Components ASME Code National Repaired, Stamped Name of Name of Manufacturer Board Other Year Replaced, (Yes Component Manufacturer Serial No. No. Identification Built or Replacement or No)

ORlF/Gf:. VA POWER NONE NIA 01-sw-F£-120A IJA1/<}Jl)WN i<EPLACED lJfJK/JdwAl HEAT# O'i-Z ORIFICE. HlJSSE.Y fFARMEl<S\ LOT ,t. A NIA OJ-sv.J-FE-l'l,C>A 2-7-8<f RE:Pt Ae,FME;tJ~ l/lllKNO\IJIJ

7. Description of Work f<EFLACE. ORIF/C/=. PLATI=-
8. Tests Conducted: Hydrostatic D Pneumatic D Nominal Operating Pressure ~

Other D Pressure A/0 P psi Test Temp. A!(} -7' °F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is 8Y:z in. x 11 in., (2) informa-tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form. (12/82) This Form (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017

FORM NIS-2 (Back)

9. Remarks ag1p1(£ Po,#: CSY- 227t:g66 Applicable Manufacturer's Data Reports to be attached CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this f?FPLA(EMENI conforms to the rules of the ASME Code, Section XI. repair or replacement Type Code Symbol Stamp _ _~ + - ' - ~ - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -

Certificate of Authorization No. ___N_/_A ____________ Expiration Date __N~_A_____________ Signed Q~~ 0 Date-~U_....~~-J~/_ _ _ _ _ , 19 91 CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State or Province of VA and employed by HSBI&I Co. of da.y\fi, .. d.l C1', have inspected the components described in th is Owner's Report during the period / i * ~:).

  • cf9 to c'.l- ' era.., , and state that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section XI.

By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspection.

   ----+---'~~~~~f~*-~-=--==.....c.....-Commissions                             VA 543 Inspector's Signature                                    National Board, State, Province, and Endorsements Date* _ _ _ _ __.._(_-""""""'j---'-/_ _19  9/

FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI

1. Owner Virginia Electric and Power Co. Date_---'---""---'-/_&'_"_{...c.q_q_/_ _ _ _ _ _ __

Name 5000 Dominion Blvd., Glen Allen, VA Address 23060

2. Plant Surry Power Station Unit __ 1_________________

Name P.O. Box 315, Surry, VA 23883 Address Repair Organization P.O. No., Job No., etc.

3. Work Performed by Virginia Power Type Code Symbol Stamp~N.,,./~A'-'-----------

Name Authorization No. -~N.,.../~A'-'------------ P.O. Box 315, Surry, VA 23883 Expiration Date _ _~ N ~ A ~ - - - - - - - - - - Address

4. Identification of System ~S~JJ_\A_b_M_('_~0~11.1~)_i/~Cl~,~*1-,~~~1='-l~Ct~m~~,Jt'-l!-;1{)~7..£,v,,,..,'----"------------------

IJ

5. (a) Applicable Construction Code B31.1 19..QL_Edition,_~N~/A~_ _ _ Addenda,N-1 N- 7 Code Case (b) Applicable Edition of Section XI Utilized for Repairs or Replacements 19 80W80
6. Identification of Components Repaired or Replaced and Replacement Components
  • Name of Component Name of Manufacturer Manufacturer Serial No.

National Board No. Other Identification Year Built Repaired, Replaced, or Replacement or No) ASME Code Stamped (Yes

    ~--~                              111                                       -                                     -           J,.., H5.,. H~>-11,. t)v o()         hv/c,a
                                                                                                                                                                          ,     ...,t,,,:(    No

_j) A-, J 1,J,\. lJ.,J, iJCtY/,'nJJ 1r,/ 960 -- I- t.iic 8- J-'W-10 <i?B R(blaa,:...t.,,,t I

                                                                                                                                                                                             /Jo C,nrtf I\\..J >J<<-l fl
  .-/ft r,{,{<-(,(...c.,,( (3cw                 -h 1/)y~d,,,<. ...                                 -                                     -                   -            ,:,,a

() 0 }eA.p &..,,..,,d ,Vo (} I I '/ 1'/l' !f* J

                                                                                                                   . f/VV-'---=-------------------------
7. Description of Work__,_,fi..c.ll'f'b""'CLLJ.c...::;:;;._-"'Ma<!~='-"-'..::..:,:'----'v"'-'-v11,-,-'-'-'--'-'vc..

I

8. Tests Conducted: Hydrostatic O Pneumatic O Nominal Operating Pressure 0 Other Ii] Pressure _ _ _ _ _ psi Test Temp. °F fiMJi 0v.l fur NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is SY. in. x 11 in., (2) informa-tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form.

(12/82) This Form (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017

FORM NIS-2 (Back) Applicable Manufacturer's Data Reports to be attached PIA v ~ --<Z.A,,,.,J.-~ - CERTIFICATE OF COMPLIANCE , We certify that the statements made in the report are correct and this £;.p{tkl.,~ conforms to the rules of the ASME Code, Section XI. repai~ or replacement Type Code Symbol Stamp _ __._,-f-L_,.__ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __

                                  - - - ' - - - - - - - - - - - - - E x p i r a t i o n Date __N_,_/_A____________

orProvinceof VA CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State andemployedby HSBI&I Co. of Ha.rtFor-d, cf. have ins.E?_ected the components described in this Owner's Report during the period _ _ _ _'-l""'J.c..---=1--'1"-'-----"~~~~--to 1).. I~ , and state that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section XI. By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspectionA /I ,/J. I.


'-~~-"--=-:----,---:-:---'~=c.=---------Commissions VA 543 Inspector's Signature National Board, State, Province, and Endorsements Date_ _ _ ~/---.&-~l~--19 q f

FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI

1. Owner Virginia Electric and Power Co.

Name Date /Id,&/ 5000 Dominion Blvd., Glen Allen, VA Sheet L of Address 23060

2. Plant Surry Power Station Unit &A/t5" Name P.O. Box 315, Surry, VA 23883 Address Repair Organization P.O. No., Job No., etc.
3. Work Performed by Virginia Power Type Code Symbol Stamp__,_N.,_,/'-"'A,_,__ _ _ _ _ _ __

Name Authorization No. _ ___,_N.,.../'--'A'-'----------- P.O. Box 315, Surry, VA 23883 Expiration Date _ _~ N ~ A ~ - - - - - - - - - - Address

4. Identification of System_~~~~~~~*~"~~~*_,____A~'P.=:d~~~~~~'v.=Wf'.~<f:~_G~~M'-""-~-'-~"""L""-------------------
5. (a) Applicable Construction Code B31.1 19.QL__Edition,-~N'-'---'/A~_ _ _ Addenda,N-1 N- 7 Code Case (b) Applicable Edition of Section XI Utilized for Repairs or Replacements 19 80W80
6. Identification of Components Repaired or Replaced and Replacement Components ASME Code National Repaired, Stamped Name of Name of Manufacturer Board Other Year Replaced, (Yes Component Manufacturer Serial No. No. Identification Built or Replacement or No)
                                              ~,(i.  ]t.ll'I
    ,/...,.~,/£          /,1>41,..4;2) J       jl. 'Ul, .,.,4      A///!)         1-c#-2).Y            -            ~~),:,9e;,J        .r./1}
   ,I.A~,//!'           /J. , ---~ rv. .         ,1 r.5'?"            u4           ,-e.-/.J.2-?Y 1;,,k?            ~.f)u1&,!-,..,J{'     pt)
8. Tests Conducted: Hydrostatic wPneumatic D Nominal Operating Pressure 0 Other O Pressure /.z.rx ..v,-iw psi Test Temp.Md , ..ttJr °F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is 8% in. x 11 in., (2) informa-tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form.

(12/82) This Form (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017

FORM NIS-2 (Back)

9. Remarks _)o=----P_.:....::Al.....::S_-.....?.....
                                               '3+'/:+95'"
                                                       .....___:G,._:,;,....,,~)_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __

Applicable Manufacturer's Data Reports to be attached CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this ~,.>~,1£/fJl_. conforms to the rules of the ASME Code, Section XI. repair or replacement Type Code Symbol Stamp _ __..,.,_._.__ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ Certificate of Authorization No. ___ N..c./_A _ _ _ _ _ _ _ _ _ _ _ _ Expiration Date _ _ N~/_A Signed G1 ~-,P ,1# Owner ~ ~ e s i g n e e , Title orProvinceof VA f >:£ CERTIFICATE OF INSERVICE INSPECTION Date -~v".~_,,,"'-'-µ...,_,_,_/~/,'-------, I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State andemployedby HSBI&I Co. 19 9'/ of tf a.rT 6:>rd , Cf, have inspected the components described in this Owner's Report during the period / l,- ~1., J>? to ~-1j, 9 3.. and state that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section XI. By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or imp Iied, concerning the examinations and corrective measures. described in this Owner's Report. Furthermore, neither the Inspector nor his* employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspection. ______.Q~~"'-1=-:---' -------,/.-':---'&r:4-"""':....::--'------Commissions_~V~A~~5~4~3~---------------- nspector's Signature National Board, State, Province, and Endorsements Date_ _ _ _ ~/_-__,/~'~-19 9/

  • FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI
1. Owner Virginia Electric and Power Co.

Name Date _ ___,_/--J./uc....L..>o"-c,,-;;-+--'-/--------- 5000 Dominion Blvd., Glen Allen, VA Sheet_---'-/-- of_.c../_ _ _ _ _ _ _ _ _ __ Address 23060

2. Plant Surry Power Station Unit _ _ C/,~"--=t.f,-'----------------

Name P.O. Box 315, Surry, VA Address 23883 1,,ft) .r# Jroo ;oo/.r? L Repair Organization P.O. No., Job No., etc.

3. Work Performed by Virginia Power Type Code Symbol Stamp__,N~/'"'A,___ _ _ _ _ _ __

Name Authorization No. _ __._N.,_,/'-'A'-'------------ P.O. Box 315, Surry, VA 23883 Expiration Date _ __oN~A,_,__ _ _ _ _ _ _ _ __ Address

4. Identification of System 4A'c.w.e' Cuu"',/ r
5. (al Applicable Construction Code B31, 1 19_QL__ Edition,_...,N"--'-/..,A,___ _ _ Addenda,N-1 N- 7 Code Case (bl Applicable Edition of Section XI Utilized for Repairs or Replacements 19 80W80
6. Identification of Components Repaired or Replaced and Replacement Components ASME Code National Repaired, Stamped Name of Name of Manufacturer Board Other Year Replaced, (Yes Component Manufacturer Serial No. No. Identification Built or Replacement or Nol "Z,tli:.'
  -r.-,,,._.Lr)... ,L    -r:_ ..~, C I
                                             ,.-~ ":f>..oz.9 A~L:,          /-£),._,!-./      c_   II/ 7.Y P,e J,, *  . A-L, \     .. J,i
7. Description of Work _ _z.,~'"""-F>.""!ACL.L..;,..,2._____."P'--"'~:::.."'U'-'6""-------------'-~----------------

I

8. Tests Conducted: Hydrostatic D Pneumatic D Nominal Operating Pressure D Other D Pressure _ _ _ _ _ psi Test Temp. °F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1 l size is BY. in. x 11 in., (2) informa-tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form.

(12/82) This Form (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017

FORM NIS-2 (Back)

9. Remarks _ _4="

_....,.C,_,_._,,,.N:.....oZ;iC4~""'""'"Ae-~C __9"--1'------=0_,0=---.--=3c=---=O::'---...J"---'9-'9'----------------

                    /1                                      /I             Applicable Manufacturer's Data Reports to be attached Ll!Ml7""&4f.1'""                   ,Rh1A£1: 4-- Ck - 6 00 /-03 q CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this 4&~£'=                                                       conforms to the rules of the ASME Code, Section XI.                                                                                          repair or replacement Type Code Symbol Stamp _ __ . _ , . ; . . . . , . . ~ - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -

Certificate of Authorization No. ___ N.c./_A____________ Expiration Date _ _N.c/_A_____________ Signed _ _.()'!,+-"-.=~---<e,,l_=,.,,F' Owner or O ~ i g n e e , Title

                                            *-=..,..........-:::"----=:::-
                                               -"                         z-<<-......,.-L. .
                                                                         ....                      ,c..&*----- Date ___,,4'_
                                                                                            ..vO<....

CERTIFICATE OF INSERVICE INSPECTION

                                                                                                                            . . . . . _ _,.,,,~ti.____ _ _ _ , 19 9 '

I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State orProvinceof VA andemployedby HSBI&I Co. of (-ja, V'T Po r d I C. T have inspected the components described in this Owner's Report during the period _ _ _ _ _.,_/..,.'J.<=--_,'.J,"--"'~=------"f'--'?-to _ _.:).=---i~i~--Cf.,_,.1~-----,, and state that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section XI. By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspection.

   ----~~l-"":..><....--*---,--=-:---/.:.._,_~""""l;..<-=..c--Commissions _                                    _,_V"'"'A,__,,5c.c4u3"----------------

I nspector's Signature fe National Board, State, Province, and Endorsements 11 Date_ _ _/,__-_/()_- _ _19 9+/- 1/

  • FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI
1. Owner Virginia Electric and Power Co. Date __l,u:'I-L-/j_,_,,,,.._"/'---...,.+-/-~9z....,,rJ'---------------

Name 5000 Dominion Blvd., Glen Allen, VA Sheet _ ___,_I_*_ _ o f _ - - 1 ~ - - - - - - - - - - Address 23060'

2. Plant Surry Power Station Unit_~~-----------------

Name P.O. Box 315, Surry, VA 23883 &lo #. ,:ron1a1/oO Address Repair Organization P.O. No., Job No., etc.

3. Work Performed by Virginia Power Type Code Symbol Stamp___.N~/A'-'---------

Name Authorization No. -~N""/~A'-'------------ P.O. Box 315! Surryi VA 23883 Expiration Date _ _~ N ~ A ~ - - - - - - - - - - Address 4, Identification of System .K5,1C!71)L, ~µJ--

5. (a) Applicable Construction Code B31. l 19.H__Edition,_~N'-'-<-/~A~_ _ _ Addenda,N-l N- 7 Code Case (b) Applicable Edition of Section XI Utilized for Repairs or Replacements 19 80W80
6. Identification of Components Repaired or Replaced and Replacement Components
  • Name of Component Name of Manufacturer Manufacturer Serial No.

National Board No. Other Identification Year Built Repaired, Replaced, or Replacement or No) ASME Code Stamped (Yes 5n-;?;<) Gh,,dMm.t 1oo~:Alq s;..~;,. J)?~'i

    /ti de e::. ,A!i $      tsi-J' , La.        J ,) 92.,J          ;Vh,        /-/2(! -L--/ t-     /178'           /&j>.,,:, ,,,Z.,!.)

y.?)

8. Tests Conducted: Hydrostatic D Pneumatic D Nominal Operating Pressure D Other D Pressure _ _ _ _ _ psi Test Temp. _ _ _ _ _° F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is 8% in. x 11 in., (2) informa-tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form.

(12/82) This Form (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017

FORM NIS-2 (Back)

9. Remarks _..,_,J:.....,,we...,&=E==--------'4,::.=.!a"""'9-=-<-u--'--"=()~=--";---'-/2--'-'!'--0-+-,'_C=.S-:'--':J=-...._(,.....3""-=-o_,,_.?~)~'1
                                                                                                    /

2)~*-------------- J

                                                               .            Applicable Manufacturer's Data Reports to be attached
                                                                                      £u:; C.f'?                            U,> 22.,r)

CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this tf.£)A,;e conforms to the rules of the ASME Code, Section x I. repair or replacement Type Code Symbol Stamp _ __.u+J....__ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ Certificate of Authorization No. ___ N_,_/_A____________ Expiration Date __N_,_/_A_____________ CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State or Province of VA and employed by HSBI&I Co. of Ho..rT p., . . d. ) ti. have* inspected the components described in this Owner's Report during the period /},/~')/ ~'i to i/1 '-/ q d-- , and state that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section XI. By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspection. _ _ _ _ _Yi_,_.~~~~-~~i~-~~-'~~-~----Commissions_.,.V.,_A~5~4~3~-------------- I nspector's Signature National Board, State, Province, and Endorsements Date _ _ _ _ _,_l~l('-/....,b~_19 9D

                                                                                                                                                                                                          *-;,;;J

z_;us

  • FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI
1. Owner (If}. pa vJW Name
                                                                                                                        -_9.__0 _ _ _ _ _ _ _ __

Date _ __,_/_1-'---__,_I_V.__*

        }_0/JV     \)tJmin,*vi..       (3_ l ,rd . Gl~vi ltd ei,,                ti1i2
  • Sheet I of _ _,__ _ _ _ _ _ _ _ _~

Address

2. Plant S1,,1 rr'L ~11vJ-W $_+/-.Plii UV\ Unit _ _ _/ _ _ _ _ _ _ _ _ _ _ _ _ _ __

I Name Repair Organization P.O. No., Job No., etc.

3. Work Performed by //Ip . Q>,1 M Type Code Symbol Stamp_..c,jj,_,A...c..__ _ _ _ _ _ __
                                                   '   Name Authorization N o . _ ~ q ~ - - - - - - - - - -

Expiration Date _ _~ ' ~ - - - - - - - - - - Address

4. Identification of System C. O~,;vi .&d- G> i / tv4 ~~ "':'\ ( c'.
  • C ) ().M.a.: 3 )
5. (a} Applicable Construction Code "'83/. / 19fl_Edition, Ii/Yr Addenda, N/J Code Case (b} Applicable Edition of Section XI Utilized for Repairs or Replacements 19 J:" I,) ~
6. Identification of Components Repaired or Replaced and Replacement Components ASME Code National Repaired, Stamped Name of Name of Manufacturer Board Other Year Replaced, (Yes Component Manufacturer Serial No. No. Identification Built or Replacement or No)
                        . {14*6 /l H~.r..t ~1 divl\,j..1t'                             ~7-C:-,,(f)-'1(.J           ft.I/,} f-(C't-(/J                 I/It      Rzh{a.cc.d     /J"{j n_e.:.i ~cl\Prfi.rµ         VitA,eA               ~   9,.(r . .4B-l8        ),/¥}       f- <c - ~ - f 13           Nit       fltPUt<.t.J    ,v,4-0 Rt.p{a.u.. (1J.b,f 6< dwin'Uv/ /µ. /)),y (i)<<J ....
7. Description of Work ~_,,r--~-~~----'-'-'"l"vf--'~~-,,~~-..,f---~~-.... ti 2-1.lt..u.~-------------
a. Tests Conducted: Hydrostatic ~ Pneumatic D . Nominal Operating Pressure D OtherD Pressure {~Sf>, e<.s:tlpsi TestTemp. N()1 °F "2;~ 'f>i ..... ~:J.,(

NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is 8% in. x 11 in., (2) informa-tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form. (12/82) This Form (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017

FORM NIS-2 (Back)

9. Remarks _,,,_P_-_v_.__B~i::_1~,~'~(iS~)'-'lf-1----------------------

Applicable Manufacturer's Data Reports to be attached CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this e.< bllJ.d"'.t>:---f conforms to the rules of the ASME Code, Section XI. repa'ir 6r replacement Type Code Symbol S t a m p _ ~ - / . l ~ - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - _ _ _ _ _ _ _ _ _ Expiration Date _ _,._/v-'-'-'lf'-------------- Certificate of Authorization No. _ _ _ __,..,_.__J-' Signed 0£~ .Z-.J'£ cf-u(i,e4e-,,,z.,,, Owner orOner'sDesignee, Title Date _ _,_Ifa,:_~__._1--'c.f:,__ _ _ _ _ _ , 19 '? O CERTIFICATE OF INSERVICE INSPECTION I, the undersigne~, hol,ding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State or Province of V~ and employed by /-1 S ,:3 .l:* r: C O* of o..r- l d have inspected the components described I l-* ).1. .. ! , to ~ - \. i" "\ 1. , and state that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report.in accordance with the requirements of the ASME Code, Section XI. By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspection.

  -------+-"(i,,,__~~~j___,,

Inspector's Signature

                                              ~==----Commissions----"<----'JCL~*~SL-t_,___3_ _ __

National Board, State, Province, and Endorsements Date_ _ _ _.,__/-"-'J._-_1_'1_ _19 'J l:\

FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI

1. Owner Virginia Electric and Power Co.

Name Date 11.&.bo 5000 Dominion Blvd., Glen Allen, VA Address Sheet L. of 23060

2. Plant Surry Power Station Unit O.v .c Name I/  ?.s-1/

P.O. Box 315, Surry, VA 23883 4w/, /?'~-1t/f' tdtJ 3K'()IJ)(199~~..,e Address Repair OrgaAization P.O. No., Job No., etc. ,l../,ho

3. Work Performed by Virginia Power Type Code Symbol Stamp~N_,_,_/A~--------

Name Authorization No._~N~/~A~---------- P.O. Box 315, Surry, VA 23883 Expiration Date _ __.N-'-'--'A,.,___ _ _ _ _ _ _ _ __ Address

4. Identification of System _....;C,__,o,,.,N:..:..<t:"""A=~~=,4,ti<IL""v=f" ,

_ _,~=-</>.-'~""CCL~-t'-------------------------

5. (a) Applicable Construction Code B31.1 19...QL__Edition,-~N_,_,_/A~_ _ _ Addenda,N-l N- 7 Code Case (b) Applicable Edition of Section XI Utilized for Repairs or Replacements 19 80W80
6. Identification of Components Repaired or Replaced and Replacement Components ASME Code National Repaired, Stamped Name of Name of Manufacturer Board Other Year Replaced, (Yes Component Manufacturer Serial No. No. Identification Built or Replacement or No)

(:Ja,v111.Er {:ftu.r.5 ~~.,.;,11. .£.,,u. {!HUH ,l~L,J,jt. j)~~! _, A ....

                                             , fN~               46 ~,,;_               ,,y_h        /-e S-/~           q ;{,t'J        /),I<. ~
                                                                                                                                            ,        -     /V1J
8. Tests Conducted: Hydrostatic D Pneumatic ff Nominal Operating Pressure D Other D Pressure 1 r psi Test Temp. 4#6 ,E,t t'. ° F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is 8% in. x 11 in., (2) informa-tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form.

(12/82) This Form (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017

                                                                                                                                                                         /

CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this ,,fk~&,,,,l:A(T conforms to the rules of the ASME Code, Section XI. repair or replacement Type Code Symbol S t a m P - - ~ + - ' - ~ - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Certificate of Authorization No. ___ N~/_A_ _ _ _ _ _ _ _ _ _ _ _ Expiration Date __Nc..:. . . .;:A_;;___ _ _ _ _ _ _ _ _ _ __ Signed _ _,(}_,,___-_('.~*~}_-~~*_ ---k=-.-;-S.=2~,..---~6~M'""~,_.,=v~*¢_'L.-~......_- Date-~P~....

                                                                                                          =7 ='-~*~/~b _ _ _ _ _ , 19    2tJ Owner or O w ~ e e , Title CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State or Province of VA                                    and employed by         HSBI&I Co.                                                         of
                      µ..._v-.,.. F., ... J I et                                                       have inspected the components. described in this Owner's Report during the period _ _ _ _ _~l~A~'~2.~1_-~K~'f~--to--1~-~i~l~--Cf~:J..______ , and state. that to the best of my knowledge and belief, the Owner has performe*d examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section XI.

By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspection. ___(2,.,__.""ll~==>,' "w~~-,,.l~--...d,....,~"'--------Commissions _ ins;;ector's Sigrrat~ _,V'-'A_._.,,,Sc.::4u3"------------------ National Board, State, Province, and Endorsements Date _ _ _~(-"~'--~---'-I.L../_ _ _19 ';,()

FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI

1. Owner Virginia Electric and Power Co. Date __;).ez_::.fc=.!..*...,2-=---,..-Ll~2r:.....Lf_,,,t}~------

Name I 5000 Dominion Blvd., Glen Allen, VA Address 23060

2. Plant Surry Power Station Name Unit C2v P.O. Box 315, Surry, VA 23883 ]>(!., f0-3 0 Address Repair Organization P.O. No., Job No., ate.
3. Work Performed by Virginia Power Type Code Symbol Stamp ......,N~(A...._________

Name Authorization No. _ __,_N.,_/'--'A....__ _ _ _ _ _ _ _ __ P.O. Box 315, Surry, VA 23883 Expiration Date _ _...,N"'"'"'A,_,__ _ _ _ _ _ _ _ __ Address

                                                                                             ..'--'/4'---"'"'~"'t,/."'"'"'"-'-'~"----c
4. Identification of System ........,C..___,..,i',l,C-,!-.=<..Dute>C-d-..~c..o&.-~.4""'*"-'v=-J .....;,e.=.l'V.c.,'J?.:..,~c:,""---~----------------
5. (a) Applicable Construction Code B31. 1 19..QL_Edition,_-'N'-!..l-/.,_A.___ _ _ Addenda,N- l N- 7 Code Casa (bl Applicable Edition of Section XI Utilized for Repairs or Replacements 19 80W80
6. Identification of Components Repaired or Replaced and Replacement Components ASME Code National Repaired, Stamped Name of Name of Manufacturer Board Other Year Replaced, (Yes Component Manufacturer Serial No. No. Identification Built or Replacement or No)
                                                                         /JOrf' ~Of'l/j-
 ~Ad,      1/,f,,_ ve?    llk_AAJ                                              /,l/115                        J/t                    J-C/.J-4.s'"J..,. rvyy                ~.I~    ~  - rr   #~
8. Tests Conducted: Hydrostatic B"" Pneumatic D Nominal Operating Pressure D Other D Pressure ).5-0 psi Test Temp./?,<,./),.!# r °F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is 8% in. x 11 in., (2) informa-tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form.

(12/82) This Form (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017

                                                                                                                                                                                                     /

FORM NIS-2 (Back)

9. Remarks _.,._j>-'Q""--#------'/--'-?."',6....,.0'""",J.~6------------------------

Applicable Manufacturer's Data Reports to be attached CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this b)e,~;,&Y'conforms to the rules of the ASME Code, Section XI.

  • repair or replacement Type Code Symbol Stamp _ __...,_,_.__.__ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
                                      - - ~ - - - - - - - - - - - - E x p i r a t i o n Date __N~/_A_ _ _ _ _ _ _ _ _ _ _ __

Signed_~z.-:J.~M.'J?.l:,{,U._ ___,!_~~=------~:.fr".-g_.t_~:V.~°eU,~~~.c:__ _ Date _~).~:.tc,~,___,L--~-----, 19 s;? G) CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State or Province of VA and employed by HS BI &I CO . of 1-l et.II'+ fo ..J J e, have inspected the components described in this Owner's Report during the period f1-a,1J.-9>Cf to 1* j..1.-'\'k , and state that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section XI. By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspection. _ ___.Q__,_~~--' 1

                             -:---::'51-f-*_,,_d nspector's Signature
                                              . ~'----==---'-'=--Commissions_V-'--'--'A----"'-5""-"'-43 National Board, State, Province, and Endorsements Date_ _ _ _           ~f~i_-~1_~__19           f/0
  • FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI
1. Owner Virginia Electric and Power Co. Date _ .... z=.,_h_.%'-O"------------

f..ccZ.=/z-'-'. Name 5000 Dominion Blvd., Glen Allen, VA Address Sheet I of_~----------

                                                                                    *23060'
2. Plant Surry Power Station Unit 0,,.,,~

Name J.,/~ P.O. Box 315, Surry, VA 23883 ~~wb )c 8")-.Jo Address Repair Organization P.O. No., Job No., etc.

3. Work Performed by Virginia Power Type Code Symbol Stamp~N-'-'-'/A~--------

Name Authorization No. -~N..,/~A~---------- P.O. Box 315, Surry, VA 23883 Expiration Date _ _~ N ~ A ~ - - - - - - - - - - Address

4. Identification of System _G-==::&'"'et.L#-Ji.r.._.~=~"-',?.~!M==--~e......-~--=o,to:.U.=:rl'L.~=-_,,C,_.,""~~~""""""L....____________________
5. (a) Applicable Construction Code B31.1 19..QL__Edition,-~N~/~A~_ _ _ Addenda,N-1 N- 7 Code Case (b) Applicable Edition of Section XI Utilized for Repairs or Replacements 19 80W80
6. Identification of Components Repaired or Replaced and Replacement Components ASME Code National Repaired, Stamped Name of Name of Manufacturer Board Other Year Replaced, (Yes Component Manufacturer Serial No. No. Identification Built or Replacement or No)
7. Description of Work _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
8. Tests Conducted: Hydrostatic ~neumatic D Nominal Operating Pressure D Other D Pressure ?rt2 psi Test Temp. AR61i,;t/ r °F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is 8% in. x 11 in., (2) informa-tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form.

(12/82) This Form (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017

FORM NIS-2 (Back) CERTIFICATE OF COMPLIANCE We certify that the statements made in the .report are correct.and this . R . f ; > ~ r-conforms to the rules of the ASME Code, Section XI.

  • repair or replacement Type Code Symbol Stamp _ __._,_,_....__ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __

Certificate of Authorization No. ___ N~/_A____________ Expiration Date __N~/_A_____________ Signed (21( ~ 4-- Owner o ~ r ' s Designee, Title

                                         .L.f"'f                                   Date~A~~~C=*-L~------, 19                   9a CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State or Province of VA                               and employed by     HSBI&I Co.                                                        of

~H.._,_,.(L...,._\t_:t.......6~a"-"-"-'J=-Jl--"C~f-____--=-_ _ _ _ _ _ _ _ have inspected the components described in this Owner's Report during ~.he period 11- :J. 3:

  • 8"'f to_i~--:J.~i~--j~L,-=------, and state that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section XI.

By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspection. n ft Ji ---~~~--_..,.f,_._~~-----Commissions VA 543 Inspector's Signature National Board, State, Province, and Endorsements Date_ _ _ _ _~( .y..,._..,-.,___19 ro

  • FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI
1. Owner Virginia Electric and Power Co. Date_....,.M'"-"'-'-'CQ.,/-"-'-=.z_~;:i-.*........._I.L..2.L..~...;;c.o_ _ _ _ __

Name 7 5000 Dominion Blvd., Glen Allen, VA Address 23060

2. Plant Surry Power Station Unit 0µ£ Name P.O. Box 315, Surry, VA 23883 /a,J,t, ?"'1-.JJ)

Address Repair Organization P.O. No., Job No., etc.

3. Work Performed by Virginia Power Type Code Symbol Stamp___;N-'-'-'/A,_,__ _ _ _ _ _ __

Name Authorization No. _ ___,_N.,_/'-'A'-'------------ P.O. Box 315, Surry, VA 23883 Expiration Date _ _....,N.u....A,_,__ _ _ _ _ _ _ _ __ Address

                             ~,
4. Identification of System ~1(. h-E,t.hUA>-n1!"4
5. (a} Applicable Construction Code B31.1 19~Edition,_....,N.u....(A,_,___ _ _ Addenda,N-1 N-7 Code Case (b) Applicable Edition of Section XI Utilized for Repairs or Replacements 19 80W80
6. Identification of Components Repaired or Replaced and Replacement Components
  • Name of Component Name of Manufacturer Manufacturer Serial No.

National Board No. Other Identification Year Built Repaired, Replaced, ASME Code Stamped (Yes or Replacement . or No)

                                                        ...'-"11'.<'-'~=.....X:e.._....,~=~:...;L.J_.....ds:=..a
7. Description of Work~~-=-.,,=-:),_..~==..__-"'0_.,~:...~ ~..,,.,=.,~=~~~J_..,;.A~;~p."""'""~e:::.,6...__

T?

8. Tests Conducted: Hydrostatic ~neumatic D Nominal Operating Pressure D Other D Pressure /ti 2,S': psi Test Temp. /~ °F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is 8% in. x 11 in., (2) informa-tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form .
  • (12/82) This Form (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017

FORM NIS-2 (Back) CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this 4?~""4conforms to the rules of the ASME Code, Section XI. repair or replacement Type Code Symbol Stamp _ _~ + - ' - ~ - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Certificate of Authorization No. ___ N~/_A____________ Expiration Date __N:..c...t..-=A-=-------------- s;go,a t/2~. T;"~=- Date-~A4!~~,/.~,~.Z.~Z-----, 19 ?a CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State or Province of VA and employed by HSBI &I Co. of l+/-"-r-t- fo.,.J. 1 e_ +/- have inspected the components described in this Owner's Report during the period r ~' '- :l.~ 2f q to .1- '.). 'l.. ~Cf~ , and state that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirnments of the ASME Code, Section )<I. By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspection.


1~1-"<--"----><----'~--'f"----,---:::-:--~---------Commissions _ _,V'-'A..,___,,Sc....4...,3~---~--------~---

lnspector's Signature National Board, State, Province, and Endors*ements Date_ _ _ _ _./_,_/_--'"'~-*7.,____19 'f6

FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI

1. Owner Virginia Electric and Power Co. Date _ _ /,~Y4'-"~=-/-+-~---='7_ _ _ _ __

Name . ' 5000 Dominion Blvd., Glen Allen, VA

  • Address Sheet I of--L----------

23060

2. Plant Surry Power Station Unit _..,,,t)'-',J/,:.::.......:£=---------------

Name P.O. Box 315, Surry, VA 23883 Address Repair Organization P.O. No., Job No., etc.

3. Work Performed by Virginia Power Type Code Symbol Stamp__,N~/,..,A,___ _ _ _ _ _ __

Name Authorization No. _ __,_N.,_,/wA._.__ _ _ _ _ _ _ _ __ P.O. Box 315, Surry, VA 23883 Expiration Date _ _. . ,.N.e.J. -'A,._,___ _ _ _ _ _ _ _ __ Address 4 . Identification of System 46, *H-Zrllddd£-

 . 5. (a) Applicable Construction Code          B31 , 1          19 _Q_L__ Edition, _ _,N~(A,._,__ _ _ Addenda,N-1                 N- 7      Code Case (b) Applicable Edition of Section XI Utilized for Repairs or Replacements 19 80W80
6. Identification of Components Repaired or Replaced and Replacement Components
  • Name of Component Name of Manufacturer Manufacturer Serial No.

National Board No. Other Identification Year Built Repaired, Replaced, ASME Code Stamped (Yes or Replacement or No)

7. Description of W o r k - - - - - - - - - - - - - - - - - - - - - - ' - - - - - - - - - - - - - - - - - - -
8. Tests Conducted: Hydrostatic ~neumatic O Nominal Operating Pressure 0 Other O Pressure /~7"]""' psi Test Temp. /L!J °F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is 8% in. x 11 in., (2) informa-tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form.

(12/82) This Form (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017

2. ' ,

3., CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this ASME Code, Section XI. 4>~~ repair or replacement conforms to the rules of the Type Code Symbol Stamp _ _~ . , . . . . . ~ - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Certificate of Authorization No. ___ N_:__/_A____________ Expiration Date _ _N_,_/-'A-'-------------- s;goed filtw~, CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State orProvinceof VA andemployedby HSBI&I Co. of Ha..~ 1 Eo r-d 1 et have i~ected the components described in this Owner's Report during the period ( ~' ~ - ~~ to ~- ~ 'l "": 'l.- , and state that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report i_n accordance with t_he requirements of the ASME Code, Section XI. By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspecti~ I ~ Commissions _...,Vc...A..,___,,,S'-4...,3"------------------ Inspector's Signature National Board, State, Province, and Endorsements Date,_ ___,_/_,_(_- --"~'--J__.__ _19 qD

FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI Virginia. Electric and Power Co. I .......z=z~~""'Ob.<------

1. Owner Date-----.,/i<+-'l+-/
                                                                                                                    '                    I Name 5000 Dominion Blvd., Glen Allen, VA                                                                 Sheet _ _~~--of_~,/_ _ _ _ _ _ _ _ _ __

Address

  • 23060
2. Plant Surry Power Station Unit _ _&---'~-'~=--*--------------

Name P.O. Box 315, Surry, VA Address 23883 tEal~ ?9-J)) Repair Organization P.O. No., Job No., etc.

3. Work Performed by Virginia Power Type Code Symbol Stamp~N_,__/'--'A~--------

Name Authorization No. -~N.,_../~A~---------- P.O. Box 315, Surry, VA 23883 Expiration Date _ _~ N ~ A ~ - - - - - - - - - - Address

4. Identification of System_~A~~u~x_ _,F--h~*_;.r.~~~""""'4=id,..._rt.:,o--------------------------
5. (a) Applicable Construction Code B31.1 19_QL__Edition,_~N-'-'--'/A~_ _ _ Addenda,N-1 N- 7 Code Case (b) Applicable Edition of Section XI Utilized for Repairs or Replacements 19 80W80
6. Identification of Components Repaired or Replaced and Replacement Components ASME Code National Repaired, Stamped Name of Name of Manufacturer Board Other Year Replaced, (Yes Component Manufacturer Serial No. No. Identification Built or Replacement . or No)
                                                         ...~v..c9..::"""'----"A~~=~"--c..~=u.o.c=:L..~~)L--~P==-*CF-ACL:.,::L>,~~.ef'...____________
                          ~
7. Description of Work___.}:'---""'r}'"",,_""'~~----'0i<<~u.~

T7

8. Tests Conducted: Hydrostatic ~eumatic D Nominal Operating Pressure D Other O Pressure L'/""z,C psi Test Temp. /2-(J °F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is 8Y:z in. x 11 in., (2) informa-tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form.

(12/82) This Form (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017

9. Remarks )o #c.ry-/?Y9llt);

2.. ., 19" jc,r(;'?}/ "

            ,I      'I          J CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this&M~..vr: conforms to the rules of the ASME Code, Section XI.                                                                                    repfui.c;r replacement Type Code Symbol Stamp _ _.....,,,,_._,_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __

Certificate of Authorization No. _ _N~/_A_ _ _ _ _ _ _ _ _ _ _ Expiration Date __N~/_A_ _ _ _ _ _ _ _ _ _ __ SignedQ~ Owner orOwn'DesiQnee,Titf e CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State or Province of VA and employed by HSBI&I Co. of Ha.'r-TE<:>rd I ef- have inspected the components described in this Owner's Report during the period - I~- ~ ~ -1 O to 1- ~ ~ - q 9- , and state that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section XI. By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this i-n-sp_e_c_t-io-n--'.~.___..,_-=--*--'---'-----'fL...C.._~=--=--=..::::.._.:....c._ _ _ _ commissions_~V~A~=S_4~3~---------------- f nspector's Signature National Board, State, Province, and Endorsements Date _ _ ___..{--'--/--_...~'--7-'--__19 , C/Q

FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI

1. Owner __v.,,_,.I"'R,..,,G,..I.._N
                                    ......I""A....__,.E..,r.......

E.,,C,..T~R~I~c........,A,..N...,n~""P.,_a,.,_wp;....,_,R,.__,.,r..,_o.___ Name Date--><~--<-/....:.....>/ 3,<......,,,-....J.<....1.<0'------- 5000 DOMINION BLVD,, GLEN ALLEN, VA 23060 Sheet _ _....,/:....__of_--'-/_ _ _ _ _ _ _ _ __ Address

2. Plant SURRY POWER STATION Unit*--°'=-:..:c,v..:..,,,t-,:,__ _ _ _ _ _ _ _ _ _ _ __

Name P.O. BOX 315, SURRY, VA 23883 tdo # JYOOQ973.f"6 Address Repair Organization P.O. No., Job No., etc.

3. Work Performed by VIRGINIA POWER Type Code Symbol Stamp _---=N_,_./""A....__ _ _ _ _ __

Name Authorization No. __,N,.,_._/.,_,A,___ _ _ _ _ _ _ _ __ P.O. BOX 315, SURRY, VA 23883 Expiration Date_-"N,.,/c..A~----------- Address

4. Identification of System c?o"'7~e>,u<'(-Nt G041';t$'

5, (a) Applicable Construction Code B3l, l 19....6..:Z_Edition,--1N"-,£.../.,_ii._ _ _ _ Addenda, N-] , N-7 Code Case (bl Applicable Edition of Section XI Utilized for Repairs or Replacements 19 /r0tu8'0

  • 6. Identification of Components Repaired or Replaced and Replacement Components Name of Name of Manufacturer National Board Other Year Repaired, Replaced, ASME Code Stamped (Yes Component Manufacturer Serial No. No, Identification Built or Replacement or No)
    /1A.J,.,.d" Ao~ TJ I
                                                       -=-----                             -                                   )II;       1-c.~-~-/e                        ....         ..t:>.e..'- -~

I e,.. J .VO

                                      ~'" 6                               .
 \.A-'A'u-,,..,._..,
                      .fu.rl           ,ff,-/Q 1¢bt.tp& Il'lt. J'!/ iJtJ                                                     .NIA           1-cc.- c-1c..                    /9 lf'1   )l . , \     .  -
                                                                                                                                                                                                               ,r   ,II/(!)
8. Tests Conducted: Hydrostatic D Pneumatic D Nominal Operating Pressure D Other D Pressure _ _ _ _ _ psi Test Temp. °F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is BX. in. x 11 in., (2) informa-tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form.

(12/82) This Form (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017

FORM NIS-2 (Back)

9. Remarks _....,_'l>-J.o.C--/;t:.------'C ......5""'-J../'---'2"'---L--'9Z=-....L..~So<C.2...C...r__,C~,)_ _ _ _ _ _ _ _ _ _ _ __

I Applicable Manufacturer's Data Reports to be attached CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this "24)~~&~orms to the rules of the ASME Code, Section XI. repair or replacement Type Code Symbol Stamp _ _ _Na,.L..,_A.__ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ Certificate of Authorization No. - -......~ - - - - - - - - - - - E x p i r a t i o n Date __N = / ~ A ~ - - - - - - - - - - - - Signed~(]~~-;;(.~:~ /_'Ft.,...,-£_.;.--::=-* Owner ~ e s i g n e e , Title

                                                                                =:-:----------Date                                       de                               , 19  Pa CERTIFICATE OF INSERVICE INSPECTION I, t_he undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel l~spectors and the State or Province of                                                                       and employed by HSBI & I CO.                                                                    of
  -'H=A..._R,..T._F.....,.Ou.R.,.D....,.,__,C,._T,.___ _ _ _ _ _ _ _ _ _ _ _ _ ____,,--.......,,,....,.---=----have inspected the components described in this Owner's Report during the period                                                                           I~-    !ij- n to      I ').- !>-,l-- 'j :J-..      '  and state that to the best- of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section XI.

By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspection. (LW f ~- Commissions--~~~Ct,~-- ~S,_l.(-~-_3_*__________ Inspector's Signature National Board, State, Province, and Endorsements Date

           ------~-~----                 8-/(                                    199 {)

FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI

1. Owner __V.:,. , ,...

I R,.,G...... I...,N'"'I_.A.._.E..,.I...,,...,E..,.C..,T..R,..I.._C..__.JCA....N...D.,___.. P....P'""WE c....a......_

                                                                                                                  ........R..._...                  Date_-=-7J_,;(c...,,.-=-/_,_~-L......:;8:.___ _ _ __

Name 5000 DOMINION BLVD., GLEN ALLEN, YA 23060 Sheet I of_.:..!_* _ _ _ _ _ __ Address

2. Plant SURRY POWER STATTON Unit___,,@..,-
.,Mo::;~"--------------

Name P.O. BOX 315, SURRY. YA 23883 Address Repair Organization P.O. No., Job No., etc.

3. Work Performed by VIRGINIA PQWER Type Code Symbol Stamp _ ___,N,_,/..,A....__ _ _ _ _ __

Name Authorization No. ---'NS!.£../,::,A,.___ _ _ _ _ _ _ _ __ P.O. BOX 315. SURRY, YA 23883 Expiration Date _ _.N,.,_,A...___ _ _ _ _ _ _ _ _ __ Address

4. Identification of System_... 5,=.;...,e""-'l_tC-_&_ __.u~J~,.., '4<..L.(.l..C.;.£..,=c... _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
5. (a) Applicable Construction Code B3l, l 19...6.L_ Edition, N (A Addenda, N-l
  • N-7 Code Case (b) Applicable Edition of Section XI Utilized for Repairs or Replacements 19 Va r.l Yo
6. Identification of Components Repaired or Replaced and Replacement Components ASME Code National Repaired, Stamped Name of Name of Manufacturer Board Other Year Replaced, (Yes Component Manufacturer Serial No. No. Identification Built or Replacement or No)
                                                                                                                                                                                                                          )I (I
7. Description of Work_......,.._,_.,._.uc,cc..z............_-5~,_-~J...s"--~k=----"'d.._.,,,w,,_,,<-rS ....._

__::~;.:M:::....:'.?::;_...eff.C.L...£.r-_~#CL._Lzz,~&".L.CG=-----

8. Tests Conducted: Hydrostatic O Pneumatic O Nominal Operating Pressure 0 Other O Pressure _ _ _ _ _ psi TestTemp. _ _ _ _ _°F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is SY. in. x 11 in., (2) informa-tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form.

(12/82) This Form (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017

FORM NIS-2 (Back)

9. Remarks -""~=...,,Y""'"'-~-.... 2~-f-1D~,?"-.....,G"°'"Z..=r,)_________________

t4~r,~?r-~Q.=5'""'l~y'~2.-=--6....

                                                 \~.                    Applicable Manufacturer's Dyta Reports to be attached
                                                ~rIE__         C    9/     26?.J r.r'(.4-/

CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this ,e..~~ffCt/!t<fk,C conforms to the rules of the ASME Code, Section XI. repair or replacement Type Code Symbol Stamp _ _ _N"""""..,_A.,___ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ Certificate of Authorization No*--='-""'-----------Expiration Date _ _.,N"'/..:.Ac<...._ _ _ _ _ _ _ _ _ _ __ Signed 0. ~,A___

  • Owner or O w ~
                                                                  -
  • Date_~d.,......._..,.""ef._...__,,~/-5,..-

_ _ _ _, 19 P t:1 CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State or Province of and employed by HSBI & I CO* of _.H,..A,....,R..T._.F.._0.,._,.R,.D...._.__,C~T~-------,--"""--------~-......,---=~--*--,-:- have insp~ted the i;ompoilents*. described in this Owner's Report during the. period _ _ _ _ _,_/..,.d"'----=1},....,;)......__*~S' .......

                                                                                                                   'f_to*
  • I~- !>.i, ~ 1.~ , and state that to the._best of my knowledge and beUef, _the Owner. has performed exami.nl[lti.or:is an!1*taken corrective measures described .in this ov,;~er;s R~port in accordance with the requirements of the ASME Code, Section xr.

By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall, be Uablfl _in a~Y. ma,nner for any personal injury or prpperty,damage*or a loss.of any kind arising from, or c9nnected_with this inspection.nr:+/- f.. . ~ 1

                                                                                                                               ~. SI'
   -----'~~=--=-------,--cc:---->~"""".c..-==..;::....:....__ commissions _ ____,..:.Vi...;"'-'-C,__'1.:...=--------------                   3 1nspector's Slg*~,atura                                                   National Board, State, Province, and Endorsements Date_ _                                        /h..____19

___.;.f_r...... ?tJ

FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI

                               .....r..A.....,.E.Iw.,...,E,.C'""T~R,._I""c.....""A'""ND....__p~o"'WE...,..R"--'.......
1. Owner __V.Y. J,I. :R,i,Gi!.,I~N C a.__ Date _ _,,C.1.b='..1'--6L..9=0_ _ _ _ _ _ __

Name 5000 DOMINION BLVD,. GLEN ALLEN, VA 23D60 Sheet of...:../---'---------- Address

2. Plant SURRY POWER STATION Unit_~tz~.,,_~c.:=~::....-------------

Name P.O. BOX 315, SURRY, VA 23883 Address Repair Organization P.O. No., Job No., etc.

3. Work Perfonned by VIRGINIA POWER Type Code Symbol Stamp _ __.N,.,/'-'A""--------

Name Authorization No. __,N,:.L./..,A....__ _ _ _ _ _ _ _ __ P.O. BOX 315. SURRY, VA 23883 Expiration Date_...,N,../..,A'"'------------- Address

4. Identification of System___,(!=.:.#..<..=...',t.'-",¢6"""':.<.'"'v."'4 ...* - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
5. (a) Applicable Construction Code B3 l , J 19..fi2._Edition,__.N.._,.,__/,,A_ _ _ _ Addenda, N-1, N-7 Code Case (bl Applicable Edition of Section XI Utilized for Repairs or Replacements 19 YO&tl,t'O
6. Identification of Components Repaired or Replaced and Replacement Components ASME Code National Repaired, Stamped Name of Name of Manufacturer Board Other Year Replaced, (Yes Component Manufacturer Serial No. No. Identification Built or Replacement or No)
                                                                                     'fj' 9-J.'4.!,',! C,lt Cf1"',t,,!_i          AASC.c;                                   3fi"IOIOZ..                             ,(/ t     /-C#-.!-.s".-4                  -     IJJ)~.,.-,. ~ ,.__,_    ji)
7. Description of Work_-"~--'~::2.)...:"-:::~e.<.s"'&"--'~=Vwd"""'ef-~..,O::*.L/.t.=--~=e.i't2.<.?.,,.,H--"--<"--------------------
8. Tests Conducted: Hydrostatic @ Pneumatic 0 Nominal Operating Pressure 0 Other O Pressure S:0: psi Test Temp, #o -r' °F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is 8X. in. x 11 in., (2) informa-tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this fonn.

(12/82) This Form (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017

FORM NIS-2 (Back)

                                                          ....<2"",;1>."";:;;""d-';;.:,:.tt-=--~~c...=---S-+f--...!..&:;~-.J::;;....,3<....L2_...,,C...,;/-,,.,~J_ _ _ _ _ _ _ _ _ _ __
9. Remarks _..,.!i..::!:u=d:..e,__at;,.L.<t(:&?............C Applicable Manufacturer's Data Reports to be attached CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this A~&.l'..c,1z::: conforms to the rules of the ASME Code, Section XI. repair or replacement Type Code Symbol Stamp, _ _ _. ! , : , N ' . L . ! ' . A " - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -

Certificate of Authorization No, _ _.....,.....~_ _ _ _ _ _ _ _ _ _ Expiration Date _ _,_N,../'-'A,_,______________ Signed,_""""Q.._..._---1C...._,_.-'-.=.c..,/_.._.,,6~-==73~5'--~-r- __ b~tf'-'"--_ _ _ Date_..J;,~-.e.~v~3_ _ _ _ _ , 19 5' 0 Owner or Ow~gnee, Title T CERTIFICATE OF INSERVICE INSPECTION I the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State

  ;r Province of                                                      and employed by HSBI &' i
  • CO* of
  -...Jli.:wA,.R,...T...F"-'-O"'R,..Di.u,__,C"'-"'T-----------------:::--::------=-=----have inspected the com*ponents described in this Owner's Report during the period                                                         /~- ~!l-              ?i           to_~/_:1.-~~-~---'1~9-..      _ _ _ _ _ , and state that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section XI.

By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this i-nsp-e-ct-ion-"-e""~"--"-~--::-'f'=':-~---=~-=t)-=--c,---'---Commissions_---,-~J..,...tL---=5'-'t{-;,i,..__::c:J _ _ _ _ _ _ __ Inspector's Signature National Board, State, Province, and Endorsements Date*_ _ _ _ _ _ 7_.___-_)__19 ro

FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI

1. Owner __V.i'.....,oI._..R,.,G,...I.._N.....,,I..:.A..__.E t E.,,C~T...,Ro....i.I,.C~A,..N:,uQ.,__.cP.s.D"'WE'""'"'B"--""'c.._n......__

Name Date _-...:..S-.=-<b-L-f./-.J.~..i.12L----------- 5000 DOMINION BLVD,, GLEN ALLEN, VA 23060 Sheet _ _......../ _ o f _ : . . / ~ - - - - - - - - - -

                                                        *-... Address
2. Plant SURRY POWER STATION Unit {!!t,t Name P.O. BOX 315. SURRY, VA 23883 )cS:~,v aA.v,sf 8'.2-2 2 U:1/. t12, ~/C.i' 2 Address Repair Organization P.0. No., Job No.; etc.
3. Work Performed by VIRGINIA PDWEB Type Code Symbol Stamp_......,Na.!.L./...,A.___ _ _ _ _ __

Name Authorization No. --'N,.,.._/""A.___ _ _ _ _ _ _ _ _ __ P.O. BOX 315, SURRY, YA 23883 Expiration Date _ _.N"-'-'A"'-------------- Address

4. Identification of System c$Mf,.c.,r ~/~
5. (a) Applicable Constructio~ Code B3 l, 1 19..fi.2.__ Edition, N (A Addenda, N- 1 , N-7 Code Case (b) Applicable Edition of Section XI Utilized for Repairs or Replacements 19 i'Q' W $"0
6. Identification of Components Repaired or Replaced and Replacement Components ASME Code
  • National Repaired, Stamped Name of Name of. ManufacJurer Board Other Year Replaced, (Yes Component Manufacturer Serial No. No. Identification Built or Replacement or No)

I~

~Al,A-1./        C'll.JJ("
                                                              --.                             -                               -               1-c.c .£,/)             -            Ll,, .*. ,     .vO I
       .52..
/1~,, .. , ... d NIA"ri:                                   --                               -                                -               ,/.,.,. _.,e.l',\        -           LLe,\.A.,_t!)   ,,,, "

I

7. Description of Work _ ___.R.e..=,c;:z!':.,.t'...,t!.s,~=-iC.....t:.f:_~~c....L.<:.&<<11"""'""1L&9./_ _(1.,,;;,:c...oH:.<4"t-Lr_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
                                                                                                            /
8. Tests Conducted: Hydrostatic O Pneumatic 0 Nominal Operating Pressure 0 Other 0' Pressure /II())> psi Test Temp. ;Vo T °F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is 8Ya in. x 11 in., (2) informa-tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form.

(12/82) This Form (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017

I  : '

  • CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this ##dt,t!&,!,vr conforms to the rules of the ASME Code, Section XI. repair or replacement Type Code Symbol Stamp _ _ _N ~ ~ A ~ - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -

Certificate of Authorization No. _ _.....,..._._ _ _ _ _ _ _ _ _ _ _ Expiration Date --"'N"'/...,A"'-------------- Signed t2 */: / "~ -- Owner or ~ e e , Title

                                              .Z-f_L  L,c;t;,614(,.e_         Date _~//,.~-""""'"'"l'--"-2------, 19 I'

f o CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State or Province of and employed by HSBI & I CO* of ~R~/\-E~T~f~b-*~R-P~,~C~T~------------:-:c---:---;:c----==-=-----have inspected the components described in this Owner's Report during the period---~'...~-=----~~~---~fi?~1~-to / :l- l}.1- q :J., , and state that to th*e best *of my knowledge and belief, the Owner has performed examinations and taken corrective measures*described in this Owner's Report in accordance with the requirements of the ASME Code, Section XI. By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspect~ ..fl* /O_ [) --+-~=--=---:----:-J."7""'.=:---~-------Commissions _ 1nspector's Signature __.lft,:..;a.."".,__,Y.._Y-'--'3=------------ National Board, State, Province, and Endorsements Date _ _ _ ~b_-_( g'_**_ _19_ '/lJ J

FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI

1. Owner __y......,I..,R.,.G,.I..,N.....,I..,A.....,.E;i..T.i.,E...,.C_.T,.R._I'"'c..._~A....NU
                                                                                               ......_P,._._.Q""'.......

WER"---'C...._.Q.___ Date _ _.,:_u..__l~')--,..,,&,....'()-*- - - - - - Name 5000 DOMINION BLVD.

  • GLEN ALLEN, YA 2 3 060 Sheet Address
2. Plant SURRY POWER STATTON Name Unit -~o~'d~a.,..--------------

P.O. BOX 315, SURRY. VA 23883 Address Repair Organization P.O. No., Job No., etc.

3. Work Performed by VIRGINIA PQWEB Type Code Symbol Stamp_--"N'"'/..,A""--------

Name Authorization No. ~N=/~A=------------ P.O. BOX 315. SURRY, YA 23883 Expiration D a t e _ ~ N ~ A ~ - - - - - - - - - - - Address

4. Identification of System Y~r~ @r,!L
5. (al Applicable Constructic:>n Code B3l, 1 19..6.1.._Edition,~N.-.,,..l=A---=--Addenda, N-l , N-7 Code Case (bl Applicable Edition ~f Section. XI Utilized for Repairs or Replacements 19 !l'owt()
6. Identification of Components Repaired or Replaced and Replacement Components ASME Code National Repaired, Stamped Name of Name of Manufacturer Board* Other Year Replaced, (Yes Component Manufacturer Serial No. No. Identification Built or Replacement or Nol 5-.c?,'Df/ d!et:.
         ,L - ',L                       11,;,(
                                         £,.,.,,, " ~,.~~..

J/.d.,.J t/0012.. - /-.Jw-AM~ ....._ ~.!)e A , ,._ Al d I u X2.. 1 '

             '2
                ~
                'd:~,>L.~
                   ,,               ~.,;14!,,J h~
                                                      ,                      i:             /QQ           2.r                 -           J - J t,J _,)_,;<;I             -               ...          ,'I/ 7)
8. Tests Conducted: Hydrostatic O Pneumatic 0 Nominal Operating Pressure 0 Other O Pressure #fJr' psi Test Temp. #d, °F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is BY. in. x 11 in., (21 informa*

tion in items 1 through 6 on this report is included on each sheet, and (31 each sheet is numbered and the number of sheets is recorded at the top of this form. (12/82) This Form (E00030l may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017

FORM NIS-2 (Back)

9. Remarks _ _,,S:~u~c~r..Li~~*,,,_,.,,c.._...,,d=.r.="-=.e.:..........M=-"o'-'"""v.,.,r.l'-re"'-"o'---').......:co_P-_.c..J"-,c-t/--..,,.A'-'n.""'....._r._,t;)~l'---...._.."'7""-------------

I

                            .,                                                    Appllcat,le Manufacturer's Data Reports to Pc:,#                       -        OS-.

CERTIFICATE OF COMPLIANCE We certify that the statements.made in the report are correct and this b.k.d<,,;!..,..,W conforms to the rules of the r ASME Code, Section XI. *

  • repair or replacement Type Code Symbol Stamp _ _~ N ~ = A ~ - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -

Certificate of Authorization No. _ _....,......,_ _ _ _ _ _ _ _ _ _ _ Expiration Date __N=/..,A""------------- Signed _ __.,_Q.=--*..a.J':.'"'.-/-=--=,.,1""""/."":,--:~--.,...,.-.zj__,>..~.:Z--~-~-~f~"=,.,;,~.;;-C._,<-='4--_ _ Date .....~~~Al'--i'v'--__.?_ _ _ _ _ _ , 19 9/2 Owner o r ~Designee, Title 7 CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board *of Boiler and Pressure Vessel Inspectors and the State or Province o'f and employed by HSBI & I CO* *. * *

  • of
  .....tt......A...&~T~f~P~R~P~*-C=T-----------------,--,,--------. have_ in~~e,~ed                                                                             if e components described in this Owner's Report during the period _ _ _ ___,l_'l..-_-_B,~i~-~f?_G.,_f_to                                                            I!),- !l,. ::l q             , and state that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section XI.

By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspec~tion. i. ~ /[) fl *L),, 7',-1 J*

   --i-=c-><--.a---,---:-~--:::-----------Ccimmis;ions*_-'-----'"""---'-_._.,.}_-r.,__~------------

1nspector's Signature National Board, State, Province, and Endorsements Date_ _ _ _ ~,C~--8__19 9a

FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI

1. Owner _......:1.V-I1.,R,:,.GS!..,II...N:i..I.....,A.....,.E.,_T...,.,E..,.C~T.....R~I.,.C.__.A:i.NU
                                                                                                    ......."-'Pc.,Q..,,~D.L:..cRL....JCu.D'---  Date _     _:!%'--.L!.9Yc.......,7L..-.,......_;l:.....£.JLM.=..._ _ _ _ __

Name 7 5000 DOMINION BLVD ** GLEN ALLEN. VA 23060 Sheet _ ___,,/_ of _ _;_/_ _ _ _ _ _ _ _ __ Address

2. Plant SURRY POWER STATION Name Unit _...,fJ.c.....:v.c....:::~=------..;_-------

P.O. BOX 315, SURRY. VA 23883 Address Repair Organization P.O. No., Job No., etc.

3. Work Performed by VIRGINIA POWER Type Code Symbol Stamp _ __,Na>.L-/!i2A,___ _ _ _ _ __

Name Authorization No. _N.,_.,_/..._A.,___ _ _ _ _ _ _ _ _ __ P_O. BOX 315. SURRY. VA 23883 Expiration Date_..eN,_,_,A,.,__ _ _ _ _ _ _ _ _ _ __ Address

4. Identification of System _ _h~'t!,~£~J~a/.~',9..,_./~-="bf=.c..,, ______________________________
5. (a) Applicable Construction Code B31.] 19...fi1_Edition,--JNu.+/-"A,.___ _ _ _ Addenda, N-] , N-7 Code Casa (bl Applicable Edition of Section XI Utilized for Repairs or Replacements 19 To(</ JJ6
  • 6. Identification of Components Repaired or Replaced and Replacement Components Name of Name of Manufacturer National Board Other Year Repaired, Replaced, ASME Code Stamped (Yes Component Manufacturer Serial No. No. Identification Built or Replacement or No)
    .),re.f)5                                                  ~                                             -                         -          1-~w-,l'J/'.'.'                   -                 .~.~..,- _,,_ .r;;>  /VfJ
      ~"'T.S
                                                           --                                        -                             --             ,/ . ,z *. 1_2 '")t:-,           -                             ..,,       /1/19
7. Description of Work_....£..~--'lf'?A:"-' /'-"~-'==---'/hc...<:.:.-9.£.-'~e:....:vc....=,:;.;.:::C.:___ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
8. Tests Conducted: Hydrostatic O Pneumatic O Nominal Operating Pressure 0 Other O Pressure _ _ _ _ _ psi Test Temp. °F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is SY. in. x 11 in., (2) informa-tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form.

(12/82) This Form (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017

FORM NIS-2 (Backl CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this ~)<<:&?-,c'&Z: conforms to the rules of the ASME Code, Section XI. repair or replacement Type Code Symbol Stamp _ _ _N ~ ~ A ~ - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Certificate of Authorization No. _ _...,,.'"'"'_ _ _ _ _ _ _ _ _ _ _ Expiration Date _~N~/~A=------------- Signed <i:2£ 'o2;;. Owner or

                      ./        ut.---     ~.S..Z:-

Deslgnee, Title 6.,(,uW Date__,4'4<-+~-,,,....V-2 _ _ _ _ _ _ , 19 ,/,0 CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State or Province of and employed by HSBI & I CO* of HARTFORD , CT have inspected the components described in this Owner's Report during the period i :l. * :).;J,

  • f? 1 to I '.l- 1} - '1 ;)__ and state that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section XI.

By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspection . * !1::-/J. /7)~

---GL'--'-""-=~'---:"---:-----:-~-':::-. _G~=~-------Commissions,.._ _ _ _

Inspector's Signature lfr~cc~__j~---~i_[--'---J__________ National Board, State, Province, and Endorsements Date_ _ _ _ $~~g__ 19 'fQ

FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI 1 . Owner __V~I...i;:R~G;i..I.i.N1.LLI....A,.__...E..,r,..,.E.,.C....T.._.R.,_I...,_,C--"A,..N:uD.,__.c;p_..pLICWEu:..iR>--CL..1..0L--- Date _ _.,re+~.:::.:le/CL....1.b---'jc...._O_ _ _ _ _ _ __ Name 5000 DOMINION BLVD,, GLEN ALLEN, VA 23060 Sheet _ __,/~_of...,__ _ _ _ _ _ _ _ _ __ Address

2. Plant SURRY POWER STATION Unit_..,,a.::;..L.P::....::cF_ _ _ _ _ _ _ _ _ _ _ _ __

Name P.O. BOX 315, SURRY. VA 23883 Address

3. Work Performed by VIRGINIA POWER Type Code Symbol Stamp_---"N,.,/....,A"'---------

Name Authorization No. ----'N"-'-/-"A'------------ P.O. BOX 315, SURRY, VA 23883 Expiration Date_,..,N,,;/_.A..__ _ _ _ _ _ _ _ _ __ Address

4. Identification of System C.cz14&',,;.4L. 4<¥~ ~,1. Y'.&.f (;,.,,,-~e,~
5. (a) Applicable Construction Code B31, J 19..n1.._Edition,__,N.,.,,t--l,,,A_ _ _ _ Addenda, N-1, N 7 Code Case (b) Applicable Edition of Section XI Utilized for Repairs or Replacements 19 _ _ __
6. Identification of Components Repaired or Replaced and Replacement Components ASME Code National Repaired, Stamped Name of Name of Manufacturer Board Other Year Replaced, (Yes Component Manufacturer Serial No. No. Identification Built or Replacement or No)
                                                                                                                                               / - (! II- ,llfe} / -

Sr. .;5' - .._, - IZ. 67/? - ,c'.,!1~ ..... ~ ...,l A/(3

    /Ve,;r)                                  -                                              --                          -                     /-(!,'f- ~ D p -
                                                                                                                                                  /,U,"7A                                     -         .A ~ L       *.   .e,j   A/7J
8. Tests Conducted: Hydrostatic O Pneumatic O Nominal Operating Pressure 0 Other O Pressure _ _ _ _ _ psi Test Temp. °F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is BY. in. x 11 in., (2) informa-tion in items 1 through 6 on this repo" is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form.

(12/82) This Form (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017

FORM NIS-2 (Back) Applicable Manufacturer's Data Reports to be attached CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this &.t>e,;4&/,'N'/fC conforms to the rules of the ASME Code, Section XI. rep~ir or replacement Type Code Symbol Stamp, _ _ _. . , N ' L - O A " ' - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Certificate of Authorization N o * - - = = ~ - - - - - - - - - - Expiration Date-~N,../""A...__ _ _ _ _ _ _ _ _ _ __ Signed,---'Q"-' ~ '11:_q.. =. . _~~*-*=-~- :. .___ 6w;er ~ Q n e e , Title

                                                    . .-                   ~..zJ~r:z:~~~--6~,v.~<4'.~,-- Date _ _A'--'-,Fe.4./~'-=*-"'-L."'"y_ _ _ , 19 7

2 t:I CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid *~ommission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State or Province of

  • and employed by HSB I & I CO* of HARTFORD , CT have inspected the components described in *this Owner's Report during the period ( 'J. f i (l_ / §' J to I 9. / 1 .1-( 9 ds. *; and state that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section XI.

By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this i_n_sp_ec--tio+~-"*~*'~'-'-'-:-_;t-_,___,£....,,.-'-'- .....-..* ._._.

                                                                     ~   ~*,,..,-'-'"----Commissions_-:---:-',U"-':'a~*..,5=-£/_,_..;3~------,-----

lnspector's Signature National Board, Statfl, Province, and Endorsements Date*_ _ _ vf..._-....~'--tf....___19 '/0

FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI

1. Owner :LIRGINIA ELECTRIC AND PONEB co Date Name 5000 DOMINION BLVD., GLEN ALLEN, YA 23060
  • Sheet _ _..,;/__ o f _ - + - - - - - - - - - - - -

Address

2. Plant SURRY POWER STATION Unit --'°'=-<',0=c.",________________

Name P.O. BOX 315. SUR.RY. YA 23883 Address Repair Organization P.O. No., Job No., etc.

3. Work Performed by VIRGINIA PQWEB Type Code Symbol Stamp _ __,N,../'--'A"'---------

Name Authorization No. _N.,_.,_/.._A.____________ P.O. BOX 315, SURRY, YA 23883 Expiration Date _ _.N'-'-'A=------------- Address

4. Identification of System _.....,~=,..6.,~e.,'"/"::...;'Gc..,:.d?<<.#=._.i.C=,4-1t:""'"'"-"ld~V=,t'<:.
5. (a) Applicable Construction Code __.,.B_3._..1...._ * ..,]___ 19..6..]__Edition,-N...,.l.cA..__ _ _ _ Addenda, N-1, N 7 Code Case (b) Applicable Edition of Section XI Utilized for Repairs or Replacements 19 _ _ __
6. Identification of Components Repaired or Replaced and Replacement Components ASME Code National Repaired, Stamped Name of Name of Manufacturer Board Other Year Replaced, (Yes Component Manufacturer Serial No. No, Identification Built or Replacement or No)
                                                                                                -           1~ /2c.-n,t1-1c~~L A         --      k?c.e>e .At,:.ZJ S'T"u:li<:                                                                                                                                   I                      ~m NtAr.s                        -                                   -                         -           11-f.l.,,~u,   .,_,.<'.'.-.;A         /J.J-~, ...... L.\

7 Aid

7. Description of Work _ __,.Q.c..:~c.,U=c,M""~:.uV"-..,l.-'--...:,/}....:;;:9""-e.:..;.:.,/--'tf'=--------------------------
8. Tests Conducted: Hydrostatic ~Pneumatic 0 Nominal Operating Pressure 0 Other O Pressure 23 /6 psi Test Temp, '12
                                                                                                            .f"               °F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is SY. in. x 11 in., (2) informa-tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of th is form.

(12/82) This Form (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017

CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this ,ec),;4cd".,,..tvrconforms to the rules of the ASME Code, Section XI. repair or replacement Type Code Symbol Stamp _ _~N~=A~------------------~------------- Certificate of Authorization No. --=...,...___________ Expiration Date __N=/...,A"--------------- Signed_() ____.~~....c.L.*~-=r'l--'c...-.----..L--S--==;r---£._~;;.,1~~~----Date~A'-"->")'-'"2-----'-',.t!.=*_.d.="-f'~---, 19 211 Owner or ~ e , Title / CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State or Province of and employed by HSBI & I CO* of HARTFORD << CT have inspected the components described in this Owner's Report during the period 11/ !l ~ I 2 9 to I 'J-, I f1 ~ I '1 Q...... and state that to the best of my knowledge and belief, the Owner has perf:.J:d examinations and ;aken c~rrective measures ~escribed in this Owner's Report in accordance with the requirements of the ASME Code, Section XI. By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspection.

--f-'Q""'"--~-':--~f~.{3~,&_-1--_commissions_lft_o..-=-St-f-=]_ _ __

ins;;ector*s Signature National Board, State, Province, and Endorsements Date_ _ --'l-f..__-_;;._4~___19 <J 0

FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI

1. Owner __V,.__.I. ,R.,.G...I.._.N.,_I.. .,A. ._. .E. ,r....,E.._C.._.T,.,B..I..,c_"'A..,N...n.__.pc..,Q..._WE
                                                                                                           .........R.._.c...a....___     Date _ __._,..,_f_,_/_,_1f"~,_;;_,9_tJ_________

Name 5000 DOMINION BLVD,. GLEN ALLEN, VA 23060 Sheet_.,--..,___of_....__ _ _ _ _ _ _ _ __ Address

2. Plant SURRY POWER STATION Unit _ _a=--&:~,!-~-------------

Name P.O. BOX 315, SURRY. VA 23683 Address Repa_lr Organization P.O. No., Job No., etc.

3. Work Performed by VIRGINIA PQWER Type Code Symbol Stamp _ ___,.N,../'---'A._.___ _ _ _ _ __

Name Authorization No.----'N'-'-"'-/""A'------------ P.O. BOX 315. SURRY, VA 23883 Expiration D a t e _ = N ~ A ~ - - - - - - - - - - - Address

4. Identification of S y s t e m - , - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
5. (al Applicable Construction Code B3l. l 19..fi2.__Edition, N/A Addenda, N-l , N-7 Code Case (bl Applicable Edition of Section XI Utilized for Repairs or Replacements 19 Po tA.IFO
6. Identification of Components Repaired or Replaced and Replacement Components ASME Code National Repaired, Stamped Name of Name of Manufacturer Board Other Year Replaced, (Yes Component Manufacturer Serial No. No. Identification Built or Replacement or No) 5;... J., .,J.!0,:r_;
                                                                                              -                                    ~

_h.,,.,,11,L -- Jb->... A-.J,} /VO

  <:;,,.u~(' ./, d-r-s                         -                                           -                                      ~

h.d;,1&1!

                                                                                                                                                                       ~

A"l,.,.,,!J ,iv{) Sru)<" .J. M,,0 - - - 1'.en.,4,c! - A~-:a,lo NO

7. Description of Work e~,)?44 c; c- 5 r u/> 3 ; ,I(/u ['3'
8. Tests Conducted: Hydrostatic O Pneumatic 0 Nominal Operating Pressure ~

Other O Pressure #dJ.,,V psi Test Temp. 11/o t: °F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1 l size is SY. in. x 11 in., (2l informa-tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form. (12/82) This Form (E00030l may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017

CERTIFICATE OF COMPLIANCE We cenify that the statements made in the repon are correct and this ,A?.,.e)~ conforms to the rules of the ASME Code, Section XI. repair or replacement Type Code Symbol Stamp _ _ _N ~ - A - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Cenificate of Authorization No. _ _.....,.'-""'-----------Expiration Date _"""""'N"'/_.A ......____________ Signed---=:Q~_-...,./........,-1,~/_~~~"':,<'d""#=-"---:,.,...,...--'fi::.c_...,.Se..'£=-__,b=<<=';vtf:,r....~---Date _ _~~,,.""'"""'"',t;t.'""'c..,,~r'.__~/.~f---, 19 £Q Owner;.O~eslgnee, Title CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State or Province of and employed by HSBI & I CO* of __.Hu.cA...&._T._F....,.O,..R,.D......,,---'C....,.T_ _ _ _ _ _ _ _ _ _ _ _ _'l"":."_T""-=-----==.----have inspected the components described in'this ow*ri~r's Repon during th~ pericid_._ _ _~/~l._,_.,,,~1-_-_Jf~T~-to '1-il-9.L . and state that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Repon in accordance with the requirements of the ASME Code, Section XI. By _signing this cenificate neither _t~e Inspector nor his employer makes any warranty, expressed or implied, concerning the exa~ina1:ioris and corrective measures *described in this Owner's Report. Funhermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or propeny damage or a loss of any kind arising from or connected with this inspection.

        --i-~~---"--'iiF-f._~                      Inspector's Signature

___ commissions_..........,..l/~=-2......._._Y:--"--3_ __ National Board, State, Province, and Endorsements Date_ _ _ _ * '.'.J~-~/_:/.__19 9°()

                                                                   -***-*--~----
                                                                    * ,* ' *,*, '~,; * . : , I
                                                                                               -                         * ,. t  . : **** --;.**.J.-*, ..*: :*-*.****

FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI

                                                    ...r.,.,...E..,,C~T...,R.........
1. Owner __V.:,....I,...R.,G"'I.._N.,...,.I..A...__E r c----"A...N,,..D.,_,._p_..p...WE
                                                                                                                .......R.,,_...

c ...a.__ Date_..,,&~=.,.e..,p;""-"-'7'--'/'-'.S-,....,_l,._9.,_'1-=IJ_ _ _ _ _ _ __ Name 7 5000 DOMINION BLVD,. GLEN ALLEN, YA 23060 Sheet _ _-4/c....__of_+----------- Address t

2. Plant SURRY POWER STATION Unit l'),v,?

Name P.O. BOX 315. SURRY, YA 23883

  • u2tl-#= 3r()l<JOffvL Address Repair Organization P.O. No., Job No., etc.
3. Work Performed by VIRGINIA POWER Type Code Symbol Stamp _ __,_N,.,/_,A~-------

Name Authorization No. __,NS!L/,.,A'------------ P.O. BOX 315. SURRY, YA 23683 Expiration Date _..,Nc,..<A.,.____________ Address

4. Identification of System __s:::~~"'£"-"-r/.,_/.,:C.... (,.t:.~_.U""-"'&;,;<~.,ofd
5. (a) Applicable Construction_Cod.e B3l.] 19..fiL_Edition,--'No.,_,(.,,Ac__ _ _ Addenda, N-l , N-7 Code Case (b) Applicable Edition of Section XI Utilized for Repairs or Replacements 193'0 w J(O
  • 6. Identification of Components Repaired or Replaced and Replacement Components Name of Name of Manufacturer*

National Board Other Year Repaired, Replaced, ASME Code Stamped (Yes Component Manufacturer Serial No. No, Identification Built or Replacement or No) I- 5't<J,/fftJ I-s;.~>> (

        /\.It.(,>'
                                                                                                                                   -              10.<A I- 7w-,.,o t1-1o<'A
                                                                                                                                                                                                    .,t?,_e).-.4cC,J
                                                                                                                                                                                                     ~b~ddI          l Nb
                                                                                                                                                                                                                       ;A'/0 7, Description of Work                         ,i)L, ~c.--k 6                              ~,,-..,,~::, .,J, /l"vrr: ( Gtvl:- Ar
                                                                                                                                                           /.J   7/~~)       ,
8. Tests Conducted: Hydrostatic O Pneumatic O Nominal Operating Pressure 0 Other O Pressure _ _ _ _ _ psi Test Temp. °F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is SY:, in. x 11 in., (2) informa-tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form.

(12/82) This Form (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N,Y. 10017

s Data Reports to be attached CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this Ac.r<<@'!4i<:'- conforms to the rules of the ASME Code, Section XI. ,, repair or replacement Type Code Symbol Stamp _ _ _Ne,.L..,_A,__ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ Certificate of Authorization No. _ _,..._~-----------Expiration Date _~N~/~A~------------ Signed £)~A Owner or O ~ i g n e e , e.VV Title fsf 64. CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State or Province of and employed by HSBI & I CO* ,* of -JHu.cA.,.R,..T._F...,.Ou.R.,.D....,.,__,C.._T...__ _ _ _ _ _ _ _ _ _ _ _ _-:---,:-,:----,:.-:::;-------,have inspected the components described in this Owner's Report during the period----~'=,>_'_j.._1,.~~-{f._.c;__ to / 1, 1.~ ,Cf!)..  ; and state that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section XI. By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspection. {) /1 . -J- .£)

---                       .....* --=--*-~          _*----'-,.__;_J_*. .,,~-""->,=,c_:___*commissions
                                                                        *                                                    ,;;L-'+/-..t.....;;;;3;___ _ _ _ _ _ __

_ _ _v;;..._a.::...::;_.... Inspector's Signature National Board, Stat,, Province, and Endorsements Date,_ _ _ _ _ J_---"-/_h__19 Cf 0

FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI

1. Owner YIR~INIA ELECTRIC l:.ND EOWER co Date ljd.2. !9f0 Name I 5000 DOMINION BLYl2,, (;iLEN ALLEN, Jl~ 23060 Sheet I of_--<...._ _ _ _ _ _ _ __

Address

2. Plant SURRY POWER STATION unit_......:::0,~tv:'-'~"--------------

Name P.O. BOX 315. SUR.RY, VA 23883 Address Repair Organization P.O. No., Job No., etc.

3. Work Performed by YIRGINH EOWER Type Code Symbol Stamp _ __.N.,_,/'--'A....__ _ _ _ _ __

Name Authorization No. ___,N..,_,._/A....___ _ _ _ _ _ _ _ _ __ P.O. BOX 315. SURRY, Yl:. 23683 Expiration Date_..e:N!L-'A~----------- Address

4. Identification of System_S.=:....:~=,e.......,,;~,....,c_*.. rf~_a)._c.c'4.,_,_r.-=-L-=-.e-c.=-_ ________________________
5. (a) ApplicableConstructionCode B31.l 19...nL_Edition, NIA Addenda, N 1, N-7 Code Case (b) Applicable Edition of Section XI Utilized for Repairs or Replacements 19 3'(J W Ji"()
  • 6. Identification of Components Repaired or Replaced and Replacement Components Name of Name of Manufacturer National Board Other Year Repaired, Replaced, ASME Code Stamped (Yes Component Manufacturer Serial No. No. Identification Built or Replacement or No) 5'ru'>. <:::(;t.6/ -- -
                                                                                                                                 -                      l-$1/ *"fl) ti-
                                                                                                                                                           /ll<f'"4               -         h,, ,
                                                                                                                                                                                                       .. e,\   No
       ;.Jursfnu          /
                                                 -                                        --                                ~
                                                                                                                                                             ...,                -           .,6;-i.,. A-~,)   /VI) 7, Description of Work_-'-A.. C. . .C.!-rf>""'"':.:. !?:.. .c~c.. ...=."_/6r__:.~.!,.;c.'..;.,,;_t!'_---=6'--o.:...e-.:;.7....,r.:.CV_6"'---_(...,..._v_M_;~'-"i&=r'--....,&-=-...,O'....Ll""'e:.J*~E"-')'----------
8. Tests Conducted: Hydrostatic O Pneumatic O Nominal Operating Pressure 0 Other O Pressure _ _ _ _ _ psi Test Temp. °F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is 8% in. x 11 in., (2) informa-tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form.

(12/82) This Form (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017

FORM NIS-2 (Back)

9. Remarks _,.,*""5Zuc....e,.._...1)_,....L~__.,.t)).__#_._C_c5'.+-Y--~2......_6-"--?-=.Ji-=-~--='o'-(=-2.,,.._)_ _ _ _ _ _ _ _ __

APPiicabie Manufacturer's Data R orts to be attached Id-- J:;o4 J I CERTIFICATE OF:COMPLIANCE . , We certify that the statements made in the report are correct and this Rc?)<Vll~,id;o1Tconforms to the rules of the ASME Code, Section XI. repair or replacement Type Code Symbol Stamp _ _ _N"'-L....A " - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Certificate of Authorization No. _ _.....,_.._ _ _ _ _ _ _ _ _ _ _ Expiration Date ___N = / ~ A ~ - - - - - - - - - - - - Signed _ r/ ¢'~~ __.~="-"'-'.JL"-'"-""'°-.-""'----------------- E.f-d.i... Date-~-~~-~-~---------., 0 19 .r,8 Owner o*r Owne eslgnee, Title CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State or Province of  : _ and employed.b'>'. HSBI & I CO* ~ j .: of HARTf OJ,m << CT * *

  • f-§;
  • fl 1... ,SX, I have inspected the components* described in this Owner's Report during the period  :{ _'l - 1 'J.. * ~ t o / ~ * ~ J -9 0 ' , and. state that to th.e ,~st c,f my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section XI.

By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspectio~£ ~

                                                                                                                   ~

Commissions _ _ _ ___D.._~.r"--_L{_, _3 ____________

                         . Inspector's Signature                 ...      ,                                N~.t.ion~I Board, State, Province, and Endorsements Date_ _ _ _                 ~_i~--1___ 90               19

_J

FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI

1. owner ~IRGINI8. Er..EC'.l!l.rn:: AND EOHEB co Date Name 5000 bOMINION BL~D, i
  • GLEN ALLEN, VA 23D60 Sheet -...J./'---'of~. . . . . . . L - - ' - ' - - - ' - - - - - - - - - -

Address

2. Plant SURRY POWER STATION Unit t!)µ~

Name P.O. BOX 315. SURRY, VA Address 23883 wo> # 3 YJ?oo;s---e// J7 Repair Organization P.O. No., Job No., etc.

3. Work Performed by VIRGINIA EDWER Type Code Symbol Stamp _ __,N,,_,._/..,A.___ _ _ _ _ __

Name Authorization No. _N'""'-/.,_A.._____________ P.O. BOX 315. SURRY, VA 23883 Expiration Date _ _eNu.,Aea__ _ _ _ _ _ _ _ _ _ __ Address 0

4. Identification of System _ _S:"'-'6='/l..::.V-:"'--'-e-"c."'"cf.____,("'
                                                                      "'         ::t-4:...;i::...;:..r_.'&"'-'£-c=-_ ______________________
5. (a) Applicable Construction Code B3i,l 19..fi.2._Edition, N(A Addenda, N-l, N 7 Code Case (b) Applicable Edition of Section XI Utilized for Repairs or Replacements 19 /O ~?4
  • 6. Identification of Components Repaired or Replaced and Replacement Components Name of Name of Manufacturer National Board Other Year Repaired, Replaced, ASME Code Stamped (Yes Component Manufacturer Serial No. No. Identification Built or Replacement or No)

S,-c.;;, <;'(.2.1,"9,. - - - / *,$/i),,t1,J-/IJ!'i:.: - /ce!,>~nc,5/) fi/ 0

       /v'.,. r c;, &-z.t..) --                                         .....--                          --                                4                             ~
                                                                                                                                                                                               ,oo
7. Description of Work _ _ ~4-=,.,.>~e-~4. . . c.......c.t:_ _.t/.<..<:~=&.'-'v::...,,,5:"----"4~o""'-'=:'-Lu-"z"#.::...:Cr..i____________________

B. Tests Conducted: Hydrostatic O Pneumatic O Nominal Operating Pressure 0 Other O Pressure _ _ _ _ _ psi Test Temp. °F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is BY. in. x 11 in., (2) informa-tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form. (12/82) This Form (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017

CERTIFICATE.OF COMPLIANCE We certify that the statements made in the report are correct and this ,e<!'Ma15r&o-r'conforms to the rules of the ASME Code, Section XI. repair or replacement Type Code Symbol Stamp _ _ _N.,_,_.._A.__ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ Certificate of Authorization No, _ _....,=-----------Expiration Date -""""""N,.,/_,A~------------ Signed M~O~nee, Tltlµ;r .:?,v~. Date bf('/, L. ,19 94 CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State VA and employed by HSBI & I CO* of T have inspected the. compo~ents described in this Owner's Report during the period to 11- ~ !l.. - 9 1.. , and state that to the best of my knowledge and belief, the Owner has performed examinations and taken correcti~e m~asui'es* described in this Owner's Report in accordance with the requirements of the ASME Code, Section XI. By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspecti~f. /n~ C u'-- ill-?

----"'~-==~~...;..::c.:....==:::-~--:-~=='-"'-"'""'-----COmmissions _ _ _ e,......._c.....;;....;:\.:l:....~..1.....::...J=----------------

lnspector's Signature National Board,*State, Province, and Endorsements Date,_ _ _ _ _;1=--~_Cf..___19 q Q

FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI

1. Owner __V:t...1.I..iR~G!...JiuN.1.I..tiA.....J:E;,JI..i..,Ei;:..C!w..,,1,T~RuI...1C-.t;;1A..llNu.PL...JPt::JQu.WE=..tHl._JC~au.-__ Date _L,__,_;{_2..,-'-'-&...L...>/'J.,____ _ _ _ _ _ _ __

Name 5000 DOMINION BLVD,, GLEN ALLEN, YA* 23060 Sheet _ _,__ _ of_....__ _ _ _ _ _ _ _ __ Address

2. Plant SURRY POWER STATION Unit_--'{J.=-=-'l'""-=~-------------

Name P-0. BOX 315, SURRY, VA 23883 Address Repair Organization P.O. No., Job No., etc.

3. Work Performed by VIRGINIA POWER Type Code Symbol Stamp _ __eN,.,/c..,Ac,,__ _ _ _ _ __

Name Authorization No. __,N..,_/,._._,A..__ _ _ _ _ _ _ _ __ P.O. BOX 315, SURRY, YA 23883 Expiration Date_-"N'-"/..,A"------------- Address

4. Identification of System _ _,.$&=:,.;4.c.=t,/,=t.._d,,.*"'. _....,?d::....,:c...'9:.,:...ro:.....=::.:~:::::.-------------------------
5. (a) Applicable Construction Code B3 l. l 19....6..2.._ Edition, NIA Addenda, N- l , N-7 Code Case (bl Applicable Edition of Section XI Utilized for Repairs or Replacements 19!!'0 u.JYCJ
6. Identification of Components Repaired or Replaced and Replacement Components ASME Code
                                                                                                                               , National                                                     Repaired, Stamped Name of                                   Name of                                Manufacturer                              Board           Other                          Year      Replaced,    (Yes Component                           Manufacturer                                      Serial No.                             No.      Identification                       Built  or Replacement or No) 5 r,,~C'                                    -                                              --                                 -           /-5u)~~tl-
                                                                                                                                                /~46'                            -         h>t4Cc) ~

d~ - '

                                                                                                                                                    "'                           -         h), ,,u,.t,) M,
7. Description of Work_.<.te..c...,,e=-;,k-::c:.e.,.,.<:<dC-c.=,.~"--'t/.'"'""'A=,:;.:...::::~'-i£"-__,d~o=-"::..aT-c....e:..r.e.,,,PC-R=----------------------
8. Tests Conducted: Hydrostatic O Pneumatic O Nominal Operating Pressure 0 Other O Pressure _ _ _ _ _ psi Test Temp. °F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is SY. in. x 11 in., (2) informa-tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form.

(12/82) This Form (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017

FORM NIS-2 (Back) 5;!..Lr,,.=-u=~---'--=------"C--=:Y'-;/~-. . .2.....,b~2=,Jsri-<-=----i..&-~...,)....__

9. Remarks ......... . _ _ _ _ _ _ _ _ _ __

Applicable Manufacturer's ata eports to be attached CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this .,t?.t,>u1~rconforms to the rules of the repair or replacement ASME Code, Section XI. Type Code Symbol Stamp, _ _ _=.._.A..___ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ Certificate of Authorization No, __...._.u.a~---------- Expiration Date _...e;N,.,/..,A'-'------------- Signed M Y,_ Owner or

                                 /

Ow~tle

                                              ~--- f l f tt5H,f                                        Date_.... h-<1.~

_.=.,_.u....,e=.=-------, 19 "' '"o CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a _valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State

                      - ~ ~ - - - - - - -
  • a n d employed by HSBI & I CO. of h:'~ ).ns~e~! the components described
                                                                                                                  /~      ~ :.L 7 ~          , an~ ,state that to**the.best* of my knowledge and belief, the Owner has performed examinations and taken corrective measures described In this Owner's Report in accordance with the requirements of the ASME Code, Section XI.

By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this

    ;"~'°°'g~ !. @dL     I napector's Signature               *     **

Commissiors-..,.., ....,,.V..._C{.c---~--<-f~-~3,:c__________

  • National Board; State, Province, and Endorsements Date,_ _ __.,._{)._-...... 9.____19 C/O L

t FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI

1. Owner __V.lL.,l,I,11R~Gz...I""N1.J..1.I..A~E..Li.u.E~C...TuRa..I....,.,C~A,..NP:..u.......c:P,...QuoWEu:.iR"----'C....,,.a.___ Date _ _.....:.....A..,.""&'--"4o<.......ifi<?=--,.,-l'-'9ic...<:.9.::lJ_ _ _ _ __

Name 5000 DOMINION BLVD,, GLEN ALLEN, VA 23060 Sheet of_ _-4----------- Address

2. Plant SURRY POWER STATION Unit_~t/)....._""P'""cf==---------------

Name P.O. BOX 315, SURRY, VA 23883 Address Repair Organization P.O. No., Job No., etc.

3. Work Performed by VIRGINIA POWER Type Code Symbol Stamp _ __,N.,,lwA.._________

Name Authorization No. ___,N,,./......,A,_____________ P.O. BOX 315, SURRY, VA 23883 Expiration Date _ _,.Nu/_,_A"------------- Address 0 4, Identification of System_ _- ~,-'S?""""..c.,,a....a*.:cr/...,_,..,,c..,&:::.........:::~CSG.:,rz,C,:....,e,&e...£-=::....------------------------ 5, (al Applicable Construction Code 831. l 19...6.1.._Edition,__.N'"-'-/.._n_ _ _ _ Addenda, N-1, N-7 Code Casa (bl Applicable Edition of Section XI Utilized for Repairs or Replacements 193'.t) wp

6. Identification of Components Repaired or Replaced and Replacement Components ASME Code National Repaired, Stamped Name of Name of Manufacturer Board Other Year Replaced, (Yes Component Manufacturer Serial No. No. Identification Built or Replacement or No) 1-.fW-,'/Ov-5,...,.,~ (' - - - NJS-1' - /),t!:.... ....... ,t,) ,V()
        /VvrI
                                               -                                      -                               -                  ...                            -                                  .,,            A)()

7, Description of Work_...,;&,__,.~,_,_)>.'--'"'""&""-"'-"-',!-=--..,(,M"'-'~=~e.,t/.:::....!=e~-<-4,,.._.Q<<<,;;c..Lr;_,_;o:LlW""--'~°'-----------------------

8. Tests Conducted: Hydrostatic O Pneumatic O Nominal Operating Pressure 0 Other O Pressure _ _ _ _ _ psi Test Temp, _ _ _ _ _ _° F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is 8Ya in. x 11 in., (21 informa-tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form.

(12/82) This Form (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017

FORM NIS-2 (Back) _5;"0'-'-;-~=-*,>=---~~v_*#_-=C=-s_,_y:_-~2~6~?-l~rY~0_z...~)_ _ _ _ _ _ _ _ _ __

9. Remarks Nc-tr
                                                         >Al~

LJ'L - Applicable Manufacture?D1a Reports to be attached C 5c/-26 2l.rYl-!;,_ r CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and thil{ ,1?lewc?&:,t'u7"conforms to the rules of the ASME Code, Section XI. repair or replacement Type Code Symbol Stamp _ _ _N..,,.._..,A,,__________________________________ Certificate of Authorization No. _ _....,c.,,___________ Expiration Date _......,N"/...,A"'-------------- Signed......a.Q_.... -f..__."'"/,/=-,;_i-=-""'*v OWnero~esignee, Title

                                                                ~
                                                              """_____.2;. __.5-_7__C.~M~~~*~--Date-~C2_,'Z-,   ....d-==-._,4,.=------,, 19 90 CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State or Province of                                                        and employed by HSBI & I CO*                                                    of
  .....1lia../\c:u.:R..T...F...,.O,.R,.Di.u.,__,C.._T,.,________________,,--.....,'"""",--:=c----have inspected the components. described in this Own.er's Report during the period*                                          ( 1.-1'.i,- gC/ to     / 'l- 1. *~    'f 1.          >and state that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's'Report in accordance with the requirements of the ASME Code, Section XI.

By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described* in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this i-nsp-ec-tio-n-+~-'""Cl<--,-----:-=7/_,_[S,__"""~-=----Commissions_,---i,)......,,"o_--=f"::..._l(,_3 _ _ _ _ _ _ _ __ Inspector's Signet,;;.( National Board, State, Province, and Endorsements Date'---~'==----Cf.....__ _19 'l 0

FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI

1. Owner __V.JL.a,I""R.,,G,.,I'"'N"'""'I""'AL....IE"'L""E...,.C"'T""'R'-I,.,C..._.t:,A..i,Nu.UL-PtccO..,..,WccE..cRL.JC-Du...__ Date _ _L-h-'=2-.""LJ...._,.,:;,2~._,/'-'9'--'1'--=-()_ _ _ _ _ _ __

Name I 5000 DOMINION BLVD ** GLEN ALLEN, VA 23060 Sheet_----'-of _ ___;/ _ _ _ _ _ _ _ _ __ Address

2. Plant SURRY POWER STATION Unit _ _,_Q""v"'-'-c_C______________

Name P.O. BOX 315, SURRY. VA 23883 Address Repair Organization P.O. No., Job No., etc.

3. Work Performed by VIRGINIA POWER Type Code Symbol Stamp_......N,.,/c.,Ac,____ _ _ _ _ __

Name Authorization No. _N"'--'--/"'A,___ _ _ _ _ _ _ _ __ P.O. BOX 315. SURRY, VA 23883 Expiration Date_..,_N'-L..OA'"'------------- Address 0

4. Identification of System_..=5'.c._..:<!-;,::..:;,e::.:tl.:...,te..:c.::;e=---M"'*=~=-n_.,&!-d.--e.=e::.._________________________
5. (a) Applicable Construction Code B31, J 19..fi.2._Edition, NIA Addenda, N-]. N-7 Code Case (b) Applicable Edition of Section XI Utilized for Repairs or Replacements 193°"'0 uJ,W
6. Identification of Components Repaired or Replaced and Replacement Components ASME Code National .. Repaired, Stamped Name of Name of Manufacturer Board Other Year Replaced, (Yes Component Manufacturer Serial No. No. Identification Built or Replacement or No)
   )n,J,::
                                                                                                                                      /-.5a/~ptt)v'-
                                                                                                                                         / ()e/ i'i                        -              b,>,:.;?-cehJ  //0 drt;                                            --                                       --                                             "'                                                    .....    ;VIJ 7, Description of Work _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
8. Tests Conducted: Hydrostatic O Pneumatic O Nominal Operating Pressure 0 Other O Pressure _ _ _ _ _ psi Test Temp. _ _ _ _ _° F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is 8% in. x 11 in., (2) informa-tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form .

(12/82) This Form (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017

CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this M~~ conforms to the rules of the ASME Code, Section XI. repair or replacement Type Code Symbol Stamp _ _ _= N ~ A ~ - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Certificate of Authorization No. _ _.,___~-----------Expiration Date_~N~A~------------ Signed~Q ______ *~---,P~7"~=~------------Date_~h~~~d~-L ~ - - - - - , 19 2o Owner or O~Deslgnee,Title CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State

                          - - ~ - - - - - * - - - *and employed by HSBI & I CO*                                                            of
 ---'=..i.,..u.:.,.,,.,..,_.,_..,.,_,.,____________~--~--=-,,..------have                               inspected  f e components described in this Owner's Report during the period-----'--""'--""'-=--_.,.._----...__to                 I'.).. !1- - er           , and state that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section XI.

By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspection.~

 ----'~L-'--"--~-'---:-~f,._._ _,,,~""'-':;__::::....::::.......;    __ commissions _ _ _.,..l)c.....:A."'---_,,S"..__lf..__3=----------

1nspector's Signature National Board, State, Province, and Endorsements Date,_ _ _ _ _ .....,i"""---Cf_.___19 10 I L

FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI

1. Owner v;*vq ivi IC\

7/

                                ;;/.edr,'cName@td *Pow.tr td
  • Date _ _,_I_-___L*~_,_{_-__,_tt_o 5000 )or11:111"0V\ KJ.

Address arfl,V\ fl{~ vn. J,3060 I

2. Plant_<;~{lt...:..y~r,_f_ _,£'--"-"'--'v,J_.f.,c.L(_ ___,.,S'--'d'-a_,_J_,_'IJ_YI.;..__ _ _ __ Unit _ _,_/_ _ _ _ _ _ _ _ _ _ _ _ _ __
                       '                               Name Address             /                                                    Repair Organization P.O. No., Job No., etc.
3. Work Performed by _ _=_,-"'MvYYl=..:....:......:..::c..e_=----------

Name Type Code Symbol Stamp .v~~ 111 Authorization No. -----=.P.'r--------- Expiration Date ,V, Address

4. Identification of System S'vwi'C< i,JtdJf ( d tl,~j'  ?, ; J
5. (a) Applicable Construction Code (3 3/. / 19k1.__ Edition, i,flt Addenda, _ _,,,,/J'-"lr'---___ Code Case (b) Applicable Edition of Section XI Utilized for Repairs or Replacements 19  ?, D i,J S 0
6. Identification of Components Repaired or Replaced and Replacement Components ASME Code National Repaired, Stamped Name of Name of Manufacturer Board Other Year Replaced, (Yes Component Manufacturer Serial No. No. Identification Built or Replacement or No)
                            }uB11s:-t <;iu.,{

11tiVl'I. .e_ Cj

           ~
                      \I)                                               /.I I}-                 ;V/J-        I/-~w -.fl;i -!J.119 µjf}-                  ;./It        //.;e, jJofv.n lti"'l to rp JJa'oo/1.                                                               l/JY                   ,ti/)'        1-SI/J~P- I ~               /vjr           /,,/J,-     /t,~
                                                                                                                      ~
7. Description of Work /etp[ClU E~.( N 8, Tests Conducted: Pneumatic D Nominal Operating Pressure D
                                                             -=M~~~;>__ psi                   Test Temp,     ,tl/0 r        °F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is SY. in. x 11 in., (2) informa-tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form.

(12/82) This Form (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017

FORM NIS-2 (Back)

9. Rein arks 7t OvvtdL p. cJ , 1,,f  ?~s~,

Applicable Manufacturer's Data Reports to be attached

                                 )Fv,i.(       -        p, o.      '{"y D 6 c2 t'i(
                                                                    /

CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this /? ebU<Q ~onforms to the rules of the ASME Code, Section XI. repailor replacement Type Code Symbol Stamp_~/Ji_1/J' _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ Certificate of Authorization No. _ _ __,_,J./'-'-(L'"------------Expiration Date __/V<..e.._~.c._/,1~-----------

                                                  /1,,___,..,

Signed _ _~~-.c-=-*-""i/..:L....:C"-",'-"" -~,a.....,4~,c!..__:..-----=-----------Date /~.d C' ,19 ?o Ownerorowner1'an%, Titie CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State or Province of 1/o.. and employed by Hs a ..::c +r ~ (a of Ht,...,."t foY'.J IC T have inspected the components described in this Owner's Report during the period /~.  :\-:l- ~'f to 11-11-Sl. , and state that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in acco ance with the requirements of the ASME Code, Section XI. By signing this ertificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations d corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this i-n-sp_e_c-ti-\1'[4__::n::c. t.1~'-----""'-\~~~i-.~~~~~~~----Commissions _ _ _ i...}'--.~~~~S:~<.t_J____________ Inspector's Signature National Board, State, Province, and Endorsements Date'----a~.__-_.'1'---Cf_..__0 _ _ _19_ __ ~ ___/

  • -'*-*-*** ~---=-

_. -- \

                                                                                                                                                                                                               -~*,:<~ -~~-~-.l-I:-x/\:.~-;:*'-: *
  • FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI
1. Owner __V:i...-I..,R.,,G...I~N..._.I..A1....E..,L
                                                                   ......E<loc..,.T.,.R,._r...c..__..A,..NO...,._P.c:.i..C..,WEu:..iR>--i..C..i.Ci-- Date_---'1'+-,/i......;.;(0Jc._.t1_10;;::____ __

Name 5000 DOMINION BLVD,, GLEN AT.LEN, Addreu VA 23060 Sheet _ _.._(__ of _ _ ...J-----------

2. Plant SURRY POWER STATION Name Unit _ _...... 0'-A-~----------

P.O. BOX 315. SURRY, VA 23883 3?oo o r/lJ8- c, Repair Organization P.O. No., Job No., etc.

3. Work Performed by VIRGINIA PCWEH Type Code Symbol Stamp _ __.N.,.lc..Au..._______

Nama Authorization No._N l.:.A.___________ Expiration Date _ _.N1.1/~A2,..___________ P.O. BOX 315. SURRY, VA 23863 A~rea

4. Identification of System __ ' _j;;;....i~...[c.,\.,._J.,_r.,,,...e,.__..:W=.;,~..rf......v. . . _________________________
5. (al ApplicableConstructionCode BJl,l 19..£2.._Edition, N(A Addenda, N-1. N-7 Code Case (bl Applicable Edition of Section XI Utilized for Repairs or Replacements 19 :;,,'ti WYO
6. Identification of Components Repaired or Replaced and Replacement Components ASME Code
                                                                                                                                       Nationai*                                              Repaired,     Stamped Name of                                Name of                               Manufacturer                          Board           Other                  Year        Replaced,         (Yes Component                          Manufacturer                                   Serial No.                          No.       Identification             Built    or Replacement or Nol
                                                    $01'.S,;, \;de,\ f-ed i"x)" /V{VJDJ(                        0wv--        5..inb j, 1*1    {/

rg-SJvoo /IA l-Su, T:r --/dk /v)A- feoli£q) ,Jt./o

                                / I                                                                                                                                                              7 Hydrostatic                 Q              Pneumatic           n          Nominal Operating Pressure Other [J F'rl!SS'J;ll *                                                *  ;si .. Test Te;p.             *
  • NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provider:, ,li size is 8% in. x 11 iri., (2) lnforme*

tion in items 1 through 6 on this repon is included on each sheet, and (31 each sheet Is numbered and the number of sheea is recorded at the top of this form. (12/82) Thi* Form (E00030) may be obtained from the Order Dept., ASME, 346 E. 47th St., New York, N.Y. 10017

FORM NIS-2 (Back)

9. Remarks -~}J'--=-'-j~q....'.pl_i_..__Po=---f:l:---c_s_r_"d--_)_3S_lf____ 5 _ _ _ _ _ __

r APPiicabie Manufacturer's Data Reports to ba attached CERTIFICATE OF COMPLIANCE h I We certify that the statements made in the report are correct and this f'(?c ~le,,..._ (A, conforms to the rules of the ASME Code, Section XI. , repai or replacement Type Code Symbol Stamp _ _ _....._...,__ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ Certificate of Authorization No. - - = = - - - - - - - - - - - E x p i r a t i o n Date --'-'N"'/...,A"'-------------- Signed *~ / ~, L../' (2Owneroi'oliners Designee, Title

                                                                          .z:r:r-.b,,4'                       Date      s &A!, tr:                                               , 19 f'"

CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State or Province of and employed by HSBI & I* CO* of HA,RTFORP , CT have inspected the components described in this Owner's Report during the period i1-1:'.}.- SXj to / d: - ;li-91., , and state that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described In this Owner's Report in accordance with the requirements of the ASME Code, Section XI. By signing this certificate neither the Inspector nor his employer makes any warrantY, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this W-'--:""n_sp_,(; i_n_sp-ljeC......:io:;.n.i.J'...

                                 --'                    C9
                                            ....._o_r'... S..I~"'*~'"a""t""u-re

_ _ _ _ _ _ _ commissions __N_at_l_o...,0-el-~ ..... oa-r""~"'~-;..s_'!-at-e-?-P-r_o_v_ln_c_e_,-a-nd_E_n_d_o_r_se_m_e_n_t.-- Date* ____ *_____ J- --.,-

FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI

1. Owner __y.,,_,.I.,.R.,G.,_I.._N
                               .....I_.A.......E  r,...E.,.C~T"""R~I,..c......A..,.N...P......P~awWE"""'R"---'.....
                                               ......                                                          C a,___        Date _ __:l....:J....:'.r::....../jL....,qL'2!,<...._ _ _ _ _ _ _ _ __

Name 5000 DOMINION BLVD,. GLEN ALLEN, VA 23060 Sheet of_.,___ _ _ _ _ _ _ _ __ Address

2. Plant SURRY POWER STATION Unit_--=CJ.-'-~""~;c__ _ _ _ _ _ _ _ _ _ _ _ __

Name P.O. BOX 315. SURRY. VA 23883 Address Repair Organization P.O. No., Job No., etc.

3. Work Performed by VIRGINIA PQWEH Type Code Symbol Stamp_......,.N,../c.oA.,.__ _ _ _ _ __

Name Authorization No . .....,N.,./.._A....__ _ _ _ _ _ _ _ _ __ P.O. BOX 315. SURRY, VA 23883 Expiration Date_.._N,../_.A'"------------- Address

4. Identification of System__,C,.....,,...=~..:.,~:=""""""'~,__-------------------------------
5. (a) Applicable Construction Code B3l. l 19...6..2.._Edition,__.N~iaA_ _ _ _ Addenda, N-1. N-7 Code Case (bl Applicable Edition of Section XI Utilized for Repairs or Replacements 19 _ _ __
6. Identification of Components Repaired or Replaced and Replacement Components ASME Code National Repaired, Stamped Name of Name of Manufacturer Board Other Year Replaced, (Yes Component Manufacturer Serial No. No. Identification Built or Replacement or No) 14~11.f- ..r. //.
                                  ~A.;'1Cll*~f)_.c/                                       -                            -       /-r_ p .. .Z?~                                  ...... p~h..~~L,I           ,VI)
 'jt, ti L.,_,qow
                                 ..T,#.
                                  ~,e1.!C.Nl£1J '2V                               l6oetJI                           ~/ii              -                                       -"      ~~~-
                                                                                                                                                                                         ,    .._....t.,J   ;t/r)
7. Description of Work._--"~--'.!-.=t,~=... ef:'--'4:!....,,.,,J,..__,d,::..Rf~G,,_,u'.=t,._________________________
8. Tests Conducted: Hydrostatic ~ Pneumatic D Nominal Operating Pressure D Other D Pressure 2,;rd 12 psi Test Temp. # O L °F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is 8% in. x 11 in., (2) informa-tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form.

(12/82) This Form (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017

FORM NIS-2 (Back)

9. Remarks _i.""-"A.-'-"~="=<<~/1~'V.....- --:-,l!_s-y_0~9.,..../i. . . L....,i~G....,,1,,_j_ _ _ _ _ _ _ _ _ _ _ __

Applicable Manufact'}Ser's' ate Reports to be attached

                                                                .'1t Js                   2. r .r.r ( z.

CERTIFICATE OF COMPLIANCE ASME Code, Section XI. We certify that the statements made in the report are correct and this tf4'?. &&:,:.l,.,.cconforms to the rules of the repair or replacement Type Code Symbol Stamp _ _ _N..,,,_.._A.__ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ Certificate of Authorization No. _ _...,....;..u___________ Expiration bate --"'N"'/..,A'"-------------- Signed_,,.(2_..... l'.&<,4e:=,..~...A'--'Y""--'.'--=-~__. Owner or- Owner's O e s l ~ e

                                                                          --:A    ....£,-~..Z;~s~-.z.=--~L,~""~4~--Date~;z:,~~,P,~,--=f"'-------, 19                         Z lJ CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and_Pressure Vessel Inspectors and the State or Province of                                                                   and employed by HSBI & I CO.                        ....  ,

of

  ....Jlici.cA...R,..T...F.....,Ou,R,.D...,.._,c...T..________.....;.____:,----,...-,s---:,o=,------~ave .. !nsp~cte~the compo_nen!S described in *this Owne~'s Report during the pe~iod---~/~*J.,~-~:}_~4-~--~~-q~_to                                                   I 'l - !l !).- ~ .fb.                  , and state that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owne~'s *Re~o-~ in accordance with the requirements ~f th~ ASME C~de: Sec;ion XI.                                                   ... .     -               -*              -

By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspection. ~~ JJ_ /{) n l, c ,i

   -----'D,....."'/'i.~c:;;..,.=---,-::-J':'--

1 1 3

                                                                      --~----'--------Commissions _ _ _......c)}_.lL=:....~.1..._'1_,_-='------------

JfL Inspector's Signature National Board, _State, Province, and Endorsements Date,_ _ _......L../_-__;_{....J,,7_ _19 90

                                                                           *--:-.*.-                                                              *, * ....~. *     '( -<~- ._~,...--~~- ,:. *
  • C ,/
                           \

FORM NIS-2 OWNER'S REPORT DF REPAIR OR REPLACEMENT Al Required by tht Prorlsion1 of ASME Codi Stc1ion XI

-,.      0                 '            ' -f~                                                 /                                Date  J:t~~i./9'8,$5 ej5',~::z.. ".t, '~ameJ                                                                                            ShN'I                      :;;/ of_ _ _ _ _ __

Plant~~ 1'W"°='<' Uftlt_.;.J_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ 2. P. ~I!> Work P1riorrntd "tr;;;:~ bv Vlll..!iJ"<~ ~ tfe. . 1-- 3 ! K.s Ef. WR. No* .:i ~ -3 / b/{t!tJ.

                                                                                                                                                               /
                                                                                                                                                                          # tl/ /t/           Zi-3.

t)"' 11 (/ ~

                             .fcO:!.* Pt>/( 31>)~ v.a. ~ ,.,, 3 t../      ..,    ~g.3 lJ
                                                                                                       .-esi-ir°'9a111Uliantt.ON0..Jo11No.,ec.

7

4. lden1mcationofSyn1m -~~':J-Coo[c "'-;). ~
5. "' Applicablt Connrvctlon cJ6a{f3 I, I 11 7, 7 &'. . . . .

Edl1loll.... IA--;_..,._._Addenda, Codi Cases _az_:,.,::;._,% ......,..,._ _ (bl Applic1bl1 Edition of Stc_tion XI UtJliztd for Repain or R1placam1nu - 11~, {I.) ff<!, Addenda, Code C.... I?/ /A-. I. Identification of Componenu Repaired or Replaced, and Repl1cement Components N1m1of N1m1 of Mfrs. Ser. -Nat'L CRN Other Year Rep1nd, ASME Codi Component Mfr. No. Id. No. ldentl- liul11 RepllClcl. Siampecl No. ficltion or CYesorNol Replacamtnt (l/iF-C I"- VALV~ M i SSl&>I\ va .,,

p"IVAP Ct>{ ~ - - 0/- c.c:-
                                                                                                -/7~
                                                                                                                        -           R..~ ,n(t,.,c~"" e.t.+            pl)
7. Description of Work 0/- CG-/ 7' cw1J.. h
8. Tens Conducted: Hydrostatic li2f Pneumatic O Nominal Operating Pressu,. 0
                   ,,                 Pressure           9.'>

Remarks lv,er.v C '1 <ec. t-; .V" \Voe.. I ii .I: C# pal Test Temp.__µ*F

                                                                                          .Mc. 1, /:e... c.-f1.1.i,, "'dl A

9. CAoplic.alll,it.\an lac1urltl'1 Dala R pons ta be allach91S) C.o, . iW Oef,Q, li - I.S

                                           .                     CERTIFICATEOFC~MPLANCE We certify th1t the na,emenu mllde Jn this report are correct and this                                                      ~                      confOl"IN 10 Section XI of the ASME Code. /\- /j                                                    ,                                     t,pa;rar~

signed

  • yx,~,J~

p.n., Owners De iOneeJ k ~ :rsr Ttil Coatel r .9 .,,

                                                                                                                                   >/                    Y1 CERTIFICATE OF INSPECTION I, th, undersigned. holding             I   v1lid commission Issued by the Natlonal Board of Boller ind Pressu,. Vessel lnspeclOfl and lht Smta or Province of
  • t/a_ , employed t,y
  • HS l3 ;f: 't I C,D of t-/a, r1f o,.J. J ff have inspect.ed the (' e.p~a. c.et11\,ekJ f' IRtpairfs)o, ~placement(IJ described in this Report on / - / /) , 11.!1 ind 111te that to the best of my knowle~ and belief, this rep1ir or replacement has been connructed In 1ccordlnce with Section XI of the ASME Code. By signing this certificate, neither the lnspe,ctor nor hi1 lfmployer makes 1ny warranty, eicprened or Implied, conccn~

ing the rep1ir or replacement describe-din this Report. Furthermore, neither the Inspector nor his employer shill be li1ble in 1nv manner for any J)l!rsonal injury or property da'J\age ~r. :~s-~f u : r i s i n ; from or connected with this ~nspe~ion. Cate /-//;-g'f ~j.~ Commissions ~St/3 l)870ti<t (lnss:,,,,clllf) pplemenul ,h ..n In form af llns, 1lr.etchas or drawlnps may i,. uud provided It) sin 11 IM In. X 11 In.. 0

                                                                                                                                       !Stale o, Prt,,rincc. Nal,or,al eo.,11) etlan In 1,-,.,,,, 1 throui,11
  • an thl1 dua report 11 Included an uch 1hNt and (31 **ch 1h"t 11 numbered 0

umi,.r af 1hHb I* record*d at the toP of thl1 form.

    . -:--,.                 .. ** *.*  -                                                                                                                                        ATTACHMENT 2
                             \

FORM NIS-2 OWNER'S REPORT OF REPAIR OR REPLACEMENT AJ Required by the Prori1ion1 of ASME Code Section XI

  ...,.      Owner    Virginia Power P.O. Box 26666                                                                                             . *Shnt _ _ _ _ _ _ of_ _ _ _ _ _ __
                      .                                               IA,CIOrna)
2. Plant Surry Power Station Unh~-'('-=-9/v~/3~~~~~~~~~~~~

CN&fflll P.O. Box 315,1A00<'9UI Surry, VA 23883

3. Work Performed .........-.r.__________

by_V,..A.-.a.,......t'QWe 38000 A'.'. I 7 'IS

                                                .                    (NPIT'4)                                    Repair 0'1jan&:.ehofl ,.o Ho.. JoO Ho. elC.
                                                 '5ame
4. Identification of Srnem ~l'UII ( O"""f ~'61 11i* (01, f'~
5. ,., Applicable Construction Code 831-1 19 67 Edition;fi_~=A_______ Addenda, Code ~ ,*. _ ....N.::.A.,_____

(b) Applicable Edition of Section XI Utilized for Repairs or Aeplac1m1nt1 - 11..80. WBQ Addenda, Code Cam_...N....A..__ __

s. Identification of ComPOnents Rcpairtd or Replaced, and Replacement Components Name of N1mt of Mfrs. Ser. -Nat'L CAN Other Viar Repaired,, ASME Codi Comoonent Mfr. No. Bd. No. ldentl- Bunt Replec:ecf. Stamped No. fication Cit (Ynor No)

Replac:em1n1 Uu..lue NA Jl) A- /1),+ /VA )-((-/77

                                                                                                                            !V'A-           R()[JJeie,J I
                                                                                                                                                                        *;Un
7. Dncription of Work RePI~ u~tk I. Tens Condut1td: Hydrostatic 0 Pneumatic 0 Nominal Operating Prnsul'9 ,pi Other 0 I.
                                                                              .:.;ERTIFICATE OF COMPLIANCE We c1r,ify th11 the na emenu m~ In this report art corrtct ind this_........,."""'-'......-=--=------conform1 to Section XI of the ASME Code.

Si9ned--~~-'-"~~~./'4-~~r-,::::t..a.d~--~-L---__:"=~~-:;.._---, tt fl CERTIFICATE OF INSPECTION I, the undersigned, holding a valid commission inutd by the N1tional Board of Boiler and Prnsul'9 Vessel lnir:,<<tors ind the St1t1 or Provine, of VA, *employed by HSB' rn I co, of

  • Hartford, CT.
  • h, ... c inspected the regl,c e d
  • jRep *'11) 0t ~*~t1ctff\tn1(sl ducribed in this Repor, Oti 7 - ;J..Y,*,g'A end nau th11 to tht ~,t of my knowledge end belief, this repair or repl1cement h11 been connructcd ii) 1eoord1nce with Section XI of tht ASME Code. Br signing this ctrtifia1t, neither the lnsp~ctor nor his lfmplorcr makes any warranty, expressed or implied, concern-ing thr repair or rrplacement desciibed in this Report~ Furthe~ort, ntither the ln~ec1or n*or his*employer 1hall*be liable in any manner for any ~rsonal injury or propenr d1 ~ or* on of }!\Y lyfd arising from or connec1td with this ln1Pt~ipn- _

0111 2- Q._q _ 8'. r * * ,~

  • Commiuions JI f37001 V c:L f:J £(:3 ft:

flnSPKIOI) . Suppl1m1ntal 1hNn In form of Ilia. *k.*11ch*. or dr1wlni. m*r be uHd p1ovld1C,*(1) 1111 h I~ In. X 1 t In., jS111t Ptt,,,,nc,. Na1,onat Boal12I Of nform11lon In h*m1 1 through 4 on 1h11 d1t1 **Port le Included on 11ch 1hNt, and (3) 11ch 1hHt 11 numbered tto* number of 1hNb le r1cord1d at tho top of thla form*.

FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ~ME Code Section XI

1. Owner If i°'vgi*n j A r;l~c..fv,."Name0w.l p{i vJ..t.,( UJ. Date _ __,/'----1_'2-_-_rr:__i)_ _ _ _ _ _ __

S-DlJ1> Do vri ,"iJ.,,Address

                               ,*!'.]             Bl(fd . (,(yr, 14 /lt,lt}_
2. Plant 5.&.tt.rl *f2..owg, r I

s-4.J/() ~ V,9- ' Unit __O_Vl_~--------------- Name Vff, -,,_wr3 Address Repair Organization P.O. No., Job No., etc.

3. Work Performed by_..,.(t'-'-)_,_3.a..* __,p'--6i,J_..e..,_r'_ _ _ _ _ __ Type Code Symbol Stamp _ _ _ _ _ _ _ _ _ __

Name Authorization N o . - - - - - - - - - - - - - - Expiration Date _ _ _ _ _ _ _ _ _ _ _ _ _ __ Address

4. Identification of System Rea,.d-w CJo f evv-.t 5; '/5T.LltV\
5. (a) Applicable Construction Code g3/. I 1911_Edition, Addenda, _ _ _ _ _ _ _ Code Case (bl Applicable Edition of Section XI Utilized for Repairs or Replacements 19 fi O , w Su 1
6. Identification of Components Repaired or Replaced and Replacement Components
                                                                                                                   \      ~'                  '\

I ASME

                                                        ,\/                                                      -..- ;,-..,               /

v'

                                                                                                                                             \

Code

                                              '\
                                                                                                                \ -             Repaired,          Stamped National Name of                    Name of                  Manufacturer           Board              Other            Year      Replaced,            (Yes Component                Manufacturer                     Serial No.           No.          Identification       Built  or Replacement or No) qpooL      r,~u...          cp s/1cvil~4a,;

t;,.,.,;.

                                                ~    1 4,
                                                   ~ t,
                                                                   *-               -        ,-Kc; 95'                -       Rtrittc.t<,(           -
8. Tests Conducted: Hydrostatic 0 Pneumatic D Nominal Operating Pressure D Other D Pressure 1,;1'1> psi Test Temp. r?-1 °F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is BY:. in. x 11 in., (2) informa-tion in items 1 through 6 on this report is included on. each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form.

(12/82) This Form (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017

FORM NIS-2 (Back)

9. Remarks --..-+-f-*0_.-----=('-S+f--_'1--_if_7----'-----'----3--'----9--'-f_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __

Applicable Manufacturer's Data Reports to be attached CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this Rz/ifJ<Jw,$,,.,f' conforms to the rules of the ASME Code, Section XI. repair or replacement

  • Type Code Symbol Stamp _ _...i.;::...4-'*- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -

Certificate of Authorization No. _ ___,_µ"--'-/Ir'--__________ Expiration Date ---'//'._l_!f____________ s;go,d2~~ - Date--'\&~';?~""~*~1-.Z.~-----, 19 'J 0 CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, ho}djng a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State or Province of fLp.. and employed by HJ f3 S-fX {!- 0 of ffa T Fa \- d , lo' ~ r have inspected the components described in this Owner's Report during the period I a_..., :J 1 ~ B'f to , 1 i , '11.. , and state that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section XI. By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspection.

        ~~o::><=~~--'-*-~~~-----Commissions _ _ _

1nspector's Signature

                                                                                                                ~,J~a_~_S_'-{~J~------

National Board, State, Province, and Endorsements Date, _ _ ----#/_-_f'-'",l=--___19 '1 {)

  • FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI
1. Owner _ _,[J"--'-',*":....,:b4-'-'vi-'---'-',tl'-=----=!3....:l_~_i:_cii_v,_'i:.._~(3~1J-"'"-,,1-'-.(!"'-=---___;_t_d__;_._ __

tr" Name Date I - B- '1' 0

              },Vo<>                                                                                                                      Sheet       I      of        I Address
)J,~J/91
2. Plant s-1-c...1;,,...,, Unit .:&: J.

Name

                                                                                                                                                        )c£- ff7-        ?f        P-  2-Repair ~ganization P.O. No., Job No., etc.
3. Work Performed by_ll<...1/.,_,1,r'--'--.~Pl-'--"-11-"'vJ'--".2,"--C.__ _ _ _ _ _ _ _ __ Type Code Symbol Stamp_,_.c...c.,11'--"/,;,eo<.--------

Name Authorization No. ----"'"...:.i~'4---------- Expiration Date _ _ _N=-.,h~'9:e+----------- Address

4. Identification of System _L'---11-"""+f....:*_v,-=~"-'"""""'3'---"'C--="--="'---'/'---'1--'-*~.r--*__,_-..i;f-'-"-5_1'1..:..1;;::..-_U='----C-'-.(_"--....:S-=*'>::__-=:III..=------------
5. (a) Applicable Construction Code 8 ; /. I 19fl_Edition, _ _ _ _ _ _ _ Addenda, _ _ _ _ _ _ _ Code Case (bl Applicable Edition of Section XI Utilized for Repairs or Replacements 19 80 W 80 )J,,(ef'-"".de...*
6. Identification of Components Repaired or Replaced and Replacement Components
  • Name of Component Name of Manufacturer Manufacturer Serial No.

National Board No. Other Identification Year Built Repaired, Replaced, ASME Code Stamped (Yes or Replacement or No) y~s H-rd Y" be. e7-fi- 433-,13 !ii/I'( I - cc - lfr- )> ,q~8 Re plc, ,rn,~,4- ~

          /; X chruHlfU"                                                                                                                                                                          >I.. .e V                                                                                                                                                                        ~l9c
7. Description of Work_~Rt-tp=l..:..a-=c...e~~l1~~~"-~t_.,.,_\?..:..)(~e_h_*-'-'U,\,\---'-tdr-.R.'-'r'----------------------
8. Tests Conducted: Hydrostatic~ Pneumatic D Nominal Operating Pressure D OtherO Pressure *2,7:1' psi TestTemp. /9w..h,*J °F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is 8% in. x 11 in., (2) informa-tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form .
  • (12/82) This Form (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017
                                                                                                                                   \

FORM NIS-2 (Back)

9. Remarks _YF--"-~~()...-~{(~1'-f-'-n~!~P.._U_~~Af'-'-'--'"'------------------------

Applicable Manufacturer's Data Reports to be attached CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this Rtp{.ctu M,k,-,tonforms to the rules of the ASME Code, Section XI. repair or replacement Type Code Symbol S t a m p _ . , N - = - ~ f r - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Certificate of Authorization No. ---~'~/v_l9)_,__________ Expiration Date --~~~-8~----------- Signed ()J i Owner or Owner's Des~itle jJ ,AA/' ..rsr L,v1;, Date_,~6~!~1_0_____ , 19 9:0 CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holdi9g a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State or Province of Va. . and employed by 1-f sa I+ :r C g of Ha ,. 1 Par d . e t. have inspected the components described in this Owner's Report dur~ng the period / 'l. - ~ 'l- 5? 1 to f ~... 3, 1' 'f ~ , and state that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report-in accordance with the requirements of the*ASME Code, Section XI. By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspection. _ _ __._{klJ--=---'----i_.'---~---------Commissions _ _ _ lft-=Q..:.=---=5":...._4-=---J Inspector's Signature National Board, State, Province, and Endorsements Date_ _ _ ~/_-_C/~___19 'f Q

               ........                                                                                                  f-CC-E*ID FORM U-1 MANUFACTURERS' DATA REPORT FOR PRESSURE VESSELS u 19q11lred by the pnwlak>na of the ASME Code rutes. Section VIII, ~ 1 . : , .~
1. Manufacturedandcertlfledby Yuba Beat Transfer Div;fsion 2121 N, 161st E, Ave, Tulsa. OK Cname ano aaor.. o f ~
        .. Manutacturedtor                   Yirg1D1a Power E]ectr;fc Power ,_Company                                                                           _, _ _ o f ~

5000 Dominion Blyd, Glen Allen. 23060 VA

3. Location of lnatallatlon -.:1Vr...1ur-.ig!>-1.l.lDu.1.....a~P....o""w..,f"..........

_r s.a.J]1,L)TL..I71..3--...JC..iO.i.D1,1,,61::Lt.i..r.i...u~c:.t...iJ,jp:JJn.....P..,.r. i.OtJjµ;ei.11c...t.._.S....u,...r...,r.y~.a.....;VL,i....r~&~i..,n..,.1..,a~2!::.3g;s""8""3"---- c- ano ~ , az-r--433-lB ____,,,....._____ 87-G-433-1 5418 1988

4. Type* Excban ~rII)

(llanZ. Ill WM., (mfr'L - I no.) {CAN) ~-, CNat'L Del. no.)

5. The chemical and physical properties of all parts meet the requirements of material apeclflcatlons of the ASME BOILER AND PRESSURE VESSEL CODE. The design, construction and workmanship conform to ASME Code. Section VIII, DMslon 1* J 986
                                                                                                                                                                                                                                                                                 ~

A'86 lll*llda (Date)) Items 6-71 Inclusive to~ completed tor alngle wall ~1se/1, jacket, of Jacketed ve...1,, or ahella ot hNt **changers. SA-516-70 ~II .125" 4 '-3" 36 '-9~"

e. Sheu_*----,.---.....,..,,,.....--

1men (,apec. no.* grade)) ------------ (nom. ~ (in.)) (corr. llio.. Cln.11.

                                                                                                                                                                                                                          -ID-1ft.-

ldiL - - - -~-,-,.-----,---

                                                                                                                                                                                                                                           & In.))                      (lengtll !-.JI) (It. & ln.)J Dbl                               Full                                       100%                                                                               Dbl                                          Full                                     4
7. Seams:.______ - --,,---,-----

IIOnG- (Clbl., angl.l) (AT (IPOl III fulQI cetf. (%)) (HT temp. ("F)) (!Imel (b,-_..;;;;._ _ _ _ _ _ _ _ _ _ _ _ _ _ __

8. Heads: ( a l - - - = - - - - - - - , - - , , - - - - - - - - - - - -

1met*1. (apec:. no.* ;radell (fflal1. (apec:. no.* oracse11 Lacetlon (too. Minimum Conoslon ec- knuc:tde Elllpllcal Conlcel Hemlsphalcal Flat Side to PINauN bottom, /111111) Tlllclmffl Allowance llldlul AaCIR,a Ratio Ac,aAngle Radius '*-'* 1--ar-1 I fal - .. . .. . ( I (b) - If ramovable, bolts used (describe other fastenings):

      '. Type of facket:,----=------- Proof test-*- - - ' - - - - - , - - - - - - - - - - - - - - - - - - - - - -
     ~- Jacket cloaure:_ _ _ _- " - - - - - - If bar, give dimensions:,___________ If bolted, descflbe or aketch.
  • (Clnerltle .. ogee' . .1e1. lier, ..~,
11. MAWP 150 at max. temp. l SQ Min. temp.,*_-~--,-...;;;;;.----,=~- H y d r o . , ~ - test press.* 225 (Plil (

0 F) rF IWMft teu lllan -a>"Fll (pal) Items 12 and 13 to be completed for tube aectlons. *With clad 3/8" SB-265-Gr 2 Titanium Plate

12. Tubesheeta: Sl-3~0-l E2 56 2l8" l l3lH1" ,125"
  • _ :Wdded (alltionaly mat"l. (opec. no, gr.))* (CliL (In.I (8Ullject to ~ I I (nOm. lllic*MII (in.II tc,a,r. allow. (In.II (&tlac;hmeftt (INided. llolted))

SA-350-LF2

  • 56 7L8" 113/16" .125" Welded (lloe1ing mat"L (apec;. no., or.I) (dla. (In.)) (nom.. ~ CIILlt pirr.alkM.(ln.)I ~
13. Tubes: SB-338-Gr 2 3/4" .028 1600 Straisht Cmat'I. (opec. no., gr.II (OO(ln.)) , - . ~ ( I n . I l l ' oauvelt . cno., (type (ltml!ftl CII' U))

Items 14*11 Inclusive to~ completed tor Inner chambers of Jacketed vease/s or channels ot hfft **changers. Inlet Channel SA-516-70 5/8" 0 4 '-3" 4 '-SJ.,;" 14.~: (met'I. (*pee. no., gr.I) ( - . lflicllnnl (In.I) (con. allow. (In.II

                                                                                                                                                                                                         --------       .... ID (It. & In.II
15. Seams: Dbl Full 100% 1100°F 1 Dbl Full (long (Cltll., lngl.l) (AT !*POI or 1u1Q1 (elf. C"'II (HT 19mp. c*F)1 -(llffle-,-
18. Heads: (a)._ _ _ _ _ _ __ _ , . - , - - - - - - , - - - - - - - (b,,__ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __

tmar*L (aelee. no.. oraoell Cmat'L C.-. no, or-II

                    ~IOnftop,                 Mlnimuffl                Comltlon                      CrDwn                Knucllle                    Elllptlcal                          Conical                        tlamlspllalal                            Fie!             SldalD..._..

lloltom.encb> 1'llll:l!&Mel Al'->ce '-llul llaokll Ratio ""*' Aldilll Dilmetllf tcon-*_, I ,., IChannel F IZ (SA- 05-N)(Sl I I.D. X 56 7 8" O.D. X 3 1/8' thk)(C.A. - 0) Angle j (b) K:hannel F1 111 (SA- 05-N)(Sl I I.D. X 56 7 8" O.D. X 3 1/8' thk)(C.A. - 0) lfremovable,boltsuNCl(descrlbeotherfutenlnga): 3/4" SA-193-B7 studs & SA-194-2H nuts MAWP 1;2, ~ inax. temp. 1;_5F>0 Min. temp.._.--r---F-lwt-.-.- ....-ttwo----a>-.FI->>-- H y d r o . , ~ - tnt prna.2:&.2..5-,_.--

 /tems on ,,,.,.,.. 1/de to be comp,.ted tor all a,euela ,,,,.,. appllcable.

Note: &ch additional ,,,_, w/1 t>> a/gn<<J and dated by th* certlllc.t* holdM and the Al. Thia form may be ootalned from n. National 8oard of loller and Preuura VNNI ~ 1055 Cn.lpper AN., Columbus, OH G221. NS-215 Art. e

FORM U-1 (back)

        *.,~:**Nozzles, Inspection and safety waive openlnoa:
'.;i>" l'ul1ION Clnlet.

outlel, drain. .ic.1 Channel In/Out 2 Ol&cwSm 30" Plate Type Mati. SA-516- 0

                                                                                                                   ~

Nam.

                                                                                                                        ~"

Rain~ Mow AttacMll Welded L.ocattan Channel Channel In/Out Shell In/Out 2 30" 18 11

                                                                               "'FWN Pipe SA-105                    150#               -                  Welded                c.hannel 2                                        SA-106-l                   ~"       SA-516-70                    Welded               $hell Shell In/Out                             2            18"           RFWN          SA-105                     15011 SA-516-70                       Welded               $hell Shell Vent & Drail                       4          3/4"            Cnl~          SA-105                     6000               -                  Welded               $hell Aux. Cplg                                 2          3/4"            Cplg          SA-105                     6000               -                  Welded               Shell Aux. Cplg                                 2             l"           Cpb:          SA-105                     6000               -                  Welded               Shell Chem Clean Nozz.                         4             2"          IRFLWN         SA-105                     1501}              -                  Welded               Shell/C' Aux. Cpl2s                                2          3/4"           tnl~           SA-182-l 304               6000,              -                  Welded                Channel Aux. Cplgs                                2             l"          CPlR           SA-182- 304                6000i              -                  Welded                Channel Gauge Glass Conn                         2             l"           Cplg          SA-182- 304                6000i              -                  Welded                :atannel
19. Supports: Skirt No Lug_a_-_ _ _ Legs._ _ _ _ Other 2 Saddles Attached Shell Welded tra or no1 cno.1 cno.1 (daentlel (wllefl 11111 IIOw)
20. Remaru: Manufacturers' Partial Data Reports property identified and signed by Commissioned Inspectors have been furnished for the following Items of the report: - - - - - - - - - - - - - , - - - - - - ~ - - - - - - - - - - - - - - - - -

(name of part. " - IIUffllllr. mtra. ,_. and Identifying atamPI (18) Channel Vent: (2)(3/4")(Cplg)(SA-182-F304)(60000)(-)(Welded)(Channel) Channel are marked 87-G-433-3 CERTIFICATE OF SHOP COMPLIANCE We certify that the statements made In this report are correct and that all details of design, material, construction and workmanship of this vessel conform to the ASME Code for Pressu,.. Vessels, Section VIII, Division 1.

        "U" Certificate of Authoriutlon no 11,178                       expires           6-4             19_89.a...-_

Date 6/29/88 Name Yuba Heat Transfer Division (manutac1ur-, CERTIFICATE OF SHOP INSPECTION vessel constructed by Yuba Heat Transfer Division at Tulsa, Oklahoma I, the undersigned, holding a valid commission issued by The National Board of Boiler and Pressure Vessel Inspectors and the state or prov-

     . Ince of      Oklahoma                   and employed by         Commercial Union Insurance Company

_ _ _ _ _ _ _ _ _ _ _ _ _ _ _of Boston, MA have inspected the pressure vessel described In this Manufacturers' Data Report on 6/28 19 88 and state that, to the best of my knowledge and belief, the manufacturer has constructed this pressure vessel In accordance with ASME Code, Section VIII, Division 1. By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or Implied, concerning the pressure vessel described In the Manufacturers' Data Report. hermore, neither the Inspector nor his employer shall be liable In any manner for any per-sonal injury or property damage or a I g connected with this Inspection. Date 6/29/88 Signed Commissions Nat' 1 Brd. (1 8223 OK fl 268 (Nal"I. Bel. (Incl. al'ldOC'Nrnental ata11. prow. end no.I CERTIFICATE OF FIELD ASSEMBLY COMPLIANCE We certify that the field assembly construction of all parts of this vessel conforms with the requirements of Section VIII, Division 1 of the ASME BOILER AND PRESSURE VESSEL CODE.

       "U" Certificate of Authoriutlon no_ _ _ _ _ _.explres_ _ _ _ _ _ 19_ __

Date_ _ _ _ _ _ ,Name_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ S l g n e d ' - - - - - - - - - - - iaumt11* 111at certlfilel and conatruc:lad HIid ~ (~Ml CERTIFICATE OF FIELD ASSEMBLY INSPECTION I, the undersigned, holding a valid commission Issued by the National Board of Boller and Pressure Vessel Inspectors and the state or prov-Ince of and employed bY.-------------------------------

      -------------------Of                                                                                  have compared the sta!ements In this Manufacturers' Data Report with the del!lcrlbed pressure vessel and state that parts referred to as data Item                                                                         not Included In the certificate of 1hop Inspection, have been Inspected by me and that to the best of my knowledge and. belief, the manufacturer has con-structed and assembled this pressure vessel In accordanCe with ASME Code, Section VIII, Division 1. The described vessel was Inspect ... ~

and subjected to a hydrostatic test of sl. By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or Implied, concerning the pressure vesse, described In the Manufacturers' Data Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any per* sonal Injury or property damage or a loss of any kind arising from or connected with this Inspection. Date Sign Commlsslons,_~-,,-~----------:-:'."'.'-"- IAUttlanmd klllllclor) (Nat"I. Bel. (Incl. ~ t a l alate. prow. and no.>

                                                                                                                    *-.::n
                                                                                                            .....- ... ~ -:.v FORM U-4 MANUFACTURERS' DATA REPORT SUPPLEMENTARY SHEET
  • required by the prorialona of the ASME Code ruin, Section VIII, Dlmlon 1 Manufacturedandcertlfledby Yuba Heat Transfer Diyision 2121 N. 161st E, Ave, Tulsa. OK
                                                                                      <- - lddraa o f ~
2. Manufacturadtor Y1ri1D;[a* Power Electric Power Company sooo Dominion Blvd, Glen Allen. VA

(!WN an11 - - o1 purclWMt) 23060 Viri1nia Power. Surry Construction Project, Surry Yiuinia 23883

3. Location of 1nata11at1on
4. Type* Exchanger 87-G-433-lB 82~-433-1 5418 1988 (IIOriz.. wen .* I.Ink. etc.I (mtr"a. -1al no., (CAN) jdraw,ng no.) (Nat'I. BG. no.) e,..11u1n1 Data Report Item Number Remarks Inlet Channel Cover **

(SA-516-70} (56 7/8" O.D. X 4lz;" thick) (C. A. - 0) Hanway** (SA-105) (18" - 150/1) (RFWN) (C.A. - 0) Manway Coyer (SA-105}(18" - 15010 (RFBLHC .A. - 0) Bolting 11/8" SA-193-B7 studs & SA-194-2H nuts 3/4" SA-193-B7 studs & SA-194-2H nuts

                                            **Beat Treat at 1100°F 1 hour Outlet Channel (SA-516-70)(5/8 11 thk)(C.A. - 0)(4'-3" diam.)(4"-8,i" length)

(Dbl)(Full)Cl00%)(1100°F)(l hr)(Dbl)(Full)(l) Channel Flange (SA-105-N) (51" I.D. X 56 7/8" O.D. X 3 1/8" thk) (C.A.-0) Channel Flanie (SA-105-NHSl" I.D. X 56 7/8" O.D. X 3 l/8 11 thk)(C.A.-0) Outlet Channel Cover** (SA-516-70)(56 7/8" O.D. X 41%" thk)(C.A. - 0) Hanway** (SA-105)(24" - 150#)(RFWN)(C.A. - 0) Manway Cover (SA-105} (24" - 150H} (RFBL) CC.A*. - 0) Bolting Vt" SA-193-BZ studs & SA-194-2H nuts 3/4" SA-193-B7 studs & SA-194-2H nuts

                                           ** Heat Treat at 1100°F l hour
    ,to    6/29/88                 Nome6~(fflanUt~                                  n         Signed      1~ ~

( / Jack (raclrnMl1atlw9>Federline Date 6/29/88 Signed Commissions Nat '1 Brd, II 8223 OK # 268

                                               ~(Autllor1nd lnspec:tOI)     White                                      (Nal1. lld. (Incl. - -
  • 1 1
  • 1 a1a1e. pnp,. - no.,

Thi* form may be obtained from The National loard of loller and Prn1ul"8 v....1 Inspectors. 1055 Crupper Awe.. Col's. OH 43229 ~~

FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI

1. Owner __V..:....I~R~Ga..I1.JN.i.i.I..,A'--,IE;.;I....,E~C""T""R,._I'-'C-.cA....,Nu.DL-P"-Q......,WE"""'R>-..JC Name a....._
                                                                                                              .......          Date~uh~t-ft~'r.--"-7_ _ _ _ __

5000 DOMINION BLVD,. GLEN ALLEN, VA 23060 Sheet _ _. . , , / c - - o f _ _ . ' - - - - - - - - - - - -

                                               .         Address
2. Plant SURRY POWER STATION Unit -(J,v ,£ -

Name P.O. BOX 315. SURRY, VA 23883 WO d- 3.R'OtYt)£:2Z6? Address Repair Organization P.O. No., Job No., etc.

3. Work Performed by VIRGINIA PQWEB Type Code Symbol Stamp_~N~/~A~-------

Name Authorization No. __,N~/"'A'------------ P.O. BOX 315, SURRY. VA 23BB3 Expiration Date_~N,../...,A-=-------------- Address

4. Identification of System (;,ctl ;;.O.<<<J:-f!C cl!!U ,.e/tf
5. (a) Applicable Construction Code B31, l 19..fiL_Edition, N(A Addenda, *N-l, N-7 Code Casa (b) Applicable Edition of Section XI Utilized for Repairs or Replacements 19° .I'd q}g,'()
6. Identification of Components Repaired or Replaced and Replacement Components ASME Code National Repaired, Stamped Name of Name of Manufacturer Board Other Year Replaced, (Yes Component Manufacturer Serial No. No. Identification Built or Replacement or No)
  /Ln f-1h;),,                                 -                                         -                            ~~         J-r.,- -E-1""9       -       k'- .           a/)  ...v;,

tiL 7" (: ~.-?) - - .,,.v~ J -cc -e!,,1,4 - ,4.L,

                                                                                                                                                                       ..... ~;i     /,)(J
7. Description of Work_+~~~71t~e-~&e:~.f--~6~~=.ef~=M-11=/'--_,,6_,,o-?=u~/A/~r~ef-----------------
8. Tests Conducted: Hydrostatic O Pneumatic O Nominal Operating Pressure 0 Other O Pressure _ _ _ _ _ psi Test Temp, _ _ _ _ _ _° F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is BY.. in. x 11 in., (2) informa-tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form.

(12/82) This Form (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017

FORM NIS-2 (Bac1) bj /'

9. Remarks ~,.<.:L:!,S..L.-..<-1L-----"'~-\"--$..,_,_..S-/-l'-Y~-Z"""""'I__"':,2.-=-..9<-<£'"-------'l..;~,;,,,..___ _ _ _ _ _ _ _ _ _ _ _ _ __

Applicable Manufacture~* D a Reports to be attached 2.. CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this llP-Gdr~b'n:onforms to the rules of the repair or replacement ASME Code, Section XI. Type Code Symbol Stamp _ _ _N ~ ~ A ~ - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Certificate of Authorization No. _ _.....,......_ _ _ _ _ _ _ _ _ _ _ Expiration Date __N=/-=A"'-------------- Signed Q. o~Uffi:re'e, Owner f/.~- "'¢/ Title U_.t &4 Date J>s. I'/ ,19 Yf CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and.Pressure Vessel Inspectors and the State or Province of and employed by HSBI & I CO* of

  .....1H;i.A...,R..,T..,F....,.O"'R,..D.u.,__,C,,_T,.___ _ _ _ _ _ _ _ _ _ _ _ _ _-=--------,:a:-.------ohave inspected the components described in this Owner's Report during the period-----+-L~cb~-....J.,....~~?~6~-to                                                           Cj- /Cf -8 'f                , and state that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section XI.

By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a Joss of any kind arising from or connected with this i_n_sp_e_c-ti-o-'~ ..- -=>e-~-~~-f.,.__*_-'&dL=-'---=--------Commissions _ _ _ _ J_(}... _ __,).._~_':£_,_=J;_____________ Inspector's Signature National Board, State, Province, and Endorsements Date,_ _ _ _ _,l~l=--.._IL\_,___19~2_9.,._

      --~                                      .- .*~ :.  ~

ATTACHMENT 2

                                              '                FORM NIS-2 OWNER'S REPORT O:F REPAIR OR REPLACEME"NT As Required by the Prorisioru of ASME Code Section XI
      ---=-,:,o:=====-=-=~========---======-====-==--==.,,.================- .,.--
     -1. Ownrr                 Virginia Power                                                                                                                    D1l'l*~~'---~~/~           'f'__

__ "l~---------- P.O. Box 26666 Shfft _ __....__ _ _ of_ ___._ _ _ __

2. ,1,nt Surcy Power Station j,\.GOrnaJ Unh----------------------

ty;vC CN~ e.o. Box J1s Surry, YA 23883 7fN b

                                                 .                      .(ACIOf'III/
3. Work Performed by.Y...A w~e...r________
                                                            ................l:'O.......                                                  38DDD CN-i
                                                                     "-Same
      ... ldendfication of Syn em                                                        """'. . c~ ~ I    I c:q, ,,,,;..J   Uo l  VA,. f           l~ I    "i,c,
5. 11) Applicable Construction Code B31-l 19 67 Edition....l~_A...._____ Addenda, Codi ~e,. ___ A___

N__ (bl Applicable Edition of Section XI Utilized for Re;,ain or Repiac,m1nt1 - 11..80, wan Addtnd1, Codt eam__..N.... A.._____

8. Identification of Components RepairTd or Replaced, ind Replacement Components Ntm1of Name of Mfrs. Sir.
  • Nat'L CAN Other Year Rep1i,..d,. ASME Codi Co"'POntnt Mfr. No. Bd. No. ldentJ. Buth Replactd. Stamped No. fication or (Y11 or Nol
- r, lc.J"lk.~
                                            ,..o;-

o,._

  • le 7oJ..o I Ai/A MA- 1-c..1-1-30.5 fa/A
). &rSS13 JV/A VA -.J -Clli/.JS ft),4 Dneription of Work _ _ _ _..,.._t,-,,.__........_lfi"'--.._11 I &ifl).f-

_ _ __.._ _ _ _ _ _ _ _ _ _ _ _ _..,,...._~------- 7. I. Tem Condue1ed: Hydron*tic "/PPneumatic O Nominal Operating Pressurt O Othtr ~M .,23 I. Ae~rka Prutul'T .2.lYO psi Test Temp . .!::!z._*F U"i.lve fo-:Jt.. .JlJS- OS~//

                                  ~ic&llll.,..""'"'"'.,.,o.iaAe:,o,111ociea1~                                                             J ,r f.-e-e.. fo                  "*-  sy-l/Si.3S CERTIFICATE OF COMPLIANCE We c1nify that the n1t1menu m~ In this report ar, corrtct and this_....                                                         Cf.i

___ ~ t__*___ conforms to Section XI of lht

                                                                                                                                         ,../J_/"i._C._*.......__.......

ASME Code./1 .~~ r,AorrepiacemenQ Si11ned

  • l/.ti-fu!, p..,... er Owne Oe1,g,_I uf~ ISI Tel!;
                                                                                                                                          /./U(. I I (O&ltl
                                                                                                                                                                                      .,, ?-<i CERTIFICATE OF msPECTION I, the undersigned, holding                             I    v1lid comminion issued by the National Board of Boiler end Pressurw Vessel Inspectors ind tht Sratt or Province of,_                _.V....A
                                            . . .._________ , employed bv HS!r I &I co.                                                                                                                                      of

_H_a-r....t ....f_o.._r....d._.,_c'-"r. . .__ have inspected the re{)l<tc.e,....._t'j\. I demibed in this Report on _ _ _ _* .... , ...,l...-_J~Q~-. ,gfi IRrp/.,i110t Rt~l1ctme11t11I

  • ind nate that to tht ben of my knowlrdgr and belief, this" repair or replacement hai been connructed in 1cco,dance with Section XI of the ASME Code. By signing this cenificau, neither the Inspector nor his lfmployer makes any warranty, uprrued or implied, concern-ing the repair or replx.rmrnt described in this Rrpon .. Funherrnore, neither the Inspector nor his employer shall be liable in any manner
  • for any ~rsonal injury or property d*f\:~"'°Jf ~a"J'1~sing from or connected with 7his lnsptction.

Catt /:).- ~ -f'f . ~ i_. ~ Commiuion1 _ _ ..!!v;L,,a.~S~'l-3'----~----

                                                                  .                                (lnli,KIQl1 .

Non: S.,ppl*m*nt.l ehNt'I In form of Ilea, 1k*1cha. or drawlnpe may b9 .,*,.d provld*d (t) 1111 II l:K In. X 11 '"**

                                                                                                                               .                                              (State or PR>.*"CI, Nat,onal     8oarGI
   , lnformallon In h*m1 1 1hro..,gt1 4 on thle data repo" 11 lncl..,d*d on uch shNt, and (31 Heh 1hNt 11 n11mbered I """'bar               of ShNb I* recorded at the tOP of thll form.
   .. :-,.                   .... :* *-                                                                                                                                                                            ATTACHMENT 2
               *...                                 ,,~    1
                             \

FORM NIS*2 OWNER'S REPORT OF REPAIR OR REPLACEME.NT AJ Required by tht Provi1ion1 of ASME Codt Section XI

  *1.      Owntt     Virginia Power P .0. Box 26666                                                                                                                      St1N1 _ _ _ _ _ _ of_ _ _ _ _ _ __

jAOOrna,

2. Plant Surry Power Station e.o. Box. JlS~INAIIIII Surry, YA 23883 Ill Work ,erformed b\,_V...A ....t---------
                                       ......_...rmre~        4'1_,
                                              --same
4. ld1~tlfic1tion of Syn1m /;;;4-0~tf/Ari!!~

I. ,., Applic1bl1 Constn,cdon Code 831-1 ,t67 Edillon,....r~_A_____ Addendl, Code easn _ .... A___ N__ (bl Applic1bl1 Edition of Section XI Utiliud for Repain or Aeplacemenu - 11..BO. WBQ Addenda, Code Casn _....H...A.____ I. Identification of Componenu R"'1irtd or Aepl1c.d, and Replactmtnt Componen11 Nam1of N1mt of Mfr1. Str.

  • Nat1. CRN Other Year Repaind,, ASME Codi*

Component Mfr. No. Bd. No. ldentl- 811"1 ReplacteS, ~tamped No. f"ication or  ;,ttorNot R1plae1ment

    !~~)~

f~~WM,

                          **"'-** /'A          'I2. Jl'./:JO               J/h                ,v,k..              ,_~.' *-""                   n/4-                  .t>.,    >J, .A -   ~/ ' )               :.Vn
7. Description of Wort _,l'-R.=~.,.;.-~""lld_..4.,.4:....,.)__....

Y'""',fe.l;==-""'i/,"":.,e""""'4"'v._,;;f I. Tm, Conducted: Hydrosiatic D Pne11m1tic O Nomil\ll C)peratint '""" ... B' Other a )

                                      '"*surt       ,f/!Je psi T,n Temp.~., . /                                                                             \. #                 ~ H (.

Remarlts _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _..,.l(d.....,.4...e'ia.:::~........C, ~--t

                                                                                                                                                          .........     ...J......~-2....</...z.........,_
                                                                                                                                                                                                      ...~..,..------
  **                IAPl>icabie MA""lacti,raf"I D111 lw;10t11 IO Ii. 111ac_,,_.

CERTIFICATE OF COMPLIANCE Wt c1nify th*t th1 n1t1rnenu made In this r,pon are correct and th*--~--~.... ~ A(;J. 'i>:........ . ......:& ____ conforma to Stction XI of IN

   "'"'ME~-.... rl                                                                                                            ttpa,,orra~
  ;::ntd -* M,J         tow-oro-.ra E.,;!.'fj-c(~ ~44:::                                         ISI TIii
                                                                                                                                ///6 CDIIIJ
                                                                                                                                                                                 .,, ~9 CERTIFICATE OF INSPECTION I. lflt undtni;ned, holdint I valid commission luutd by tht National 8011d of Boller and ,rn1111'9 V111tl lnspector1 ind the S111t or ,rovinct of         VA    I
  • employed by use* I &I co I of Ha rt ford
  • CT. have inll)tclld the Rc:p( 0, c.-e M C(t.lT IR1p1,"11J ~,:,11carneftl(1I o,

demibed in this Repor, Oft . II~ 1'{

  • 1111 end 11111 ttl1t to lht best of my kno....,frdve and belief, this repair or replacement h11 been connrvcied in 1cC01dana with Section XI of the ASME Code. By signing this cenifiute, neither ttlt ln1ptctor nor his ifmployer makes 1ny w1rr1nty, uprened or implied, concer~

ing the r1p1ir or replacement d*scribtd in this Rtpon. Funtlermort, neither ttlt lnsp1c1or nor Ilia 1mploy1r 1h1II bt li1bl1 in in..- manntt for 1ny Ptr1on1l lnjury or propeny dfl~ o,f 1 ~ i n 1 1 from or connected with this lnapuiOft. Datt ({-I'{, g~ ~ !. ~ Commi11ion1 J/8 70b j Cc.. 5'!.(J ll"11*0<1or, CS**** or '"'"-'* Nahcr\l* 8o&ldl Non: Swpplemeftt.l 1h .. n I,, form of 11,u, *lie,ch*, or drawln .. mey be ueed provided 111111111 " ' 1ft. X 11 In.,

"!) Information In "'"" I through
  • on thl1 date repor, 11 Included on .. ch ehNt, end 131 uch *hNt 11 numbered d " ' ' number of 1h"ll l1 recorded at the IOP of 1h11 form.
                                                         .** :*   -                                                                                                                                                                            ATTACHMENT 2
                                                      \

FORM NIS-2 OWNER'S REPORT OF REPAIR OR REPLACEME.NT Al Required by the Provisions of ASME Code Section XI

    ...1.            Owner                 Virginia Power                                                                                                   Den            10/       rn / eq P.0. Box 26666                                                                                                   ShNt                                                 of~-~~-~~~

jAOdrnaJ

2. Plant Surry Power Station IN.,.,..

P,O. Box 315 Surry, YA 23883

                                                                                 "'w...e...r_________
                                                                             ~oora111
3. Work Performed by_Y...A......._,_po"' 3800019.5"~

lNa/1111

                                                                           '5ame
4. Identification of Synem >4N:;-"f Mt7!:c?""?,?U
5. fat Applicable ConstNctlon Code B'3 l-1 18 6 7 Editlon,_H._A=-----Addenda, Code Cases _ .... N...A___

(b) Applicable Edition of Section XI Utilized for Repair1 or Replac1m1nt1- 11..BD, WRQ Addenda, Coda Casn _...N"'A._____

8. Identification of Comp0nenu Aep1il'fd or Replaced, and Replacement Components Namaof N1mt of Mfrs. Ser.
  • Nat1. CRN Other Year Repaired,, ASME Codi Component Mfr. No. Bd. No. ldentl- au111 AepllCtd, rtamped No. f"ication or ;as orNoJ Replacement I l/

I~ STurl,J Ho.rel u.>o.f' e...

                                             'C-,. i-stf-., .T..
                                                                                -                   tJ/A,,            rJ/A.

01-SI-

                                                                                                                                  - -t:IR            f.J/,t             reP~c::eJ                                           u,.,,
 \

x

       ""           l",Jc,/t' I
                                                       '1
                                                                               -                    1.l/.4..          t..llA-         I\             tJ !A.            .,. .. 1'1b.ced                                      lll")
  • 7.

I. I. Description of Work ti'~;,~ *iP~ do.J ..1/n"1v.ur .:6'1-/e Tnts Conducted: Hydrost.itic (2J Pneu~atic 0 Prtssure';}:335"' psi Ten Temp.~ eF A1mar1ts _ _~---......,,..-.,,,------------S-I....v,...d_....d...__.._P...0.._~

                                          ~<.ebif lila"UIK'hlfet'I 0.ta Jw;:iona 10 be al\Ktl9dl Nominal Oper1tin9 Pressure 0                       Other 0

__5__... 5...'r'__ a. .1.....o. . . . .+....3....A.....____

                   ---~-~~~~-~---~----~__..IJ..._,.,'f:......_~                                                                                    .          ....f'....a<:J...__~~.....ei...::,....<r'........_./.......

f)~.<o ~""'~~~-- CERTIFICATE OF COMPLIANCE We certify that th* natamenu m.cSt in this report ar1 correct and this d. ,f):.e...~,£-4,<!7c<L conforms 10 Section XI of thl ttl*f or 1 e p i a ~ ASME~* Si9ned~~44,L/ tow- or I Di1,o-l ISI Tlllt

                                                                                                                                                                                   . ,, z:~

CERTIFICATE OF INSPECTION I, lh1 undersigned, holding I valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and thl Sratt o, Provine, of--Y-A_,,____ _ _ _ _ _ _ ,employed bv HSB" I&I CO of

   .......H...a. .r...,t. .f..,o.u....r.wd_.,~C<..JT,._*.___h,ve inspecttd lhe                        R-ep \"' C."1 M e       AJ ""I° IR1p1,rt1J o, ~1::,11umen1f1I dt1cri~ in this Report on                                                           It- tJ..                  .,tfl
   *nd nate thar to the belt of my knowlrdpe ,nd belief, this repair or replacement hes been connructed in accord,nct with Section XI of lh1 ASME Code. By si;ning this certificate, neither the Inspector nor his lmployer m,krs any warranty, upre1sed or implied. concerr.,

ing the rep,ir or replacement described in this Report. Funhennor1, neither the Inspector nor his employer shall be li,ble in any m,nner for any personal injury or property d ~ n l f ' f ~~rising from or connected with this ln11Ptftion. 011t //-'J..- f? ~'-{.. ~ Commiuions .A>B 7~o 1 Ve\.. S'L{ 3 (ln*-*llf'I (S111e or Pn:,.-,1,c:,, H11,ona1 8o&l1II on: $.,ppl*mental 1hen1 In form of Ilsa, tke1ch*, or drawln1,11 mav be ueed provided 111 aln h IX 1ft. X 1 I lft., Information In h*ma I throuvi , on this 11111 r*P0'1 11 Included on .. ch ahNt, and (31 .. ell ahNt 11 numbered

           ,,.., number of 1hMt1 11 recorded at ,t,e 1op of this form.
        . -:-,.                                  .... :* -                                                                                                                                              ATTACHMENT 2
                                                                               ,,~ .

FORM NIS-2 OWNER'S REPORT OF REPAIR OR REPLACEMENT AJ Rtquired by the Provision* of ASME Code Section XI own,, Virginia Power D1i._/,..Q':..f./.,.9.,./,.15...,:;,,.___ _ _ _ _ _~

       *1.

P.O. Box 26666 ShN1 _ _..__ _ _ of_ ___..___ _ __ l,AOC!rina,

2. Plant Surry Power Station .....,.,.. .

e.o, Box 315 Surry, VA 23883

3. Work Performtd by ....V .....*_._1-'JACIOrlUI
                                                         ...A                      r________

n_\<..,/_e... 38QQQ Z<o 509 4N-i

                                                                     -..same
4. ld1~tlfic1tion of Srnem S:,~~~,z2n;.l?'t?..c;I
5. lat Applicable Construction Code831-1 11 67 Editlon,...H.._A...____ Addenda, Codi Cases _ _,N.:. .A___

(b) Applicable Edition of S1e1ion XI Utilized for Aepain or Aepl1e1m1nu - 11...BO. WBO Addenda, Code c.... _N_A____ I. Identification of ComPOnents Aep1irtd or Aepl1cad, and Aeplictmtnt Componen11 Nam1of Name of Mfn.Str.

  • N1t1. CAN Other Vear Repaired. ASME Codi Component Mfr. No. Bd. No. ldentl- liulh Replactd, !tamped No. fication or  ; as or No)

Aeplaetment

   .I/ .,_

I I

                                                                                   -        u/..            ti   /1..

O~Aost: .. F~.

                                                                                                                       - 1e...t...,...          NA            ~ .... -"!?~""- ~
                                                                                                                                                                       . I_,...,                 '"'""

i I.II l\} ....L,r

                                                -                            -             1.1/1...         l.l /1,..
                                                                                                                         -                    ,. ,IA.         .
                                                                                                                                                              ~.o
                                                                                                                                                                       ~

7* CERTIFICATE OF COMPLIANCE

      =c-. Qz""~L We certify that th, n1t1menu midi In this rtpon art correct and this io--
  • e>,.,,era '0,..1 ISi T*1t
                                                                                                                         ~ ) c . ~ ~ ~C CDl1tl conforms to Section XI of the
                                                                                                                                                                            .,, ?"9 CERTIFICATE OF INSPECTION.

I, the 11ndmi911ed, holdi119 1 v1lid commission iuufd by the N1tloN1I Board of Boiler and Pr~,-~*,.* Vessel Inspectors and the S11tt o, Province of_ _.V..._A.,.,._______....,, employfd by HSB* I &I CO, of

      ~H...a...r_,t. _f&.;oWJ..r.,.d....,~c. T
                                             .....,L-._h,11t inspe,cted tht                             (..      eivT ducribed in this Atpor\ Oft _ _ _ _ __./'-/...- - ~ - - * ,g.1LJ fRr **'11J o, ~r:,t1cemen1(1I and n1te thlt to tht but of my kno ...1,dge and belief, 1hi1 rep1ir or replacement h11 been connructed in 1ccord1ne1 with Section XI of thr ASME Code. By signi119 this cenifitlitt, neither the ln1pector nor hi1 lmployer m1kr11ny w1rranty, upreued or implied, conctri.-

ing the repair or replacement described in thi1 Report. Furthermore, neither the Inspector nor hi11mploytr 1h1II be liable in any menntr for any personal injury or propeny ~ ~ *"J-..kin~rising from or conne,cttd with 1hi1 ln1PtC1i9"- D11e /(-'l-t1 ~l_. ~ Commiuion1 J/{37oD~ VC<..f'1J 1

  • fln1-1DI)
  • IS**** o, f'TDwtftCe. Naho,,. bldl on: S11ppleme11ul ehNn In form of 11,a, *htch*, or drawlnpa m1y be u,*d provided (IJ 1111 h 8:K In. X 11 In.,

U Information In l'9n,* I throvgtl , on 1h11 d1t1 repor, 11 lncl11d*d on Heh '""'* and 131 ucfl ehNI It n11mbered fld .,.. '"""be' of ehNtl le racordad 11th* top of 1h11 form.

    *-~                       .... :* -                                                                                                                                               ATTACHMENT 2
                              \

FORM NIS-2 OWNER'S REPORT OF REPAIR OR REPLACEME.NT A.J Required by the Provisions of ASME Code Section XI

  -.,. Owner        Virginia Power                                                                                                                l))-1/f?

D111.......a'a~~----------------------------------~ P.o. Box 26666 Shm---__...__-------*'---------------- f'

  • CAOOrnll Unh ____O_.'!V--::;.t:' _____________________________________
2. Plant Surry Power .:,tatrnn CN~ V.

P, 0 , Box 315.{AOOr1111j Surry,A 23883

3. Work P1rf ormtd by_,Y....A ,e.......r~-,-------
                                         .....L.-aPO._....i,...

if 71770

                                                                                                                   "'~38QQQ
                                .                ...same                "'-i                                                Otganizatioft P.O No.. Jotl No. lie.

4.

                                                                       &W_,        /Jw Identification of Synem _..------;.:-::..--....--'f--....;.;.!J_.__.,...,,,---------------.....,..,.------------------------------------:-,"T"--------
5. (1) Applicoblt Corutructlon Code B31-1 19 67 Edition,.:..H"-A,___ _ _ Addenda, Coda Cases ----=-N:::..A.,_____

(b) Applicable Edition of Section XI Utilized for Repairs or Replac1m1nt1 - 19..80. wan Addenda, Coda C.ses_...N... A____ I. Identification of Ccmponcnu RepairTd or Repltc.d, and Replacement Components Namtof Name of Mfn. Str. -Nat'L CRN Other Year Repaired, ASME Codt Component Mfr. No. Bd. No. ldentJ. Buth ReplKtd. Stomped No. f"ication or {Yt1orNol Replacement

' ".s+'1. J_~            A/ol,I<# jn).,J
                          ,M"c)...~    ..       37'riJ.-7/                   NIA- /\I!It l-t1-E-1t vV/A                                           i<p nr,i Lr)

V

                                                                                                                                                                              /Vo
                                            ~
7. ~R Description of Work _ _... t_f4...._c.(.__ __ J____S_-f-_...._J._~_~- - - - - - - - - - - - - - - - - - - - - - -

I. Tfflt Conducted: Hydrostatic O Pneumatic O Nominal Operating Prnsu'9 hf Othtr 0 PrHsurt /\1'0 f psi Tan Temp. ;Jo't"' *F I. R1marlu _ ___ ------=---:,-------------------------------------------------------------- l,l.ppal)lf IAa"UIACIUf~I DIii llc;ICl!!I IO l)e allac"-11

                                          ;,i...~S" e...,"1-- ffll.-. b...- J'6 CERTIFICATE OF COMPLIANCE Wt certify that the n1ttmanu m.cSa In this rtPOrt are correct and this                                          fY-(./tL      'f'r,..J:,.. -f-               conforms to Section XI of the
   .e.*ME ,._..._       ~                                                                                                 tpa,, oe rap&acemttlQ
  ~ned -.-.            ..       ./~u/
                             ;;.. o, Ow~ , g - 1 ISI zt£tt,-

(Ditti

                                                                                                                                                          ,ti     Tf CERTIFICATE OF INSPECTION I, the undersigned, holding I v1lid commission Issued by tht Natlo~I Board of Boner end Preuurt Ve~stl Inspectors and tht S11t1 or Provinceof            VA,                                                , employed tr, lfS B" I&I CO.                                                                                of Hartford. CT,                      have inspected tht                     f;i.'./q    l-f~y, -r              ducribed in this Repon on                                  ,_   tJ-lf *;,11 IRt  **rt*I or ~t::,l1ctma111(sl and natl that 10 tht ben of my ltnowl,dgr and belief, this repair or replacement h11 been connructed In ac001d1ne1 with.Section XI of tht ASME Code. By 1igning thi1 cenific.a,e, neither the Inspector nor hi1 lmployer makes any warranty, , .. p,ened or implied, concern-ing tht repair or replacement described in this Report. Funhermort, neither the lnsp,ctor nor his employer 1h11l be liable in any manner for any personal Injury or property dari:,,pr.!Jf_J;of.,~l ~lfd arising from or connected wi th ~hi1 Datt          0- 1Lf - ~l                                   ~-::f.l: ~                                        Commissions 1
                                                                                                                                           /v{?
                                                                                                                                                     ~IP*c:ttt , 3
                                                                                                                                                 /i)c. 9'          ct .t;.f t1n1i,.c10f)                                                 v       (SIiia o, Piv,,,nc:1. Nahonal ~

Non: SupplementAI '""n In form of llns, 1ke1ch*, or drawln1,11 may be ueed provided CU aln h BM In. X U In., (2) lnformnlon In hwma 1 1hrough

  • on thla dna noon la Included on uch *hHt. and 131 uch 1hHI la n11mbered and 'lh* number of 1h"t111 ;*corded II the IOP of thla form,
     . -~                      ...... -                                                                                                                                                          2
                                                       ,,~ .

ATTACHMENT

                               \

FORM NIS-2 OWNER'S REPORT OF REPAIR OR REPLACEME.NT As Required by the Provisions of ASME Code Section XI

   -,.        Owner    Virginia Power                                                                                                 ~n........-.6__!__   ~3__:,/~~~~----

P.O. Box 26666 Shtft ........................__ of_____..________ Unh ................c9:;;.....,._..e..

2. Plant Surry Power Stati~.

e.o. Box 315jAOOt9UI

                                                     ,.~

Surry, VA 23883

3. l:'O~W...e. .r......,,

Work Performed t,y..;YuA............... . ___________ (Name) 38000 7$~

                                              --Same
4. Identification of Synem ......-----::=-::,--,:-'""*
                                                                   ~_,,_cw    -'----r::,-----.......,,,-r----------------:-:-r-----
5. Cal Applicable Constrvctlon Codt B31-1 19 67 Edition,~H_A_ _ _ _ _ Addenda, Code Cases _ _,_N.,.A.,_____

lbl Applicable Edition of Section XI Utilized for Repairs or Repl1e1mtnt1 - 11..BO, wan Addenda, Code C.stt .......N....A._____ I. Identification of Components Rep1i~d or Repla~d. and Replactment Components Name of Name of Mfra. Str. -Nat'L CRN Other v,., Aep1ired, ASME Codi Comoonent Mfr. No. Bd. No. ldentl- Bulh Aepl~ Stel'TIPN

   .~,a....,;,.                                                              No.                       fic1tion                                      or                         (Yn or No)
   - --.uy*'{_                                                                                                                                Aeplacem,nt 3 if +/111,,Jj-t-     Hui~c..           4/S l.f~ti3.b ~A                               .All\-      }-f,u.pJ I~       #,4                    r'eP( <-1                       ~
M,,.. +t, r J/'.P,, ,i:>~ 1rt,;-,L h .. 13~55 (so ;v)t- NA 1-Sw--p,,t ;Vii( {'~ f) I (. -c. NO
7. Oflcription of Worlt _ _ _ _- - - : - - - - - - - - - - - - - - - - - - - - - - - - - - - -.........- - - - - - - - - - - - - -

I. Ttm Conducted: Hydron*tic O Pneumatic O Nominal Oper1tin9 Prnsurt G'- Other 0 Prusure ,Nor psi Ten Temp.AL'QL *F Rtm1rlu _ _ _ _ _ _ _ _ _....,,..._ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __

    **                 ~~ Ma"Ulatlllflt"I Daia ~:,onllobe 11\ACl,,s,dl3hf&:;:; f                        -   f o-,J;(S 'I          :2./ 'l .5 t'O CERTIFICATE OF COMPLIANCE We c111ify that the n1temenu m~ In this repor, art correct and thls _ _ _ _                                    f_-f-;*.p~/r,.._c_0:-:&,,

______ f__ conform1 to Section XI of the

~Code.. *0-/Ow,;.;;;.;-,~

(Ow'* OI ISI TIit t1pa,, &r11p1a~

                                                                                                            ~t £~e (OlttJ
                                                                                                                                                       .,, a CERTIFICATE OF INSPECTION I, tht undersigned, holding a v1lid cominisaion Issued by the Natlo~I Board of Boller end Prenurw Ve~11I lnlPl(tora ind tht Sratt or Provinct of          VA,                                             *employed bv          use* I&I co,                                                                              of Hartford I CT.                  have inspected the                     r-~~L,,°'. . o-,,._,\        dmribed in this Report on                                  ~-      .iq .;gffi_
                                                                           !Rcpa sJ     ~,~1ac11T11nl(1I and nat1 that to the btn of my knowledge and belief, this repair or replacement h11 been connructed in 1cc:ordanct with Section XI of the ASME Codr. By signing this ctnificatt, neither the Inspector nor hia lmployer makrs any wvarranty, upre1sed or implied, concern-ing the repair or replacement ducribed in this Repon. Funhermort, neither the Inspector nor his employer 1h1II be liable in any manner for any pe11on1I Injury or proper1y d*r;:_ '1_a 1$!!~f.a9-Y) kiJ1 arising from or connected,,, with thi1 ln1Ptctipn. ,_

D11t ~"""' ~ y -<29 i ~ rl__. ~ ll"IPKIOI) Commiuionl I: rr3 '?Do T Vet. .s q 3 (Slllt OI Pli,,,1r,c1, Nal,onal 9oarGI Note: 5.,pplamenlal 1hNts In form of 11111, 1ke1ch*, or drewlnga m*y be uoed p,o,..ld*d CU 1IH h II~ 1ft. X 11111** 121 lnform*llon In lnm1 1 thro\lgh , on 1h11 due noon 11 lncl"Cl*d on uch 1hNt, end 13) .. ,h 1hHt 11 numbered and lt\e number of ahNtl 11 recorded el 1he top of ihl1 form.

                                                                                                                        \f
        . -=--4'                   .... :*. -                                                                                                                                                                                                                            ATTACHMENT 2
                                   \

FORM NIS-2 OWNER'S REPORT OF REPAIR OR REPLACEME°NT AJ Required by the Provisions of ASME Code Section XI

      ...,.      Ownei:     Vi rgi a i a Power                                                                                                                                                                      ~

D1n__.._f!.........?--~=-~--f~~~~~~ P.O. Box 26666 ShNt _ _ _ _ _ _ of_ _......,..___ _ __ CAOOrnaJ

2. Plant Surcy Power Station (Naffllll P.O.

Box 315 .lAOOrHIJ Surry. YA 23883

3. Work Performed by_V ......_._PO_...w....e...r----::~-,-------
                                           ...A                                                                                                                    38QQQ6,Zi:U (N-.1                                                                          Repaif 0t;1niulio111'.0 No..* No. ate.
                                                     --same 4.

5. Identification of Synem-.f!.=-...v. (a) Applicable Constn,ctlon Code 831-1

                                                               .....:'?_,____*~~-;:N,,..~'1-:-----...-=--------:.,..,,..--------------:-:--r----

19 67 Editlon,..:..H,,_A,___-'-_Addenda, Codi Cases _...,_N.._A.....*___ (bl Applic1bl1 Edition of Section XI Utilized for Repain or Aeplac1m1nt1 - 19..8.0, wan. Addenda, Code. Cases _._,[:Jw;.,A.___ __

6. Identification of Componenu Aepai~d or Replaced. and Replacement Components Nam1of N1mtof Mfrs. Str. -Nat'L CAN Other v,.,. Repaired, ASME Codi Component Mfr. No. Bd. No. ldentJ. Buth Replectd, rtamped No. fication or f~* .. or Nol Replacamtnt
      .t co.v                                     .2..0.e..nul)

__ 2."u"x ~" 1(/t:,

7. Description of Work _...h=....~.;;..:;:..~:..::?:f..::.&_d.~:J'::::,---'-M...;~;;:...;.;&(./::..._....;;.S-:~*""~~#."-""?..__./_z..:::u;;::.~..,;f:"";</'--"'4"'""t""',,v.;""~=-...1/2.._*.;...N'

___./ >__

                                                                                                                                                                                                                       ....-_C"""""";?--..... -...,,.2.......,(1..___ _ _ __
8. Tests Conducted: Hydrostatic ~ Pneumatic O Nominal Operating Pressu,. 0 Other 0 Prrssure / fr psi Ten Temp.-1.l;!;J_ *F
9. . Remarlu.,.,.......,,.....,.,..~~-:----=-:e---:::-----:-7----:---------------------------

IAIIPI~ Ma"UIIC1urllf'1 Da11 Re::,0,,1 10 be a n ~ CERTIFICATE OF COMPLIANCE Wt certify thlit the natemenu made In this report are correct and this ~C~bt-td..vIC' conforms to Section XI of the

                                                                                                                                                                    ' (repa,r er repiacamenQ ASME~**

Signl<;:r~-/~ IO-net I De1,p._J ISI Tnlt a1c / (OaltJ

                                                                                                                                                                                                                            ,19_.gj_

CERTIFICATE OF INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressu,. Vessel Inspectors and the State Ot Province of VA, *employed by HS B I &I CO , 0 of Hartford I CT. have inspected the Reel A (f'.-.,..e..re IRep1,,t1) or ~e:,11cemen1(11I dmribed in this Repon on 6 -(<j

  • 1911..

ind state that to the ben of my knowledge and belief, this repair or replacement has been connructed in ac:co,dance with Section XI of the ASME Co~. By signing this certificate. neither the ln1pec:tor nor his lmployer makes 1ny warranty, expressed or implied. concerfto ing the repair or replacement described in this Report. Furthermore. neither the Inspector nor his employer shall be liable in 1ny manner for any Pt11':al Injury or property ~ ~ 0 1 1 of any kind erising from or connected with this Inspection. Cate ~ / er- M ~-CkO'-t,,,, Commiuion& 42C> 2(S111t () c> jPronnce. Ua,N11ional.1 Y3&oaril t./ ~ (IPIIPKI011

S11pplemenul 1heet1 In form of 11,u. 1ka1ch*, or drawlnpi may be UHd provided (1) alH 11 IX In. X 11 In **

Ot lnformnlon In ltam1 1 through , on thl1 dua repor, 11 Included on Heh 1hH1 0 and 131 HCh 1hNt l1 numbered d d\a number of 1hNt1 h recorded 111h* 1op of 1h11 form.

       . -~                                                                                                                                                                                                  2
                                                                ,,~ .

ATTACHMENT

                                     \

FORM NIS*2 OWNER'S REPORT OF REPAIR OR REPLACEME.NT AJ Required by the Pro,isions of ASME Code Section XI

     ....      Own*         Virginia Power P.O. Box 26666                                                                                                   ShH1 _ __..___ _ _ of_ ___...___ _ __

Unh _ _ _ _.........._.....__ _ _ _ _ _ _ _ _ _ _ _ _

2. ,11nt Surry Power Stati~

(N~ . C>N'b ~ ~ P, O* Box 315 Surry, VA 23883

                                                  -"'CSOreYI
a. Work Perf ormtd t,y_V._.A.......__,_f:'O~w....e...r___,,.....________ 38DQO 7 b& 7 D Repair °"91niulion ,.o No.. Jot> Ho. llC.
                                         .                 '$ame "'amel
4. Identification of Synem , Servile°°~"' 1 V ( Clews ] )
5. 111 Applic1bl, Constrvctlon Code B31-1 19 67 - Edition.~H~A_ _ _ _ Addcnda, Codi Cans __N.._A._____

lb) Applic1bl1 Edition of Sae1ion XI Utilized for Rep1ir1 or Replac11m,nt1 - 19..80, Addenda, Coda C.,m_N-A~--- waa IS. ldentific:&1tion of Compenents Repai~d or Repltced. and Replacement Components Nim* of Namt of Mfr1. Ser. -Nat'L CRN O,hw Vear Repair.cl. ASME Codi Comoontnt Mfr. No. Bd. No. ldentl- Bulh Reploctd_ Stamptd No. fic1tion or (Y11 OI' Nol Replacam1nt a;,...sle ,d<~p,

                                        ...                                      ,1tlit+

J" V,dv e. pl) Lf1SS8'7J o NIA /-.Sw-P-t, f'J/A Lo/.1.c-e J I

                                                                                                                                                                                    /Vo
  • 7.

I. I. Tens Conducud: __c__-e_""----Ll---'~'-{_u_{.._*- - - - - - - - - - - - - - - - - - - - - - - Oeicription of Work __."'"K.....e+f_/4-Hydrostatic D.11 Pneumatic D Preuure !ltP r. psi Tin Temp.,v'O l *F Nomintl Ooerating Prnsurt R1marks _ _ _ _ _ _ _- - = - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Other 0 ar g,.pplc.&ble l.4&"<11 Kl Uf 8f"D 0. ta ~ ::,on1 10 bt atlacheodt CERTIFICATE OF COMPLIANCE Wt c1nify that hr nattmenu m~ In this rtl?on art c rtCt and this CCJ) /q_ GC j conforms to Section XI of the ASME Code. V'"\ /\ trs- ot 11p,a~ v,-',- Si11ned ______......,,..._~, \......_+-----1--~-----,,--_...;:G"'---~--'o;;;..._, 11 s,' J (D,1111 CERTIFICATE OF INSPECTION I, the undersigned, holding I v1lid commission Issued by the Natlo~I Board of Boner 11nd Prenurw Vener Inspectors and the Srate OI' VA, rrovinctof , employed by HS B* I&I CO

  • of Hartford, CT. h1veinspect~dthe pdlctc-eul (RtpA,r{1Jlo, ~t;>llttll'ltPll(II dncribedinthi~Reponon 0-{)./ .19.E.i 11nd 11111 that 10 tht ben of my knowlrdgr ind belitf, this repair or replacement hH been connruettd In acc:o,dance with Section XI of the ASME Code. By signing this c:enifiutt, neither the Inspector nor his lmployer mekrs any warranty, upreu.ed or implied. c:oncern-i"9 the repair or rrpl,cement described in this Report. Funhermore. neither the ln1Pector nor his employer shall be li1ble in any manner for any 0trson1~ ~nju~ or propeny d0'~£fr a~s~ ofJinY At ind arising from or connected with this lnip1"ion. _

0111 0 +I cg9 [,~ j, Cozlb..i... Commiuionl (1P11pe,cl~

                                                                                                                      '-{3               /J{3 7oa9 tJo.. s
                                                                                                                                                     '51111 01 l'l.,.*ftCI, Na1,ona1 9o&tGI Non: Supplamenul ,h.,.t'I In form of llns, 1k11ch*, or dr*wlnpa may b4 UHd provided 111 tin k BM In. X ,1 In.*

121 lnforml\lon In h*mt 1 through , on 1h11 dl\a reoort 11 lt\clud*d on .. ch ahHt. *"d 131 uch 1hNt la numbered

   *nd t:t',e number of 1hMt1 11 recorded at 1h* ,op of mla form.
 .  -:--.,.                                                                                                                                                                                           ATTACHMENT 2
                                                                             ,,~      .,
                                               '            FORM NIS-2 OWNER'S. REPORT OF REPAIR OR REPLACEME.NT As Required by the Provisions of ASME Code Section XI

-,. Owner Virginia Power P.O. Box 26666 jAOdrna)

2. Plant Surry Power Sta ti on  :- _ _ _ _ _ _ _ _ _ _ _ _ _ __

Unh _ _....1...t:..:.i........

                                  .                                  (N&m1J P.O.               Box      315           Surry, VA 23883
                                                                  ,.lACIOraUJ
3. Work Performed t,y_V.,_A .......__.P_.rn....v...1e-....r_________ C)

CN.,,..I . Repair O'ianlz.alion P.O No~ Jot, No~ elCl

                                                                --Same
                                                                                '       IAOdrall
4. Identification of Synem MAl V ,51]:::ll::M, SV' ~
5. la) Applicable ConstNction Code B31-1 19 67 Edition .....l~...A,_____ Addenda, Code Cases _ ...N-A.._____

lb) Applic11bl1 Edition of Section XI Utilized for Repain or Replacements - 19..BO, WSQ Addenda, Code CISH_._N..A..____

6. Identification of Componenu Repai~d or Replaced, and Replacement Components Name of Name of Mfrs. Ser.
  • Nat'I, CRN Other Year Repaired, ASME Code Component Mfr. No. Bd. No. ldentl- aunt Replaced. Stamped No. fication or (YnorNol Replacement
 \

1)/>J(JJ ( wo1-J07H-

       't                              VELAµ                                                                               1)/;Tf
                                                                                                                            /-/l/f*7'f
7. Description of Work+:.¥...1!..<::._;k;.__...,d,---~-@_/._../_e _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _- - : - - - - - - - -
8. Ttns Conducted: Hydrosuitic O Pneumatic O Nominal Operating Prnsur9 (S Other Q_ #-~

Pressu~ psi Test Temp ____ *F /2.e/.y 41ff'.

9. Remarks Sff)c/C NO 0a1Q7[//b I~ 6/rJlllf, Y TY/ff ,4 /(},(" (ltkk ~,l.rf.

CAPP'~ MAnutaclurer'1 Da1a Rc:,on1 10 be anaChed) > I CERTIFICATE OF COMPLIANCE We c~"lify that the n1temenu made In this report are correct 11nd this, _ _...l~~""~='~'-'"'~'-'/'o,__~..;....:'------conform1 to Section XI of the

,. "'ME ,.._.,                            /7                                                                                           1ei-.;r or 1ep1aumenfl
,;
ned .......e. * . -',J~ / - ,/ I$ I -.'7:;,,t ;a.'/ , 19 ff._

p.,,..o,Owner's r:,~----....i.,T"'n~1e----__;:(o.~1r:.100 J ..._-=-+---- CERTIFICATE OF INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressurt Vessel Inspectors and the State or Province of,__V ....Au.a.,--------, employed by HSB' rnr co' of -'-'H""a._.r_,t.._f...o.._._r.,.,d. , __,,C'-cTL.. L._have inspe-cted the c lac "I JRepa, s) o, ~e;,tacemen1(11l de1cribed in this Repon on _ __;O,:::_,:G.,:_-__::;t~o_ _ _ , 19ft and state that to the best of my knowledge and belief, this repair or replacement hes been connructed in accordance with Section XI of the ASME Code. By signing this cenificate, neither the Inspector nor his t!mployer makes any warranty, expressed or implied, concern-ing the repair or replacement described in this Report. Funhermore, neither the Inspector nor his employer shall be liable in any manner for any Per,to:aa i/nr:.._ry..or property d a ~ ~ ~ any kinAarising from or conne-cted with this inr;>ect~n. . - Oate ~ d- :JS:{ ~~' ad/%::

  • Comminions fJG7D01 ()_a. !J ef3 (lnSPKU>I')

n: Suppl*m*ntal *hNU In form of ll1t1, *ketch*, or drawlnpa m*Y be und provided 111 1111 11 BM In. X 11 In., (Stale o, Pn,.,nce. Natoonal 8o&JU) Jnformnlon In h*rn* 1 throuQh , on thl* data repon 11 Included on **ch shNt, and 13) each 1hHt Is numbered nd ,t,1 n .. mber of ehMb le record*d at th* toP of.this form.

                        '         FORM NIS-2 OWNER'S REPORT__QF REPAIR OR REPLACEMENT As Required by the Provisions of ASME Code Section XI 2.
3. Work Performed by
                              . if4 ,~,    fl14tJ.C                  ** .                       ~              yef-b't          -10
                             .                     4N->                                    Repair Organization P.O No~ Job No~ etc.
                                     .... S'arYlY 4,      Identification of Synem....:=~.1..-      {.J..~~..,W~==__,µ~~~;:.....;~;L.-------.,.,...-----------..-,,T"""----

5.. Ca) Applicable Construction Code 19 Editlon, _ __.UOL.:._,__ _ Addenda, Code Cases ~..;J.---- (b) Applicable Edition of Section XI Utilized for Repain or Replacements - 19h. '1/t,u Addenda, Code Cases ....K,.....,,i: ____

6.
  • Identification of Components Repaired or Replaced, and Repla~ment Components Name of Neme of Mfrs. Ser. -Nat'I. CRN Other . Year Repaired, ASME Code Component Mfr, No. Bel. No. ldentl- Built Replaced, Stamped No. ficetion or (Yes or Nol Replacement
\/JtLV.es           f:-ltrir(  PnJ to            -          '"-            --       /~~w -i,{,           --         /)III~      ~,.;r            4"~        /Jo
    ,,                                           -                         -        1-(,W--,,7           -

I r,10

                            'I
                                                            --                                                             11
                                                                                                                                        -- __1., 1V},
    'I                                           -          -              -        1-c;w .,vf           -                ,,                     . r ~ IJD
    'I                   c,
                                                 -          -              --       r-<.w-"'>I           ~
                                                                                                                          <1 vl) u                    t,                      -          -              -         ,~ sw- ~ 3          -                                                fJV l I
                                                            -             -          1-~0-21)'          -                 c,                              µ~
7. Description of Work K_l.p~ (14/~

S. Tests Condue1ed: Hydrostatic fil Pneumatic D Nominal Operating Pressure D Other 0 9. w, ""*"v ASME ~ - * -

              ":J'"u...., ,,,..""""'"=" >:             C(/
  • of
   .uruifo:cl , Cf. haveinspectedthe.~iJ.flU~*

i pair(1) or ~ptacement(1)1 deserlbedlnthisReporton 6-<1.~ .1tfl and nate that to the best of my knowledpe and belief, this repair or replacement hes been constructed In accordance with Section XI of the AS.ME Code. By signing this cenificate, neither. the Inspector nor his t!mployer makes any warranty, eicprened or implied, concern-ing the repair or replacement described in this Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any perso:al inj~ry or property d a ~ ' } P f a~ kMd arising from o~ c~nnected with this Jnspe~IP'.'-. Date

  • 6 .f~ 8'f ~L_ ~ Comm,ss,onr t1J(3 7D 6 J U Ct.5({3 (111s~tOI)
Supplemenul 1hNts In form of llns, tk~tch*, or drawlnpa ma'( be u1ed provided (1) tlH la BM In, X 11 (State or Prt,.,,nce, National 8oalO) in.:,

formation In lt11m1 1 through

  • on thh dau npo" 11 Included on Heh ahNt, and 13) .. ch ahNt Is numbered
  • number of 1hNb la recorded at th* top of thla form.
                          '           FORM NIS-2 OWNER'S REPORT__OF REPAIR OR REPLACEMENT As Required by the Provisions of ASME Code Section XI

-,. Dte . _b~-----'----------

                                                                                                                                                                     /-l."2-            5-f Sheet _ _ _...____ ot_ _ _ _ _ _ __

Unlt_L _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ 2. Work Performed by

                               . i/4
                                              ~,

fll4l:.U-: 3.

                                                 .               4Namel                                                          Repair Orpanlution P.O No~ Job No~ ate.
                             .            ... S'amv
4.
  • Identification of Synem ~&.~,;o., ~ ( cR tv1--:> '.s ) *
5. f*l Applicable Construction Code 831. I 19 07 Edition, Ui4 Addenda, Code Cases ...V.~H-...._ ___

lb) Applicable Edition of Section XI Utilized for Rep;1ir1 or Replacements- 19h, kl~q Addenda, Codt Cases ...Y. t!..-.---

6. Identification of Componenu Repai~d or Replaced, and ReplaC1!ment Components Name of Name of Mfrs. Ser. -Nat'I. CAN *. Other Year Repaired, ASME Code Component Mfr. No. Bd. No. ldentl- Bunt Replaced, Stamped No. fication or (Yes or No)

Replacement Vl4Lv.t5 1--sw~', ~ . . .,;r u Vf.ti:.V.e5 ., /-(v-1-1? ,, tJ,) l( ,, rtJ / I} Nv

                                                                                                                        -<;w ~    H"                                  'I
     '1                   ,,                                                                                                 u1-f{vv- <<J/(5                                                          /uil
                                                                                  -                                                         ,.,.,15

( ' f&-- iv,) B/)t+s }JI.)

7. Description of Work ...:..:RC../{'f-"'{cc..~.;;.(.t._u_cJ-;.u._c_.,...._~;__c,.._,==Fe,.;.,'1c,:!!::..l0::..C';.:n-,,,~;..;;.:.,J.--'-'~--8_0 ..;..l..;..Y-5~----------------
s. Tests Conducted: Hydrostatic Cir' Pneumatic Nominal Operating Pressu~ D Other 0 Ten Temp ____ *F
9. 6r 13J<

CERTIFICATE OF COMPLIANCE

~~~~-~e n / : a t e ~ :In/this ~~ repon are =rrect and this _ _ _+~"'e*_--.,'-:~~--:'- _ .....~-rne"""'"n11----conforms to Section XI of the Signed~~ h ,rweJ~

(OwMr e1 Ownet's

                                                                                          .:l-$I; Tnle
                                                                                                                                     ,J,,,,~4~4 CDallJ
                                                                                                                                                                                ,19      ri CERTIFICATE OF INSPECTION I, the _undersigned, holding          I  v*lid commission Issued by the Natl:'I Board of Boilfr *nd Pressure Vessel lnspecton *nd the Si.tt
°'-~rovince of               V:'1- *                                          *employed bv                              tts s 1- ~ :;t. C"
  • ot
   ~ o : ck r. cf.                  heve inspected the
                                                                          ~f.o.uwu.:r:*

pail(1J o, ~pla~ement(al described in this Repon on 6-~!t , ,,fi and n*te that to the best of my knowle~e and belief, this repair or replacement hes been connructed In *ccordance with Section XI of the ASME Code. By signing this cenificate, neither the Inspector nor his l!mployer makes any warranty, e:itpressed or implied, concen~ ing the repair or replacement described in this Report. Furthermore, neither the ln'Pector nor his employer shall be liable in any manner Date . 6--a-a-fi 1 v~~- t::~ for any personal injury or propeny da":\agelfr ~..,,f *:: kip~ arising from or connected with this ln~ction. , (lns~10I) Commissions ;J/1; 7ul> 1 lf<< Slf3 (Slale Of Prt,,nnce. Nalional 8o&IO)

Supplement.al 1hNts In form of llns, aketch*, or dr*wlnlJI may be UHd provided (IJ 1ln h BK In. X 11 111.,, *.

formation In ITama 1 1hrou9h 4 on thh dai. rapon la Included on ..ch 1hNt, and (31 Heh ahNt la numbered

  • number of 1hN~ 11 recordad at the 1op of ml, form.

ATTACHMENT 2

                                  \

FORM NIS-2 OWNER'S REPORT OF REPAIR OR REPLACEME.NT As Required by the Provisions of ASME Code Section XI

  *-1.      Ownu       Virginia Power                                                                                                D1tt~___.kl.a.o'0~~<-a':;)..'--o-l~'--l?'~e.,~~~~~

P.O. Box 26666 ShHt~~..__ _ _ of~-.......,~~~-- jAOdrna)

2. Plant Surr,Y Power Station tvG
                       .                                      (N~

Unh _ __ _ . . . . _ _ ~ - - - - - - - - - ~ - - - - ~ - ~ P.O. Box 315.(AOOrauJ Surry. VA 23883

3. . Work Performed by_V . . .A
                                              . . . . __,_1-'_co"""w...e..r_________                                   38000 7'7 .r ID (Name)                                , Repair Or;anlZalion P.O No~ Job No~ etc.
                                                       --Same
                                                                           !Addrall              .                   .
4. Identification of Synem LI)µ IIEf/0 S'&h:7Y ..:Z-µ'17:;:?TforJ s-V J.}2;>,
5.
  • lal Applicable Construction Code B31-1  ; 9 67 Edition, l~A . Addenda, .Code Cases -.:..N:.:..Aa......._ __

lb) Applicable Edition of Section XI Utilized for Repairs or Replacements - 19....80, WSQ Addenda, Code Cases-N-A..__ __

6. Identification of ComPonenu*Rep1irtd or Replaced, and Replacement Components
     . Name of               Name of                       Mfrs. Ser.             ,Nat'I.          CRN          Other          v..r            Repaired,                   ASME Code Component                    Mfr.                             No.                Bd.            No.         ldentJ.        aunt           Repleced,                       Stamped No.                       fication                            or                       CYeaor No)

,, NM ~- /'-/,,,< Replacement

                                                                                                                                                                         /l;/C/

C.tt. &

7. Description of Work Be!{}we ¢., CoAc;.kk J j.o\+,.. 5
  • 1:..i..\\p\\c.!. N:<:V,J Sf!.. fl.,*':) P1wl1....
8. Tests Conducted: Hydrosutic O Pneumatic: 0 Nomin,I Operating Prnsu'9 0 Other 0 Pressure psi Ten Temp. _ _ _ *F
9. Remarks S:n.Jl)S _,, Pa~ est .. .1..l.5'131 ~ Vj> -':;> &JJ. CSY 2."2..C,5 ~

jAppl;u:.&e l.lanutacluref"a D&1a Fle:,on110 be anac"9CII CERTIFICATE OF COMPLIANCE conforms to Section XI of the

                                                                                                                                                     ,19      P5 CERTIFICATE OF INSPECTION
, *,i> .

I, the undersigned, holding* a valid commission issued by the National Board of Boiler and Pressurw Vessel Inspectors and the Sratt or Province of__V ...A~----------rl'mployed by HSB" I&I CO. of _H_a_r-t-f-o-r~d........_C=T...._...__ have in~t:cted the le&-\ 11Ji- dHcribed in this Repon on _ _ _ _ _*.,,.{,._....~1::-1-I-*-

  • 19~

(Repa, 1) o, ~e;,lacemenl(*D and state thin to the best of my knowledpe and belief. thi1 repair or replacement h~s been connructed in acco,dance with Section XI of the ASME Co.~. By signing this cenificate, neither the ln1pector nor his l!mployer makes any warranty, u:prened or implied, concern-ing the repair or replecement described in this Repon. Funhe""ore, neither the lnr.pector nor his employer shall be liable in any manner for any personal injury or propeny da'W°na lo~of anyAin~riling from or connected with this inspection. d Om to----~, "~Cf1-..\ ~~ t, ~,,Ms., Commiuions µ ~ 70 0 er V().. 6 ~ '.J

    ,e:

(lnspo,c100, S ... pplem*nul ,h . .n In form of !Ins. *ketch .. , or drawlnpo m*v be UHd provld*d (11 alZI la 8% In. X , , In.* (S111e Ot Prt,.,nce. Nal,onal lnfo'rmnlon In hwm* 1 throuph , on thla data r*POl'l 11 Included on *ach ahMt, and (3) *ach ehNt la number*d nd th* number of ehMb la record*d at th* top of thl1 form.

           * - ;-6,.

ATTACHMENT 2

                           . *~ ..                                ,,~ ...
                                         \

FORM NIS-2 OWNER'S REPORT OF REPAIR OR REPLACEME.NT AJ Required by the .ProYisions of ASME Codt Section XI

      ._ ...,.       own1r Vi rgi ni a Power P.O. Box 26666 j,\Odrna)
2. ,1ant Surry Power stat i an CNAlftlf P.O. Box 315,!AOOrall/ Surry, VA 23883
3. Work Performed t,y_V....A .....__._PO\r_...,,...e~r_________

(N_,

                                                                                                                                                       .>c a:1 -~ 1r-...1
                                                       -..Same
4. Identification of System C,~t:::"'~ c:bao~C
           !. . la) Api:,licable"Constn,ctlon Code B31-1                                       19 67                Editlon,..:.;H::..;A:.-_ _ _ Addenda, Code ~
  • __N..,.A..:.-.___

(bl Ai:,plic1bl1 Edition of S,ction xr Utiliud for Rep1in or Replacemenu - 11.BO, waa Addtnd1, Codt C.set......,N.... A.._____

s. ldentifieation of Comp0nenu Repaired or Replaced, and Replacement Components N1m1 of Namt of Mfrs. Ser.
  • N1t'I. CAN Other Year Repai,..d,, ASME Code Component Mfr. No. Bd. No. ldentJ. liulh RepllCtd, ~tamped No. ric1tion or  ;,*nor Nol Replacament
                                                            /JA Lt l I l   I
7. Description of Work _~~.-r.i...-..c---;;;.;.:;.;..<.,;;....:;.....::a.,_ _._...;;...__...;J:.....,..c.._l~..,._-......._..;...;._;:;;..___ _.,,_,,_"-----.:..a:c+---'::..:::a&=.........~ -
8. Tms Conducted: P'neumatic O Nominal Operating Prnsurw 0 TenT~*F I. Remarks ) tJ If .Z - 9.r~ -')
                                   ~pplcaDie~

~*(.- .. *:'*'-~-;--.--------------------------------------- CERTIFICATE OF COMPLIA"lCE Wt crrtify that the nat1menu m.ldt In this report 1r1 correct and this A S M* E ~ ** . , . . . *

                                                                                                                              £e.P~c.4"'1tf.vL jrtl)&i7orrep<ac:.emenQ c:onfonns to Section XI of 1h1 Signed          .          r   r
                                        -             I De11Q,...I ISI Tnie
                                                                                                                                  ,T;,,,v£ /2 , 19 Rt (Olfel CERTIFICATE OF INSPECTION I, the undersigned, holding a velid commission issued by the Netional Board of Boiler and Pressurt Vessel _ln~tors end the Statt or Province of               VA.                                         , employed by HS B" I& I CO ,                                                                                              of Ha rt ford. CT.                     have inspected the               re       6..( eMev.>+.5            described in this Repon on                                      ~-    d: J , 191.i IRr **'11) 0< ~~:,11cement(18 and nate that to th, belt of my knowl,dge ind belief, this repair or replacement hes been connNcted in acCC1d1n~ with Section xr of the ASME Co~. By signing this cenifiate, neither the Inspector nor his lmployer m11kes any warranty, upres~d or implitd, concern-ing the repair or replacement described in this Report. Funhermore, neither the lns.pector nor his employer shall be liable in 1ny manner for any personal injury or proper,y ~ ~ 1 1 , j f ~ ki_MI arising from or connected with this ln1P1ction_-                                                                 jL J ate             6--.'.)..J-f1                     ~J, ~                                              Commission*                      /JIJ7{JDC/                 1/01._ if flllll)KIClf)
S.,pploment.l ,11 .. n In form of llsu. 1kuch*, or drawlnlJII may be uud p,o,,.ld*d CU*1ln h IX In. X 1t In.,

jSlale Dr l'n,,nN~. Nll,onal 9o&rlll Information In lnrn* 1 through 4 on thl1 data rapor, 11 Included on **ch ,h ..t, and (31 **ch ehHt 11 number*d and If\* number of et>N'II 11 record*d nth* toP of thla form.

                                      '          FORM NIS-2 OWNER'S REPORT__OF REPAIR OR REPLACEMENT As Required by the Provisions of ASME Code Sec:1ion XI ShHt _ _ _...____ o f - - ~ - - - - -

2.

3. Work Performed by i/4 f'l4l:U:
                                                               !?- ~amel
                                                   .... 1!14tt14-:'
                                                                     ~
      ...        Identification of Synem_.;~ue;;:~...,.;,~~.e-r=;.:i...::::.____.~:::.:,;~;..:..-1---~-:....;...-;.T------------...----
s. lal Applicable Construction Code 19 Editlon, _ __.m....:........- - Addenda, Code Cales --.a._...._____

lb) Applicable Edition of Section XI Utilized for Repain or Replacements - 19h, klt,o Addenda, Code Cases _.14.. . ,'4. ____ fi. Identification of Componenu Repai~d or Replaced, and Replacement Components Name of Neme of Mfrs. Ser. -Nat'I. CRN Other Year R~aired, ASME Codi Component Mfr. No. Bd. No. ldentl- Bunt Replec:ed, Stamped No. fication or (Y11 or No) Replacement 51tcW*"I (n tr,.PY* 1w w.d, - - ,,....£(- E., ,4 ,. - ' *.C" ?LL,.:P

    ~WW'!                               w.t.f,                  -               -             -          (Alt-~ -         I!}                 -             I P..t.JJ"°'V               -
               \. I /
                '1
                                        \ I                     -                --           --          ,-le-if - IV                        -               f..t.,17,;,.,V I
7. Description of Work ~ri..e WvVIIIW~ , /
s. Tens Conducted: Hydrosutic 0 Pneumatic' 0 Nominal Operating Pressu~ 0 Other Gr 9.

s 10 be atlachecSI CERTIFICATE OF COMPLIANCE We unify that the na emenu made In this repon are corrKt and this _ _ _.,..4.,. ....l_o.. . a..... u "1"'"*....~="'-----COnforms to Section XI .of Ille ASME . r.:t; or replaca!MIIQ CERTIFICATE OF INSPECTION 0 i, i~ ~',:~fflKr~ned, holding-... ~a~lid ~;;;bslon Issued by the Natl~."fI Board of Bollfr ;r:d Preui:~ VM~I lmpecton and tht Stata _ or.~¥cM:§ f.l~ V'lf- * .. _ *employed 1,v_ _f1S 8 1- S >: Ccl

  • of
  . ~&tif,r J t C. f, have it~tffl %~
                                                                                    * ..-\.~,~

pailfs)

                                                                                                     *_ _ _ described In
                                                                                          °' fttp!ii~*="iesi~

this Repon on b - ().. ~

                                                                                                                                                                                                  , 1.f1
 !  illi:ii~ ll'lC'i!lll that to ih11 toiis-i o1fmt. ~'*~le~e ind belief,:,;hi~* r~~sl? or rn13!11~ment has been e§nll'\trneied In o<<:©&'JdtJ;,ce with Section XI of J <Jhe ASME Cr;,;\.. 6v                 gf~nine .t~J:l:rltl'/~if,~~~;~eithenr.!i l.it9'3cior fl@r Mo ii\fi!ployer mokgil flit\? w11~~m1fy0 G:i!~ref:"~ ~r implied, concer~

f ,i~t) ~h!'i fo,j:li;iir or rnplatt1nr.int4.~1~~h,'i1i!fRepoM: t,'yr.~r.irmm.i, neM,.:r tl'I~ !ng.pet;Ri)r .i@r Ms .@mg:i;C~v:w @~M ~ !11ible in any manner f "foflill'l\'*!X1rsor,ti! inju,v or prcPl,lnV &mage cir a loss of 1nov l.lAfl 1ri1ini, 1r@m ~r eon'1eci(<;tj wiii'i '20<i~s;'Jlfoltc1el','g!@.r"l. _

: * . , £ > a ~ ~ -~_:l,. . .~ _ Comrnis11i~n* µ(J 2oo_J_t./o._~~'f.__3_ _ _ _--+'-_

( ,, .. -,.. * '" .. . . .. ,... *. (in~~!Glj *

 'N*;~: .s~*PPl9';_)\m~hhw~ la for~*,;, ii~, aket~hem*,-~;;;;;_,.~;~!P lli-H>'i' be UHCI provided (tJ s!20 i. 8M IR,~ 'i1 In., .
                                                                                                                                                       -   C,ll11!1;1,:_~_a,Nut1CnAIBoa,II)

Jl'lf@rrnouli.in In lw,m 8 'i t:iet:>w~.)'-\i'll-" mis_ Cl*~ '**P"on ~s inelM.io.g on each ahNt, end 131 each ahNt I, numbered\ the number oi lhNtl ,, F(o).£!:)ri:100 0! ~h* IOP of VIII forn-,. .

     . -~                        .... :*  -                                                                                                                                                            ATTACHMENT 2
                                                        ,,~ 1
                                 \

FORM NIS-2 OWNER'S REPORT OF REPAIR OR REPLACEME.NT As Required by the Provisions of ASME Code Section XI

    -,. Owntt         Virginia Power P.O. Box 26666                                                                                                             Shm=-__..___ _ _ of_ _ _..__ _ __
  • l,A4Clteu,
2. ,1,n, Surry Power Stat, (N~

an Unh _______,{)""'"____ 'Jt} /;;___

                                                                                                                                                           ;::______~---------~---~

e.o. Box 315 Surry, YA 23883

3. Work Ptrf ormtcl by VA e Po°:iet ~.,._, 38000 2 () ~i C;I q
                                                                                                               -~-~~w~*0r;....,.~."-~-,f,-tion....._P~.O~Ho.,-~Job.....,.H-o-.etc.----......;.------~
                                   .            ,same
4. ldentlficat,on . of Synemo r:l ~ .JM"~ c "I \ r, 16, [v /,6 /aj* r"~*y,,,
                                                                                                        -' 1 c* '---'1 05    1                        1'\-)
5. 111 Applic1ble Construction Codt B31-1 19 b7 Edition.~H-A_ _ _ _ _ Addend1, Code Cases _..:..N,,.A.,___,,__

(bl Applicable Edition of See1ion XI Utilized for Repairs or Repleomonta - 19..80, wan Ad~ndl, Code CalMtt ........ N...A____

     &. Identification of Components Rtl)ai~d or Repltced, ind Replacement Components Neme of              Namt of              Mfrs. Sar.          -N1t'L              CRN             Other                          V111'                     Rep11i,..d.                   A.SME Codi Comoontnt                  Mfr.                 No.                Bd.              No.             ldentl-                        Buttt                    Replse9d,                         Sta~

No. fceation Of (Vn o, Nol Aepl1e1m1nt J-ff p,~p ~ G,....... ,J\\1,~ 3~rss r:i,o AIJ/l /J/A 1-Uf-),To ;JJA ~ i'.o ftu. r r71 ;Uo p

   ')-'\JC\ l 0 l         G.," v,"' I,.;,£. lo':t111S NJ/\                              JV/A          J*-l Ii *-)lJ                  ('J/A                      ~'°':ph,>e..t'j                    /1/o
7. ~ription of Work R-~vl. l~~G..LL UJv-t... "-) * .(,1:y *.,-l, 4

I. Tens Conduc:1td: Hydrosutic* Pnwmatic O Nominal Operating Pr2S1urw O Othtr 0

                            ,p            Prt;f::lrl! 1 L/'-/0 psi T,n Temp. F,1'~1'4 *F
9. Rimarlu J- i'p ~ rD :J:i.. - St - 1 / S / :i > -o I
                         ~icabll ""4""'1Klllfllf'I 0.UI Ra:,on110 bs atlM:~                I,
                                                                         )- ,, C, ,,, ), i Vr, / J <.

pQ .::!::l _ Op L.J l 0O I 0 CERTIFICATE OF COMPLIANCE

~ ~ ~ ~ a ' / 4 ' ' /m~ ~u In this report are correct and thls _ __.t:__~:....~!-'pa,,'vl.,..;c.,:;..
                                                                                                                                  "'r ,.'-"~"'"'0.""'u._:-~-~---conforrris to Section XI of the 06
                                                                                                                                             ~....

Signed

                         <ti/*£:_.,,/

CO,.net 010..net'I 1,p..... ISI Tlllt

                                                                                                                   .:r;;,r1,;f::,

(DIIIJ

  • 11 n CERTIFICATE OF INSPECTION I, the undtnigned, holdint I valid commiuion luued by the Natlo~I Board of Boner and Prt11urw Vessel lnspKtors 111nd the State or ,rovinceof VA - , employed bv HS B I&I CO
  • 0 of Hartford. CT. heve inspt*md the C':<'£ l'l.c..('.,._ Y\ t dtscribed in this Repon on
  • J - 7 . ;g f<'f IRcpa, I) OI ~c;,l1ctme111{al ind 11111 that to tht btn of my knowledge ind belief, this repair or rtplactment h11 been connructed in 1c:C01dancc with Section XI of the ASME Code. By 1igni119 this cenificatt, neither the Inspector nor his i!mployer mikes any w1rr1nty, expressed or implied, concern-int the repair or repltcement described in this Report. Funhermore, neither the Inspector nor his employer 1h1II be titbit in 1ny manner for 1ny personal lniu,:y or property d13~ ~f.* lo!J of 1nyAin~1arising from or conne-<:ted with thia ln11Ptcti~ / ,.,..... _?

0111 7 ~J J/_"U~ l ~ Commiuion1 /JfJ 7 bo'f - Vt).._ 1..S tf"._) (ln11>Klot) (S1at1 o, ~ ' " ' '

  • Nal0'\ll 8o&,dl Non: S.,pplemenul 1h"te In form of 11111, tk*tch*, or drawlns;Jl mer be und p,ovld*d 1111111 h II~ In. X U '"**

121 lnformetlon In lt9rne 1 through , on thla det* repon 11 Included on uch ahNt, *nd 131 uch the'et le numbe**d and the number of ehHta la recorded et \l>e top of thle form,

     . -~                                           .... :...                                                                                                                                         ATTACHMENT 2
                                                    \

FORM NIS-2 OWNER'S REPORT OF REPAIR OR REPLACEME.NT AJ Required by the ProYisions of ASME Code Section XI

   ...,.          Ownff                 Virginia Power                                                                                                                6/.so/~q.

o.n, _ __..,_____._.;;._;.___ _ _ __ P.O. Box 26666 Sht11................~.... of..............~---~---

2. P11n1 Surry Power Stati~ (H~ .

Un1t _ ____.;(~-:).!..I.N:..=-io:£:;;...-- - - - - - - - P.O. Box 315J.AIIOrHlj Surry, VA 23883 .... *. ~*...

3. Work Performed by_Y
                                                             ...A                         ,.__,
                                                                ........~l:'0-...W...e..r________                   _               38DOO           7j       ;)., OJ ~
                                                                         '-Same
     ,.           Identification of Synem la) Applicable CoNtructlon Coclf B31-1
                                                                                         ~ralj    S'  f.N{?, f,,

11 67 Wc,.Jsc Editlon,_..H,,_A.,___ _ _ Addenda, Codi Case, ........N ...A_ _ __ 5. lb) Applicable Edition of Section XI Utilized for Repain or Replte1m1nt1 - 11.BO. wan Addtnda, Code C.set _..N"'"A.._____ I. Identification of Compenents Rep1irtd or Repl,~d. and Replacement Components N1m1 of Name of Mfr,. Ser. -N,t"L CAN Other Y11r Rep1il'ld, ASME Code Cornc,on.nt Mfr. No. Bd. No. ldentl- Bulh RepllCftf, StafflPH No. r1e1tion or (Y11 or Nol Replacement 3 'r_ l..ec,/<( },. /, i: r,~~,1~~ ~/~

                                                 .      I  I      /           '-I JS _1 L/' So Al.A- AJA ,-sw-Ji                             NA             I~      pi)JtJ, I

U!rA J/o 7. I. Dftcription of Work Tem Conducted: gef }qO(_<cl Hydro1atic {)r;.. IIJe rneum1tic O Nominal Oper1tin9 Prn1urw O Other 0 Prtnu~ pal Ten Temp. _ _ _ 'F I. Atmarks~-,,---,-..,.,........,.--,--.,C"":"--:::-"":"'.":--.----:--::-------,-------------------*;*_*- - - - - - - 1,1.ppf~ 1,1a...,,ac,.,..,., eaia Ac:,on, ,o t1e 1111ached9..3 ,,(A/v-t .p -:fl- _ C5 y- 2 JS' I 6S O CERTIFICATE OF COMPLIANCE We ctr1ify 1ha1 the n1t1menu md In this report are correct and thls _ _.:..Y'-'f"-"'/J..;./...:"lc.::Le.::~=::..;,e_:;_;f-.______ conform, to Section XI of the ASME Code/'"1 ~ i,r-711p1a~ Si9ntd ~p;;;.;;0w .£__ 4/./

                                                                               *'0-1 ISi TIii
                                                                                                                                      ~ho i&tiJ                            * ?9 CERTIFICATE OF INSPECTION I, th1 undtniQntd, holding I valid commission luutd by th1 Natlonil Board of BoUtr and Prt11urw Vessel lnll)IC10f1 and the Sratt or Provine, of,_                          _,Vi..cA:i.,,.________
  • employed bv us o* I &I co e of

_...H...a. r. ...t...f....o....r. d..,,.._,.CuT

                                     .             ......___h,ve inspt<:ltd the V:riJ )q Cem.,_ti, 1 dtmibed in
  • IAtp1Jii1 o, ~,;,11cem,,.,1,1 th~ Report°" _ _ _ _.c.:,b:::.....-,.:;;3::..l>~-, ,,£L and nate that 10 tht ben of my knowl,~t and belief, this repair or replacement h11 been connruc11d In acco,dance with Section XI of the ASME Code. By signing this c;er,ificatt, ntilher the ln1pec1or nor hi, lfmployer make& any w11ran1Y, u;prened or implied, concern-ing the rtpair or rrplKement dt1eribed in this Rtpor1. Furthermort, neither the ln1,pec1or nor hi1 employer shall be liable in any manner for any peno:al Injury or proper1y d * ? \ ~ ' of.1ny kind 1ri1ing from or conne,c1ed with this ln1P1ction. _

D11t (Q 30-<l'1 /li,~{/?a:J1.>: (ln1pe,c10I) Commiuiona prJ7ot>f tJ.,.__jlf3 ISlllt 01 l'ri,,,*ftCI. Nat,o,,at 8oar1II 11101"1: Suppl*meni.l 1hMt'I In form of ll*ta, air.etch*, or dr1wlnl)I mey be u**d provided (111111 h ll>l In. X 11 In., (2) lnformetlon In lnmt 1 through

  • on thl1 deta repo" It Included on uch 1hNt, end (3) uch thNt 11 numbered 1nd tt,e n"mber of ehMta It record*d al the top of thlt form.
  . -:",-                                    .... :* -                                                                                                                                             ATTACHMENT 2
                                           \
                                                       . FORM NIS-2 OWNER'S REPORT OF REPAIR OR REPLACEME.NT AJ Required by the Proyisions of ASME Code Section XI
...,. ownei: Virginia Power                                                                                                                              Dtff _ _ _ _07-    ___ or*__  ?"'I P.O. Box 26666                                                                                                             ShNt _ ___...___ _ _ of_ _ _ _ _ _ __

jAOdrn.l) P11nt Surry Power Sta (N~ ti an Unh__..~=-"'-;f:_;;;;;;Z...c.;........_______________~ - - - - ~ - - ~ ~ e.o. Box 315 Surry. VA 23883

a. Work Performed ......._._t',tAClclre&lj by_V...A O_...W_e....r________

(N.,,,.J

                                              .                -..Same
4. Identification ofSynem C O ~l!\.J c.qo 1...11.J l:, s iJ1l;:'v) Hl"'91 @C ttfll/ <tc:?l - ¥@! *'.{
  • 2 .i?,';f
5. 11) Applicable Construction Code 831-1 19 67 Edition, HA Addenda, Code Cases _ ...N .....A.._____

s. lb) Applicable Edition of Section XI Utilized for Repairs or ReplactmtnU-Identification of Componenu Repaired or Replaced, tnd Replacement Componenu

                                                                                                                                            ,,..ao. waa                Addtndl, Code C.sn_....N...A...__ __
  • Name of Name of Mfrs. Sar. -Nat'l. CAN Other Year Repai,..d. ASME Code Component Mfr. No. Bd. No. ldentl- Buth RepllCtd. ft1mped No. fic1tion Of  ;,*nor No)

Replacement 't:Af exe,,1,1 ,-o.Jt.. Yu~A - - l*tr*t:*IA :fp/1,9/fl. Yes

7. Description of Worlc--1~'"1J;l~-¥-,:~.....i.~<<.:..:::::....J.L.:~-1.<~~:i..::JL-.:::lia:!.U.:::~L.U:.:.......~:...u.=....i...-..::;;::.=--t::w.1.:f':..:._=..i.._ _ _ __
8. Tens Condue1ed: Pneumatic Nominal Operatin Pressure psi Ten Temp. _ _ _ *F
9. Remarks ]Jo': t:tt-,J.>trl, t;:7../Jt, r,-o YJ
                              ~ic.allll Manulacturltl"I Da1a Ae;,o,,1 10 be allact,eGI CERTIFICATE OF COMPLIANCE

____E,...e...~_.......i[_______ conforms 10 Section XI ov tht c,;;&;or 1ep1acema:iQ CERTIFICATE OF INSPECTION I, th1 undersigned, holding I v1lid commission issued by the National Board of Boiler and Preuurw Venel Inspectors and tht S11tt or Province of_..V,..A.....___ _ _ _ _ _ _ , employed by*_fuiS..u.tB_". i. l.1.1&..i. I-J.oC:1..10:..,_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ of _H_a....r...t...f~o...r...,d.._..,_C....._T.&.__ h,ve inu,ec:red the .v jRep1,rt1 or i,e;:,l1cem1n1(1II dHcribed in this Report on _ _ _ _c___ 7_-_a_r __ , 19~ tnd n1te that to the beu of mv knowledge and belief, this repair or replacement h1i been connructed in 1cc:o,d1nce with Section XI of the ASME Code. By signing this cenifiatt, neither the Inspector nor his ll!mployer makes any warranty, upreued or implied. concern-ing the repair or replKement described in this Report. Funhennore, neither the Inspector nor his employer 1h1II be liable in any manner for any pers:a~:jury or propeny dlf:":~OJ1 ?:ny)Jtind arising from or connected ~th.this lnipection. D11e 7 ~ Bi ~1-.~~ Commiuion1 /JB 7oo'f tJCL SY.J (lnSPt<IOfl C5111, or ~,nc,. Nat,onar 8ollGI

$ypplement.l ah"n In form of ll1t1, *ketch*. or d1awlnpi may be YHd provided (111IH h BM In. X 11 In.,

lnform11lon In ltern1 1 throYgh 4 on thla date repor, la lnclYd*d on 11ch 1hHt, and (3) uch 1hHt l1 nYmber*d d ltl* nymt,er of ahMII 11 racord*d 111h1 1op of thl* form.

 * -:to                    .-~ .. -                                                                                                                                      ATTACHMENT 2
                         \

FORM NIS-2 OWNER'S REPORT OF REPAIR OR REPLACEMENT AJ Required by the Provisions of ASME Code Section XI

-,. Ownet:    y; rgi ni a Power                                                                                       D11-~~::Z       .....~..........._/?-.v,/'--"-_.._tf"'~°/~~~~

P.O. Box 26666 Shtet _ _.___ _ _ gf_ __.._ _ _ __ CMc'raYJ

2. Plant Surry Power Station ~~
                                                                   *.                           Unh~--->=C).:...::~c=-f::'_~~--~----~~~------~

e.o. Box 315.{AOOraUJ Surry. VA 23883

3. Work Perform~ by_Y...8-,....... PQ w...e...r___,,--..,...______
                                         ......                                                          3aaao 7 5?? £                   f f IZ - t:?':_ '/tJo* f'f/u 1 C,J
                                                   '    4"amel                                         Repair Org*n1Z.11ion ,.oHo_.lOb Ho_ete.
                                      '-Same
4. Identification of Synem CMc'rall *{( :< '\c 1-0/"' Uo f56 +-

'5. Ce) Applicable ConstNctlon Code 831-1 19 67 Edition,..:.M"'-'-____ Addend1, Code Cases ___N__ A._____ (b) Applic1bl1 Edition of Section XI Utilized for Rep1in or Replac1m1nt1 -11..80,.WSQ Addtnde, Code c.... _N_A____ I. Identification of Comp0nent1 Repaired or Replaced. and Replacement Componenti Nam1of Name of Mfrs. Ser. -N1t'L CAN Other Year Repaired. ASME Codi Comoonent Mfr. No. Bd. No. ldentl- aunt RepllCtd, Stamped No. f"ic1tion ~ CYft or No) Replacement IKC..-33. 7-f/' Pr() e.. J.?~~Jk-'.."v-. /VA- /VA- ;t!J ry J.jq c..:ecl .,,Vo

                                                                                                      /.So:)..
7. Dflcription of Work &-e f f'\ '--"e.
  • A---p e_
8. Tem Conduc,ed: Hydrosutic.g?' ,neum11ic O Nominal Operating Prnsurt O 0,htr 0
 ,. Remarlu
                           ,, 1
                         /Vo(-'t!

PrHsure .1.3..Ju' psi Test Temp ..tiZ_ *F

                  ~~ Ma11e1tacluret'a O.ui Jile~110 be               attJ' p     1 ;p'e..      pt)   .q;J- CS y           J ? lf !JS '{

CERTIFICATE OF COMPLIANCE We certify that the n1temenu made In this report are correct and this _ _ _ _....;._ _ _ _ _ _ _. conforms to Section Xlof the ASME Coderl c:-LJ ~ * '"pa;,°' 1ep1acetne11Q Signed ~- 0

                     !Ow,,.. or Owne      1~
                                            '.'..:1//                               ISI TIiie
                                                                                                        ,&?*/
                                                                                                        - (Daiei' (2

CERTIFICATE OF INSPECTION '>., I, the undersigned, holding I valid commission issued by the N1tioni1 Board of Boiler 1nd Pressurw Ve~sel Inspectors ind the Srate or Province of_ _,VLLA......___ _ _ _ _ _ _ , employed by HSB" I& I CO, of _H_a~r...t_f~o_r_d...,._C~I~,~-h1ve inspecled the (? e p (Ace fl,\ ell.II fAepCt(1J o, ~~:,**cement(II ducribed in this, Report on _ _ _ _ _7_._-_(__ q____ ,19.n and 11111 thlt 10 tht best of my knowledge and belief, this ;ep1ir or replacement h11 been connructed in accordance with Section XI of the ASME Code. By signing this certificate, neither the Inspector nor his l!mployer mikes any warranty, el!(prened or implied, concern-ing the repair or replacement described in this Report. Funhermore, neither the Inspector nor his employer 1h1II be liable in any manner for any per1on1I Injury or propeny d*w o:.* ~-*~ it,i,d arising from or connected with this ln1Ptction. . D11t 7-/f-&'j ./k~ J* ~ Commiuions /Ll8 7 O{J ~ /}a_ 62( J

         .
  • flns~uw,
Supplement.I 1h"t1 In form of ll1t1, 1ke1chios, or dr*wlnpa mer btl ueed provided (1) 1IH h 8~ In. X 11 '"**

(S111e or Prt,.,nc,. National 8oudl lftformetlon In lftm1 1 tl\rough

  • Oft thla date repor, It Included on Heh 1hHt, and (3) .. ,11 thHt 11 numbtlr*d d lh* ftumbtlr of ah"ta 11 record*d et th* toP of thl1 forrn. *
   . -:-.,.                                          ..... -                                                                                                                                                           ATTACHMENT 2
                                                                                  ,,~ ...
                                                   \

FORM NIS-2 OWNER'S REPORT OF REPAIR OR REPLACEME.NT A.J Required by the Provisions of ASME Code Seetion XI

 -,. ownei: Virginia Power                                                                                                                                                           7a.s/~"I Datt~~------------~

P.O. Box 26666 Shfft _ __...___ _ _ of____~ - - - ~

                                                                                            . jAOCSrna)
2. . Pr,nturcy S Power Statrna O N£ Unh~-~~"'-'-...c...;.---~-----------~
                                    .                                         (N~

P.O. Box 315~oorauJ Surry, VA 23883

3. Work Performed t,y_V....A
                                                                ......._._PO....,W"""e....r__,,_-,-______                                           38000 fD~fg
                                                                            .                CName>                                             Repair OrganlZ.llioft P.O Ho~ JoCI No~ ete.
                                                                         --Same 5.
  • Identification of Synem
11) Applicable Construction Code B31-1 CAOO,aa, Re'll4p...-

11 67 Cool-\- Editlon,..,_1~.,_A.,___ _ _ Addenda, Codi Casn __N.:.:.A.._____ lb) Applicable Edition of Section XI Utilized for Repairs or Fieplacamanta- 11..80, wan Addenda, Code C.sn__..N~A____ I. Identification of.Comp0nenu Repaired or Replaced, and Replacement Components N1m1of Nemtof Mfrs. sir.

  • Nat'L CRN Othtr v* .,. Rep1ired. ASME Cc!de Comoonent Mfr. No. Bd. No. ldentl- aunt Repleced, Stamped No. fic1tion 0, rv.. or No)

Replacement X~-1~ AJl.ll,f1ec:-.. . 3 7.S'11,s

                                                                     ;"tr                         .A)J+.                  AJA l-f<c-1 l3                       >>A                rrPl~ao!                      /IJo
                                                                        ..:Dig.2_5t
  "}E,SiJs H~1.1,./te,~ll                                            ~                           A)A                    /JA          i-(c-1 l3              ;V.A               V--tf) feic~J.                 JJo
  • 7.

8. I. Description of Work _ Tem Conducted: __._~-~----o~ve~/_R_e__; Hydrosutic &"

                                                                                                         "=st,..-"-'-/-'-/.-~---'-f~__._~__"h-'/._":'9_.e'----------=---------

Pneumatic O Nominal Operating Pressurt Prtssurt .ZQ.f' psi . Test Temp. f l ) *F Remarks _ _ _ _ _ _ _. . . , , . . . - - , , , - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - O Other 0 IAPPI~ Manulacluret"I Data Ae;,on1 10 be allac~ '.l/. J J ._

                                                                                                                £J-         /'f If N>\. 1.r fo    1i- C r).s {  -/'-'

f (,'.3J b

                                                                                                             ,r-1.-Y-1"5i..rl; fD .... or- :i.JDu.s CERTIFICATE OF COMPLIANCE We cenify that the natemenu made In this report are correct and t~it____f'_O_p_)_"'-_c_.-e_,...,.~e....                                                              ........i____ conforms to Section XI of the
 *ASME~                                               ~-                                                                                               (l,pa;rorrep1a~

Signed w-L . / (6:.,,.,~DelipllNJ IS I Tnte J;,4 IDaJII 4 cz , 11 zz CERTIFICATE OF INSPECTION I, the. undersigned, holding I v*lid *commission issued. by the National Board of Boiler and Pressurt Venel Inspectors and the State Ol Province of_~Y~A~~~-------, employed bv uso* I &I co e of _._.H....a...r_,t.._f..,n....rLd.....,.....,.c'-'T_,*.___have inspt<:led the . r-(p!. .,~"(/\. 'T IAepaf;i,1 o, Ae:,l*cemenl(II dHcribed in this Aepor, on 2-a.s= .19.n and na,e 1h11 10 the ben of mv knowl,dge and belief, this° repair or replacement has been connrvcled in 1ccord1nce with Section XI of the ASME Code. By signing this certificate, neither the Inspector nor his lfmployer makes any warranty, expressed or implied, concern-ing the repair or replKement described in this Aepon. Furthermore, neither the Inspector nor his employer ahall be liable in any manner fo_r any pers':'11 ~~ry or property d'::"::::-2:" of *nrjind,,1ri1ing from or connei:ted _with this ln1Ptctie>l}r Om 7 1~ ~J ~M:{~ f_ (ln1pe,c1or,

                                                                                                                  ~ Commissions                                       /U/J )()()         7      Va. ~'(J (S111e or Pn,,,,nu, Natoo,,.1 80A1GI ra: S.,pplemental ah .. n In form of 11*'11, 1ketch*, or dr*wlnpe may ba UHd provided 111 tin h IM. In. X 11 In.,                                                                                                              *.

Information In 119ml 1 througtl

  • on Ihle dn* repor,i 11 Included on uch 1hN1, and (3) uch 1hH111 numbered nd lh* numbar of '""b 11 recorded el 111* IOP of thl1 form. *
       --~                                                .....    -                                                                                                                                                           ATTACHMENT 2
                                                       \

FORM N1S*2 OWNER'S REPORT OF REPAIR OR REPLACEMENT AJ Required by the Provisions of ASME Code Section XI

    .-1.          Owner                   Virginia Power                                                                                                                                       7/f(')?e>i D1tt_ _ _ _ _.....;......,...._ _ _ _ _ _ _ _ __

P .0. Box 26666 Shnt ___.....__ _ _ of_ _ _ _ _ _ __ CMOrnaJ /;f"

2. Plant Surry Power Station p,,~ Unh _ _ _ _..LJ~/V,__"----------------~
                                                                                                                                                                           ,;, J /

P.O. Box 315.{AOOrwuJ Surry, VA 23883

3. Work Performed by_V...A ......._._l;'...co...w...e...r_________ 38DOO I b8:~ b CN-i Repair Orv*n&z.alion P.O No.. .loll No~ etc.
                                                                           --Same
4. ldentlfic1tionofSynem CWrall .5Jt-fe7Y J:*,;,J)£c 1Io/J
5. laJ Applicable CoNtNctlon Code 831-1 19 67 Edition, .....H--"A._____ Addendl, Code Cases __N""A_____
       ,.         lb) Applicable Edition of Section XI Utilized for Rep1in or Replai:1m1nt1 - 11..80.                                                                               wan           Addenda, Codi c.... ~N-A..____

Identification of ComPOnents Repaired or Replaced. ind Replacement Components_ N1meof Namtof Mfrs. Ser. -N1t'L CAN Other Viar Repaired. ASME Code Cornoonant Mfr. No. Bd. No. ldentJ. Bulh Replectef. Stamped No. f"ic1tion or -IVft orNoJ Replacement ll 11

                .ST~D~ 5pt~i<\.l'r, t'<.-6\.;Qf~
                                                                                                                  .))tr ,;11A-                    J-S~-;).*I(            .,Al)-              Re--1lrtc,-,;             .;-c/o IL
    )-~
      .J.-,, If
   ) Y -tx >>..ts *£~;\..eeri'.v, fq-f."(.

O~D7t1'-JO D1oJoo8' NA- ftA- /-S'J *)-f / AJA- (<-f' f) /'l c. etl. µ() -

7. Description of Work ___O ___v.=~-,i.....M.._W.......'U,45-.'-"";}----....0~,9-~-~aa........~--------------------------
8. Tem Conducted: Hydrostatic (J)/' Pneumatic O
  • Nominal Operating Pressure 0 Other 0 Pressure ,23,Jf psi Ten Temp. s-¥? *F I. R1m*rks _ _ _-,--_ _ _. . . . . , , , . . - - , , - - - - , . - - - - - - - , - - - - - - . . . . , . . . . - - - - - - - - - - - - - - - - - -

i,.pp1ic&DII Manulaclurar'1 O.i. Re:,0,,110 be ,11,ct,edl / {' ,, t'-l JJ 5 pO~ S.5 'j _ ) / Q'( ~ 9 11" rl<><Jv,t 5 Po* ssY-;;..1"13'{8 CERTIFICATE OF COMPLIANCE We certify that the n1temenu mlde In this report are correct ind this r-qi Joi c.-<,...~ 't- . conform, to Section XI of thl ASME Code. ' . ~ . - lrtP&it or ,,paacernenQ Signed 'i:-J._

  • L/

io,.- OI Owner.a ....,

                                                                                           -<     <Yf <<                              IS I TIIII
2. 9,& ,/

(DIIIJ /

                                                                                                                                                                                                     .,, )?J CER Tl F ICATE OF INSPECTION I, the undersigned, holding a valid comm.inion issued by the National Board of Boller and Pressurw Vessel Inspectors end the State 0

or Province*of_ _.V....A

                                                     . . ..._...;.;______- -
  • employed t,y__.f~iS...Bw._.;I&......,r_c...,o........- - - - - - - - - - - - , - - - - - ~ _ o f

_,_H....a...r_.t.._f...o....._r...d-a,..-C<.JTWIL.._h.ve inspected the v--cf {q, c~ -ti\,.. (RepaJist °' ~e*::,11cemtn1f1l1 demibed in this Repon on 7 - 3( . 19.n ind 111,e that 10 thr ben of mv knowlrdpr and belief, this repair or replacement h11 been connructed in eccord1nce with Section XI of thr ASME Code. By signing this cenificau, neither the Inspector nor his t!mployer mikes 1ny warranty, uprened or implied. concern-ing the repair or replacement described in this Aepon. Funhennore, neither the Inspector nor his employer 1h1II be liable in 1ny manner for any penon~ inju~ or property d

  • f f p ~ a n v kind arising from or connectedlV1th this ln1Ptctif':_

Cate 7 3( 'R?

  • lU=~ Commiuions r3 7ooi IL~4..3
                                          .                                          _
  • flftSP<'CICW, n: S.,pplemanul 1hMt1 In form of l11u. 1ke1c.h*. or drawln111 may be UHd provld*d 111 sin h 8~ In. X 11 '"**
                                                                                                                                                                   ,                       jSlllt or f'ti>w*nce. Nal~I Bo&r1II i Information In Ir.me 1 througtl , on 1h11 data r*Por, 11 lnc.lud*d on ..ch 1hNt, ana 13) aacfl ahMt 11 numbered nd Iha number of 1hMb la racord*d 1t th* 1op of thla form.
          . -~#"

ATTACHMENT 2 I!~. ""

                                                         \

FORM N1S*2 OWNER'S REPORT OF REPAIR OR REPLACEMENT AJ Required by the Pro\'i1ion1 of ASME Cod, Section XI

        ..,.         Ownff                Virginia Power P. 0. Box 26666                                                                                                                      Sh~----------Of--~----~
                                                                                                              ~rna)
2. Plant Surry Power . Station p,.,.... Unh~~---e:>=...-/\)....£~-~-~~~~~~~~

P, o. Box 315.(AOOraa1J Surry. VA 23883

3. Work Performtd 1:,y_V...A ..............t::....<Q..t..../e. . .r. _________ 38QQQ 71~63 CN-i
                                                                             ,same
4. Identification ofSynem s,.oaruai (0~1,t ";._'°'",\ Se["'-~
5. la) Applicable Constn,ctlon Code 831-1 19 67 Edit{on,..,..H:::..A.____ _ _ ,.ddenda, Code Cases _ ....N A_______

Cb) Applicable Edition of Section XI Utilized for Repain or Replac:1m1nt1 ~ II.BO, WBQ Addtnda, Code C.m_...N.... A,_____

          &.         Identification of Ccmp0nent1 Repai~d or Replaced, and Replacement Components Nam,of                               N1mi of                          Mfrs. Ser.
  • Nat'L CAN Other v,.,. Repairtd, ASME Codi
     *
  • Con,oonent Mfr. No. Bd. No. ldentl- Built Replac9d. Stamped No. rication 0, (Yes or Nol Replacement

( ~ ).:, I A)._,_ t; s .A:Jo --f1) 1 'r511)s ?t! )..I/~(> ,....VD. 7. I. I. CERTIFICATE Of "'OMPLIAN.CE

~~~~11 t~e n~at,menu ~ ~ Ithis a_ _

n report .,, correct and thls _ _ _ r+fL--/.. "-~-::--l)la-~--IT--~-no---COnforms

                                                                                                                                                                      ..                                          to Section XI of the Signed                                                   <~                                     *   ~                       ISI                     'lluc..e:f     ,1                  , 19 .P;5' to-~OwnerioeSJQJ                                                                     Tiu:                     (uateV CERTIFICATE OF INSPECTION I, th1 undersigned, holding I v1lid commission luue-d by the National Board of Boiler and Pre11urw Vessel Inspectors ind the S1at1 0,   Province of_                      __.V. ._A.....,__________ , employed bv HSB' I&I                                                                ca.                                                                   of

_._H...a....r_t...f.._o.. . _r...dL.1,,__.C._TL-LI_have inspe<:ted the reeJ"l.t~~t IRtpa11{1) o, ~,;,11ctmtl\tlll ducribed in this Report on 7-3/ ,,9..£j ind natl that 10 the ben of my knowledge and belief, thi1 repair or iepl1ccmen1 h11 been connructed in 1cc:crd1n~ with Section XI of the ASME Code. By signing this c:ertifiau. neither the Inspector nor his 4mployer makes any warranty, uprened or implied. concern-int the repair or replacement described in this Report. Furthennore, neither the ln&pector nor hi1 employer shill be liable in any manner for_ any ~": injury or property dam[r. ~JtJsya;.nv k_ind ~rising from or c:orine,cted with this lnsptc:tiop. ~ . . 0111 J :! ~

                                               / K'(                                                  -~                                            Commissions                Jr.!{j71Jof
                                                                                                                                                                                .!./,.

V4 ,S q.3 N: S11pplemenul ahN'tl In form of (l"IPKIOfl ** 11*'11, *ketch*, or drewlnpe _miry be und provided CO 1IH It IM In. X 11 In., Ii 151111 or Prc,.,r,ce. Nahcn11 9,oa,Gj formedon In lnme 1 1hro11gh

  • on Ihle Cina repor, h Included on *.*ch ehNt, and Ill uch *h"t I* numbered d'I* number of ahN ta 11 rec ord*d 11 th* 100 of thle form,
          * -:"'#"                                      .... : .   -                                                                                                                                                                   ATTACHMENT 2
                                                                                          ,,~      .
                                                        \ .*

FORM NIS-2 OWNER'S REPORT OF REPAIR OR REPLACEMENT As Required by the Proviiiont of ASME Cod, Section XI

         -1.        Owner                 Vi rgi oia Power P.O. Box 26666                                                                                                                          ShN't _ _....__ _ _ of_ ___.....,.._ _ __
                                                                                                        ~rnaJ
2. Plant Surry Power Station Unh-~~(;'.)=-.~-=(t?=---~~~~~~~~~~

(N&mlf e.o. Box 315.{AooSurry, ..uJ VA 23883

3. Work Performed by_.V...A ......._._t'Q........w...e. .r.________ 38DDD <j--J.4/ / 1 (N->
                                                                           '!>ame
4. Identification of Synem ~<UII CoiV\f.o,.,.ro, '\- C0'0 }r.....r
5. lal Applic1blt ConstNctlon Code 831-1 1SI 67
  • Edition.~H-A_ _ _ _ _ Addenda, Code Case, __N __A._____
                , lb) Applicable Edition of Section XI Utilized for Repain or Replac,m,ntl -                                                                    ,,..BO. wsa                              Addinda, Codt C.SH....,N..... A....____

S. Identification of ComPOnents Repai~d or Replaced, and Replac:tment Components Namtof Name of Mfrs. Ser. .Nat'L CAN Other Year Repaired. ASME Codi Cornoontnt Mfr. No. Bd. No; ldentJ. su11t Replactd. St1fflPld No. ric1tion or cv.. or Nol Repl1i::emtnt 02.) .!(. "S '1'.). s H.,.J.\.J,,,.-ll Sneiio./h Ob]L3){ }J/r )JA J-{C-Se>i /V,f- Re,t,u-c-/ ,//o

  *1z) fr "I-JtxA+!.

__(j_ t-J,;,l"-,c,,,( 5Q,~i... \'b. 01019., 1 j1J .,+- µ,k-. /-!C-Sl AJA- l<r~kct'J A)o

7. Description of Work n~ Lfl"' \ cke.lf.r- 0"" lu.z /

a, Tens Conducttd: . Hydro1u1ic 0 ,neumatic 0 Nomirill Operating Pres1urt ~ Other 0 Prtssu~ JlltJ? psi Tt11 Temp. tYll t: *, I. R1marlts_._,..._~----,-:---:a-----:----c--::--~-----,--------------------- lo'PPI~ lolAFIUIKluref'°I Data Jle:,0,,110 be~"K~ p[) ~ ss y h) 0 !?"3 .) ______________;~ JV,.,f-s PD ii> ss Y l,l 3 2,e,t CERTIFICATE.OF COMPLIANCE

~~~~It t'2~' nmme;~m..:HIn this report 111 correct and this _ _-'-r--;+~--J __'lc....°'e,...._

__a..apia-=e,._-cemenQ-"\-*_ _ _ confonn110 Section XI of tht 1 Signed ~ C~~ ~ ISI Vqt..v Z-'7 19,£:,9

                                                      ;;;erOwner~....!                                                            T111:                (Dlt*J '                                            '

CERTIFICATE OF INSPECTION* I, the undersigned, holdint a valid commission iuued by the National Board of Boiler and Pressure V,uel lnspKtor1 and the Stall o, Province ot-V..._A..,_*,~ - - - - - , employed by HSB" I &I CO, of _H._._a.... t ...f...o...r.,.d..,.,__,.Cc..1.I...a,__ have inspected the r ... r-e.p 1.:ic~<A. -r. jRtp1u11J O< ~t~laetmerit(II described in this Aepor, ~ _ _ _ _ _J

                                                                                                                                                                                                                           . . . .-_3...,f_,  19.n and nate that 10 the ben of my ltnowltdpt and belief, this repair or replacement hH been connructtd in acc:o,dance with Section XI of tht ASME Code. By 1ignint this cenificaie, neither the Inspector nor hi, lmployer makes any warranty, uprrned or implied, concern-ing the repair or replacement described in this Repon. Funhennore, neither ih.e' lnt.pector nor his employer 1hlill be liable in any manner for any per~n1I injury or property d*0,~o r ~ ~ any kind arising from Cir connected with this ln~tcti_cr- ,,_

Datt 7 :>\~2~ ~ ~ 1.lnsi;>o<tCIII

                                                                                                                                            *. Commiuions /J'.i3 ]tJO f~*net.                      (State o, lffi bl{ J8oe'1II .

NatOOf\11 o'l'I: Supplem.ent.l thNt'I In form of lln:11, *~*1ch*, or dr*wlrips mey be und provided (1) 1111 h BM In. X 11 111.,

            !nform*don In ln,n, 1 11\rouvf\ , on 1h11 date npor, h Included on **ch ahNt, end (3) . . c,., 1hHt la number*d 1h* number of '"""' la recorded at th~ toP of thla form.
 .  -:-,..                                       .... :*     -                                                                                                                                                    ATTACHMENT 2
                                                 \

FORM N1S*2 OWNER'S REPORT OF REPAIR OR REPLACEMENT AJ Required by the Provisions of ASME Cod, Section XI

*1.          Owner               Virginia Power                                                                                                                             7/ois)~"1 D,11 _________________                                           _

P .0. Box 26666 Sht11 _ _..___ _ _ of_ _ _ _ _..,...,,--_

                                                                                              ~ma)                                           _
  • 113*_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __

Unh _ _ :..::_/~V.:;....

2. . Plant Surry Power Statinn (N.,.,.,

C) P.O. Bcix 315 Surry, VA 23883

                                                                       ,.V.OC,rHIJ
3. Work Perform~

by_V,..A-'A.......

                                                                   . t'O'L
                                                                         ......,l""'e....r_________

(N&/nl) 38000 1 ~811

                                                                     '5ame
4. Identification of Synem J
                                                                                          . IAOCIIUII ervJce           WO\,~    Y-
5. lal Applicabl, Construction C.ode 831-1 19 67 Edition .....l~""A"'-___ Addenda, Code Cases -,-..... N.....A______

lb) Applicable Edition of Se~ion XI Utilized for Repain or Replac1m1nu .:_ 11..80, WBQ Addenda, Code C.sn_....N,.,.A.__ __

6. .Identification of Compenenu Repaired or Repleced, and Repl,c-ement Components Namtof Namt of Mfrs. Str.
  • Nat'L CRN Othtt Year Rep1irtd. ASME Code CofflOOntnt Mfr. No. Bd. No. ldentJ. Buth Repltctd. Stamped
                                                                                                     .No.                      rication                                         or                         CY11 or Nol Replacement
 )J;, ;Jv.. 'r;.                                                                                   Al),4                   '-' , ~ I )
                                                                                                                                    /{J., C.                                                              ;Uo
                                                                                                                            ~u-.M.oU I{ .5 hol                                                                                                                        I ol{ C..                                                                    0
7. Description of Work _ _ _ _...;R.......,.e+* .....a=.>......,;---~~,;;c---------------=-----------

I. Tnu Conducted: Hydronatic O ,neumatie Nomi~I Operating Pressurt O Other 0 Remarks Pressure '(,S: psi Test T e m p ~ /? ";U. t J' f O

  • CS )> ,;). '( ?'fL).

I. -~--,ica:,lt--=..... o c_s_Y_~-,-,-S"-D-,,.. . l:a...*------

                                                       ~...,..,.,ac-,ur-af"..,.,-=~c-~--=-~-:,on-=,-,o..,.be-11--:I-K..,..~--=-------,r.-:-.,-,""",s-'-~-J"""s""""'"-Pi"'_____
                                                                                                  * ~tHTIFICATE OF COMPLIANCE
=~~~~(lat                           t~r nm;~nu                     m.ot       In this rrport are correct and this __-~\['.__-e..,.f,-~-ll'""~-~-,.-p1a-f.\._~_i'__
  • _ _ conforms to Section XI of the Si9ned*lf'., ~ ISI 2s:l ?l: / ,19 d"'f' to-;;;;~ee~ Tni; ~.,"7 CERTIFICATE OF INSPECTION I, the undersigned. holdin; 1 valid commission issued by thr National Board of Boilrr and Preuurt Vessel lnipectors and thl Statt or Province of_ _.V. .A......._________ , employed bv HS8° UI ca ft of H....a...r_t...f.._p><.L.r_..d._.,........C._.Jw,.___have inspKled the

..... ,tp lo.c. tM..t i' dt1cribed in this Report on ----7-i*,.--. .3'. -L..J__ , 19-!J.f I\,

                                                                                               . fRcpiortsJ o, ,e:,t1ctmen1(11l
  • w and nate that 10.thr brn of my knowlcdgt ind belief, thi.s repair or replac:cment h11 been connrvc1ed in accordance with Section XI of thr ASME Code. By signing this cenifiatt, neither the ln1pector nor his tfmployer makes any warranty, .,xprrned or impli,d. concern-ing the repair or rep_lactment described in this Report. Funhennore, neither the lnr.pector nor his employer shall be liable in any manner for_anf per~nal irijui:r r property d~n:]' r.'9n!Jf any kind arising from or connected with this ln1Pecti°t'1 _. ~

Oa1t ~ - ~ _ S.h ~ Commiuions /J L) / l)O f k'_<'.l. 6 J (lnsr;,ec10f)

Svpplement.1 ah .. n Jn form oflln1, 1ke1ch*, or dr*wlnpt maw be u,ed provided Ct> 1IH h*I~ II\. X 11 lft.,
  • C5111e or PR,,,,nc:e. Na1,ona1 lloa1'II nformetlon In 1nm, 1 throus,tl , on thl1 date upon 11 Included on ..ch 1hHI, and C3l Heh 1hHt 11 nymbered tt>* nufflber of 1hNb 11 recorded at th* IOP of thl1 form.
 . -:-,-                 ..*~ : . -                                                                                                                                                   ATTACHMENT 2
                                                 ,,~      .
                         \

FORM NIS-2 OWNER'S REPORT OF REPAIR OR REPLACEME.NT AJ Required by the Provisions of ASME Code Section XI

-1.      Owner    Vi rgi ni a Power                                                                                                 0,11-~~.:.....::~).. __S..._~_g--'-4~~~

P.O. Box 26666 Shff!. _ _.__~~-Of~---i.-~---

                                  .                           c,t.OdtllUJ
2. "'"'
  • Surry Power Station* ~ ....... Unh~--'--.. e>~.JJ,~'/;:=------------------~

P.O. Box 315 Surry, VA 23883

3. Work Performed by_V.._.Ac..o.&.,--'-~...uJ t______....;..._

(Name! 38DDD 7?'.8'"1 'i

                                          "-Same IAOdru&I           ~

4.- Identification of Synem J e'("\)J"c c WO\.~

*s.      11) Applicable Construction Code B31-1                               19   67               Edition ...... f~._A,_____ Addendt, Code Cases __. .,.N.....A___

(b) Applicable Edition of Section XI Utilized for Rco1ir1 or Replac1m1nta - 11..80. wan Addenda, Code Cases ...... N....A.____ fi. Identification of Components RepaitTd or Replaced. and Replacement Components Nemeof Namt of Mfrs.Ser.

  • Net'L CAN Other v,.,. Repaired,, ASMECodt Co"'OOntnt Mfr. No. Bd. No. ldentl- .Suitt ReplllCld,. Stamped No. f"ication Of (Y" or Nol Aeplacemt1nt 11 o~ojoo7o /iJJA f't7 l~cet{ pe 51'...J~ ')..1375/ b >>IA ,r-e Iii c. r ~, ()

CERTIFICAi~ OF COMPLIANCE We certify that the natemenu made In this report are correct end thil _ __._J::e~ii::*D~)_"l~C.;.;~=.;:.:'&\.,~~t-_*___ &:enfonns to Section XI of the

                                                                                                                 'c,,pa,, °' ,ep1,acemaft0 ASME Code.

Signed ~- c~a.-<:: io-- ar r1 Duog,_J IS I TIil:

                                                                                                               ;;;;(.. ../

tc.**V 2, q , 19 l':'i CERTIFICATE OF INSPECTION I, the undersi;ned. -holdinv I valid commission iuued by tht National Board of Boiler end Prenurw Vesnl ln5P<<tors ind the Stitt or Provine, of VA, , employed t,y,_fuiS..uJ.8_"._Iu.&.i..I....wCMO.,..,_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ of Hartford, CT. h1veinspemdthe repl~a-~t (R~ptr(,)Of R1::,11c1mentf1I dtscri~dinthisAep0'1on "7- 37 *

                                                                                                                                                                                              ,gJ'.J ind    11111  that to the  ~n of my knowledge and btlitf, this" repair or replacement h11 ~en connructed in 1cC01d1nce with Section XI of 1hr ASME Code. By sipninv this cenifiaite, neither the Inspector nor his fmployer makes any w1rr1nty, upreued or implied, conceri.-

int the repair or replacement described in this Aepon. Funhermore, neither tht Inspector nor his employer shall be liable in any manner for any penonal injury or propeny*d* ~ or 1~11 f any kind arising from or connected with this Inspection. Date --J '.l'f

  • Commiuiona /µ /J (Si.11 7co<t \)a S:Cf 3 (lns~IOfl
Supplement.I 1hNn In form of lln1, 1k11ch*, or e1,awln111 mar be und p,ovlcJ*d ltl 1ln h 1x*1n. X 11 In.,
                                                                                                                                                     .ar Pn,.,,nc,. Nal,on.al 8o&r1II formation In 1nm, 1 1hrou9"' 4 on 1h11 d1ta ,apor, 11 Included on uch ahNt. ancJ 131 Heh 1hHt 11 numberad a number of 1hNb 11 racorel*d at th* IOP of lhla'for"'*
                              .... :* ..                                                                                                                                           ATTACHMENT 2
                              \

FORM NIS-2 OWNER'S REPORT OF REPAIR OR REPLACEME.NT As Required by the Provisions of ASME Codt Section XI

    -1.      Owner:    Vi rgi ni a Power                                                                                                . Datt-2~i"'----"-=h......,7,___ _ __
2. ,1an1 P .0. Box* 26666 Surry Power Station
                                                                              ~,  ...,                                                     Shtt1~__......__ _ _ of~~..........._~-~~
                       .                              CNAfflll e.o.       Box 315.{AOClraU)       Surry, YA 23883
3. Work Performed by_V,..A. . . . ._._Pn......kt...e...r......,.________

(Name)

                                                  --same
4. .lde~tlfication of Srnem ,AuK ~4¢ea#L
5. (a) Applicable CoNtnictlon Code B31-1 19 67 Editlon,..:..1~"-A'-_ _ _ Addenda, Code Cases _ ....N ....A____,--__

CbJ Applicable Edition of Section XI Utilized for Aepain or Aeplac1m1n11 - 19..BO, wan Addtnda, Codt Casn_...N.A'---- I. ldentific.ation of Comp0nents Aep1i~d or Replaced, and Replacement Componen11 Ntmtof N1mt of Mfn. Str.

  • Nat'I. CRN Other Ytar Repaired. ASME Codi Component Mfr. No. Bd. No. ldentJ. Built ReplKtd, f.tamped No. f"ication or  ;'rn or Nol Rej:,lacemtnt
  *7     .#    Q
 ;o(.2. t I 72i£         :/£&., °£H,                  -                             -               -               -             nrr              At..~.bb~!!,)

{ 7. 8. CERTIFICATE OF COMPLIANCE

                                                                                                                       ~ 5 },.,~,q/&tt-                        conforms 10 Section XI of the er~pe;r Qr replaun,et!Q
                                                                                                                           ~111 "lh~t- £                    , 19  Jr'J CERTIFICATE OF INSPECTION I,. the undersigned, holding a valid commission issued by the National Board of Boiler and Prenurt Vessel Inspectors and the Stitt or Province of         VA,                                                      ,  mpl yed by         HS B" I &I CO ,                                                                       of Hartford. CT, have inspt<:ttd the                                       (.  /11\(?llJt-IRep1 1) o, ~e:,lteernan111l1 described in this Report on                             7-.31 . 19.fl and nate thlt to the best of my knowledge ind belief, this repair or replacement h11 been connructed in 1ccord1nce with ~ction XI of the ASME Code. Br signing this certifiau, neither the ln1pec1or nor his fmplorer makrs 1ny warranty, upressed or implied, concern-ing the rtp1ir or replacement described in this Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal inju:l'. or property d1mt91_jf~ any kind arising from or connKted with this ln11Pt~_iop.                                                        _.i Om          7-:s f - OJ                                        rr.JJ_~.....                                    Comm inion,           MB loo qor Pti,.,nce.v a.ou Boaldl 1

(lnlPKlllfl (51111 Na11onar

       ~: S11pplemani.l 1hNt1 In form of l11a, thtch*, or drawlnpa may be uead provided CU tin k 1.X In. X 11 In.,

lnfo,rnetlon In ham, 1 through

  • on thl1 due nport 11 Included on .. ch thHt, and Cl) ..,., thNt 11 n11mber*d
    *d lf\1 n11mber of thNtl It recorded at th* top of thl1 forfft.
   . -:",-                            ..... -                                                                                                                               ATTACHMENT 2
                                     '           FORM NIS-2 OWNER'S REPORT OF REPAIR OR REPLACEME.NT AJ Required by the Provisions of ASME Code Section XI
 .;.,_         Owner      Virginia Power                                                                                                       4 - s-- '13""

Datt-~---------'----------~ P.0. Box 26666 Shfft_......_ _ _ _ of_____ _ . ~ - - - ~ jAOdrn.a)

2. Plant Surry Power Sta ~Afflll ti an Unit OA/E P.O. Box 315.{AOOre&al Surry, YA 23883
3. . Work Performed bv-Y~A_._eo_w_e~r_________ 38DQQ &C:> 2 37
             .                                                         ~~                                       Repair Or;anLZ.llion P.O Ho.. JoO No. tie.
                                       .           -.Same
                                                                      &AOll,aaj C

I *

4. Identification of Synem f!EJ<,11c.ilft. /1-JVD V O L. u //h. CO l<JTR..l:) L-
5. ia) Applicable Construction Code 831-1 19 67 r~....

Edition ...... A'--___ Addenda, Code Cases ___N __A____ lb) Applicable Edition of Sec:1ion XI Utilized for Repain or Replactmtnta - 19..BD, WBQ Addtnd1, Code Cam _._.[y._.A______

6. ldentifjc:ation of Comp0nenu Repaind or Replaced, and Replacement Components Nimt of Namt of Mfrs. Ser.
  • Nat'I. CRN Other Yaar Repair-ad, ASME Codi Componant Mfr. No. Bd. No. ldentJ. Bunt Repl~ Stamped No. fication 0, CY11 or No)

Replacement

   . /I
       /l,,tM.             t.f".6 uyo,I                 l{p.._              NA               NA        61-C+C-qz_             NA              2 E Y't-/1-Ctz    Na 1/AlVt                 fri5c~~rJ                   AfPr                  NA              AIA             ;,
                                                                                                                         ;vA-             l?~PLAC/3             NO
7. "'-*-
             ..,,...;ription of Work_..,._.._,_:;;.,.,..;.;l'T'--~..._   vA-t--t/c ..
                                                         ' ,,v ___________________________
8. Tem Conduc:ud: Hydrostatic O Pneumatic O Nominal Operating Prnsurw 0 Other
1. Pressure psi Ten Temp._ *F I. Remarks ti:'P;/2.£--POi!fk,1440-4-' t/lltv~ PD-#5lj'- 69hlf
                          ~~'M&nulaCIUlel°I Data ~:,onl 10 be al?.cheelj                                         r .

CERTIFICATE OF COMPLIANCE ASME Code. Signed r)

                        *X,Lt:.6
                                        §'&.

We certify that the n1temenu m.C,1 In this report are corrl!ct and this __}<,_*_F-_1_ p.,;;; Owl0eSIQIINJ

                                                     ~                                         ISI Tnlt 9 t_//kE
                                                                                                                  ~1.t.

__-______ confonn1 to Section XI of the (rtp&i, 0, **P'aca<nenll

                                                                                                                                  ,1'?                     '31 _
                                                                                                                                                    ,,9 _____

1e1 CERTIFICATE OF INSPECTION I, the undersigned, holding I valid commission issued by the National Board of Boiler and Pressurw Vessel Inspectors and the State . or Pro~inc:e of___V ....A..._,- - - - - - - -

  • employed by usa* I &I co, of
 -...H-a....r~t. .f-o~r~d
                   . ...,.__..C'-'T.........__h1ve inspec:ted the 72.Jz.pi-#C~

JRepi*'1sJ Ot*~t:>lecemant(sl described in this Report on _______ 4~*~'.1-,. . 19~ and 1111e that to the ben of mv knowledpe and belief, this repair or replacement*h11 been c:onnruc:ted in accordance with Section XI of tht -ASME Code. By signing thi1 certifiate, neither the lmpector nor his lmployer makea any warranty, uprened or implied, c:onc:ern-ing the repair or replKement described in thi1 Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner

*for any personal ~njury or property dM~ or ~on of any kind arising from or connected with this ln1PtC1ion.

Date /..(-/7 g! . t~f. ~ Comminions /tJR 76of/ Vet. S'f 3 (lns~IOI') n: Supplement.al 1h*n* In form of Ilia, 1ketch*, or drewlnpa mey be uud provided 1111111 h 8:K In. X I 1 In., (S111e ~,nee. N1honal.!lo&rOJ o, lnformetlon In h*m* 1 1hrou9h

  • on 1h11 due rePon 11 Included on **ch 1hHt, end (3) **ch 1hNt la n11mber*d

.nd 1:h* number of 1hNt1 h recorded et th* tap of thla form.

   . -:-,-                                      ... :* -                                                                                                                                                   ATTACHMENT 2
                                             \

FORM NIS-2 OWNER'S REPORT OF REPAIR OR REPLACEME.NT AJ Required by the Provisions of ASME Code Section XI

  -,.          Ownff            Virginia Power P.O. Box 26666 (AOdrna)
2. Plant .

Surry Power .. Station (N&rnel Unit Q/../E P.O. Box 315.(AIIOraU) Surry.. VA 23883

3. Work Performed by_V,..A....._.*_._t'Q w...
                                                                  ....... e...r........,________                                      38000 h2            9-:z. /
                       .                                                             (Name)                                       Repair Or;aniution P.O Ho.. JoO No. etc.
                                                               --same
    ,.        Identification of Srnem (',klfM 1(;/JrL
                                                             .                     ~reuj i4~D r/tJ     l-U N'I  're     C!Jt{TfZ-.01-
5. lal .Applicable Construction Code B31-1 19 67 Edition,,..,_l~.,_A,...__ _ _ Addenda, Code Cales _,..NA'-'----...--

lbl Applicable Edition of Section XI Utilized for Repain or Aeplacementa - 19..BD. WBQ Addenda, Code C.sn _._.N~A.._____ G. Identification of Comp0ncnts Aep1irrd or Aeplacttd. and Replacement Components Name of Namt of Mfrs. Ser. -Net'L CRN

  • Other Year Repaired,, ASME Code Comoonent Mfr. No. Bd. No. ldentJ. Buth Replaced_ Stamped No. fication or IYes or Nol Replacem,nt rJPr ot-<.H.- p- No.
-+hr~,\,~ .,(, "B i l f /Ill & l!Jtifi )C>J, .                                                   /UA-          ti ft         I I+                    f/4        R15/JcM/J
  'Yr,"

I sf'AP-01'.w [( ' Nf\ I-/ A µ!+ It f.JA 'R rf PIIN rW ,Jo 7. 8. I. CERTIFICATE OF COMPLIANCE

                                                                                                                             *-r71-C <'D;   ,.,..,. ;;;:_

We crnify that the natemenu made In this repon are correct and thlt__,~---~-n_v;_Vf"_'-_*_

  • _ _ _ _ _ _ conforms 10 Section XI of the ASME Code/;) - ~ * .
  • c,,pa;, or repia~

Signed 'tt:J*g~q,L eo,.,,., nara Oe,;p-1 ISI Tntt

                                                                                                                                             /J->A.,~

CDet=f I 0 ,19 ri CER Tl F !CATE OF INSPECTION I, 1he undersi;ned, holdi"SI a vilid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the S1at1 o, Province of_ _.V....A.. ,*.________ , employed by HSB' I &I CO. of a_.._r....t..,_f...,nCLr-"d4,'-"'C'-'-T__..'--_h,ve ins;,Kled the _._._H... ~p~ - dncribed in this Repon on ---~tl~- .......!i...Y___ , ,& IR*P**rfll o, Rt;,lactmant(IJI and siatt 1h1t to tht ben of my knowlrdgt and belief, 1his" repair or replacement h11 betn connructed in acc:c.rden~ with Section XI of 1ht ASME Code. Bv signing this certificatt, neither the Inspector nor his l!mployer m1ke1 any warranty, u:preued or implied, concern-ing the repair or replKement described in this Repon. Funhennore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or propcnr dar:r3r~*J~11J o ~ : i : : arising from or connKted with this Inspection. Oett {f-/1- £'/ ~J. ~ Commission, µ/37609 l/tl... Sl/3 (ln1pec10I) n: Supplemant.l 1hMn In form of 1111:1, *~*tch*, or drewlnpa m*r be und p,ovld*d (ti alu h 8" In. X 11 In., (Slalt o, ~,net. Na1,on.a1 80&rO) lnformnlon In 1nm, 1 11\ro\llta , on tl\11 dna upon la lncl\lded on **ch ahNt, anel (31 each ahHt la numbered end 1'>* number of ahNta la racorel*d at the top of thla form.

ATTACHMENT 2

                                                      '             FORM NIS-2 OWNER'S REPORT OF REPAIR OR REPLACEME.NT AJ Required by the Provisions of ASME Code Section XI
 -1.              Owner                  Vi rgi oia Pmver P.O. Box 26666
                                                .            .                                jAOClrllN)
2. P11nt Surry Power Station IN~

Unit OIJF P.O. Box 315..{AOOrallJ Surry, VA 23883

3. Work Performed bv-Y:u8 ......__._PO......w..,e. r~--:-------
                                                                                          . fNarnej                                          38DDD ,4 S-8~

AepairOr;anwilion P.ONo..JOO No.eic. .

                                                                        ,same
                                                                           . .              '400,alj
4. Identification of Synem Cotv,(\1 f.J ".".::%1" T ~~
s. 11) Applicable Construction Code B31-1 19 67 Editlon, ....H_A____ Addend1, Code Cases __N_A____

lb) Applicable Edition of Sec:1ion XI Utilized for Repain or Replacamtntl - 11..80. waa Addenda, Code Cam ........ N.A.._

15. Identification of ComPOnentl Repaired or Replaced. and Replacement Componenu Namtof Name of Mfrs. Ser. -Nat'L CAN 0th., Veer Repai,..d. ASME Codi Comoonent Mfr. No. Bd. No. ldentJ. au11t Repletld, Stamped No. f"ic1tion or (YnorNo)

Replacemtnt lJl -c.S 1'I IA.T - S J~,_i* Carl,n11! t1,4q1..qo ,JI+- rJv+ - 4~ Al>'r ~~J rl& ~,Z~,O*.D1..r1*-i p Ji:(fV'...t ~Ir- 4,/54% 30 /J A- /\JA- ti ,V/4- '"fv nfMoi) /.Jo 11 m .. 0, /) i,r~ f!mvJ(l ""-'- 31B8ZS' /a #"Ir NA- '1 "'It 12.a.,,~~ Vb I J.I,, vA.t:t .t.a.'I h 0.:).0('1&) .:W IJ/1-- /.//} I\I.J'-1, Pu,(~ PD

                                                                                                                                     "                                      I 7.

8; I. CERTIFICATE OF COMPLIANCE We cenify that the n1temenu made In this report ar1 correct and this_~ ___.....:f_lo.c. ___""e...n.-e..."----J ______ conforms to Section XI of the ASME ~ * * . c,epa;, or **Pia~ Signed~£~

                         .                     io-~ners Dn,g,...J ISI Tnlt                    IDl**I 4/~4 0-i-9--
  • 19 .....

CERTIFICATE OF INSPECTION I, tht undersigned, holding

  • valid commiuion issued by the Natiol')II Board of Boiler and Pressu'9 Vessel Inspectors ind tht St1t1 or Provinctof_ _.VLLA....." " - . - - - - - - - - , employed bv HSB" I&I CO, of
........H...a.._r...t..._f...o.,_r...d..,.,__.,C:. LT. . .__ ha11e inspected th~U\<...EMe.JJ                               I *

(R~pa,,tsJ o, ~e:,lac1m1nt(1I demibed in this Report on ----~S:--~'--* 19fl ind nate that to the ben of mv knowledge and belief. this repair or replacement h11 been connruc1ed in acc::ordanc:e with Section XI of the ASME Code. By signing this certificate, neither the Inspector nor his ll!mployer makes any warranty, e,,:preued or implied, concern-ing the repair or replacement described in this Report. Furthennor1, neither the lnspecior nor his employer shall be liable in any manner for any ~rsonal injury or property d ~ or I on of 1nv kind arising from or connected with this lnipec:tion. 0111 j- / -'£ C:, Commiuion1 µ(3 7() c,q t/~ £1./ j (ln1po,c1Df) n: Supplemental 1hNt'I In form of 11111, 1k11cha, or drawlnpa may bl uHd p,o.,ld*d (ti 1111 h BM In. X 1 I In., (Stale or Pn,,,1nc1. Na1,ona, ~ Information In lnm1 1 1hrou9h , on 1h11 Cina *noon 11 Included on **ch 1hNt, and 131 ..,h 1hHt 11 numbered d th* numblr of 1hN1I 11 racord*d at the top of thl* form.

      --~                                            .... :* .                                                                                                                                                          ATTACHMENT 2
                                                                                        ,,~ .
                                                     \

FORM NIS-2 OWNER'S REPORT OF REPAIR OR REPLACEME.NT As Required by the Pr0Yision1 of ASME Code Section XI

    ...,.        Own11                Yi rgini a Power                                                                                                                D1t1         L/ - :2. S--    ~ ,q P.O. Box 26666                                                                                                                  Sh Ht                                 of_ __.._ _ _ __

CMOrna, U11h_...,..........__ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

2. "' Surry Power Station 0 E. ~

e.o. Box 31s(Ns'utry, ,lAC!O*HII YA 23883

3. Work Perform~ by..Y ..........ro
                                                                ....A         . . . .k....te....r...,..._.,...-_____                                 38000 tf .s-~ '??

C'lemel

                                                                           ...Same CAOd.....,
4. ldtntlric1tion of Synem R k /1/s f vJ }II(: AJ T It r.A
5. f1I Applicable Construction Code B31-1 19 67 Editio11,-""H""'A,___ _ _ Addend1, Code Cases --"'N""A'-----

(bl Applicable Edition of Section XI Utilized for Rep1in or Aepl1um1nts - 19..80, WBQ Addenda, Coda Cam_..f.J.... A_____

s. ldentifiaition of Comp0nenu Rep1i1Td or Repl,~d. ind Replacement Components N1m1 of Namt of Mfra. Str. *Nat'L CRN Other v,.,. Repaired. ASME Codi Comoon111t Mfr. No. Bd. No. ldentJ. Buth Replactd, Stamped No. fic1tion or (Y11 or Nol Repl1cam1nt M<- :Jvn k:~

I./~ £ttJtlW (,17, p. '525f'2.7b AIA Al A oi-IA-7t7'/ ;tiA- fl.. -e_>> Iac f ;1/;J qtJ 0 Et.lJ~w ~fJ.Ist.-HlfoflN , S'1 o/3 t- #Ir Al Ji, o:/.*IA-7or.t AIA flp n la1f Af rJ

                                                                           ~6<102s-r)                                                                                                   I 2     MTf VAl/lf:                    ~Ji!.lsc!-1/ro/i.f.J             7. fJh O'llftii                11/ A                !VA- o1. -:CtJ-7t74          AJA-               fl.f.olac-e                     !110
                                                                                                                      \
                                                                       ~.

RePlacettf v.,r ve, /ve,<,"C 01/tll1 f ) /ld,f~c/ /{J/JI$8 ., rr /6.'f /..eqka f.

7. Dflcription of Work I ) f r 1::/:- CJ~ 'i"o ~* 2.. 2- 0, 'I I 5 c. f' /-I I. Tem Condue1ed: Hydrostatic Pneumatic O Nominal O~ratin9 Prnsul'9 0 Oiher ~ PT- //,,4 /h/ept-Pressurt psi T,n Temp._ eF ) '><)

I. R1mar1ut)tfr"' /.!tt, /JtJJ:1- :q?Hs: 2)1P" /:U, Po.#: Cf'(J/6'"ft/D-OP, Mff VAlllE fo./:f-.'O'I-IC/3~co-0 2. V,W~ ~"YIKl ... ~1 Dita Rc:,onl lO be IIIK,... CERTIFICATE OF COMPLIANCE Wt certify 1h11 the natemenu midi In this repon are correct and thls ....R~e,.,_p.,_/a..,c.._e_.M:..:....:;.e...:.11....,t...__ _ _ _ _ conform1 to Section XI of the ASME SigntdJtt'.-~~ eo,fl , ~

                                                    ,.... or        net'I De109ANJ ISI TIit
                                                                                                                                               '      .,pa,, or
                                                                                                                                                  'f-'2.s--';?q (Ditti 11p&acaflWIQ CERTIFICATE OF INSPECTION I, the undersigned, holding I valid commission Issued by tht N1tlo~I Board of Boner and Prt11ure Ve~sel lnspacton and tht Statt 0,     Provine, of                         VA      I
                                                             *,                                              '  employed bv us o* I& I co                  e                                                                    of
   ......H_a.._r....t....f_o..r...d.. , . . . ,C...T_.*....___h1ve inspe-c:ttd tht &n lac-e Jn c'l4 (: .

(Rtpe,1111 Df ~e;1IA'1m111l(II demi~ in thisRepo,1 Oft y J ',,!1... and natl that to tht ben of mv lcnowl,dgr ind belief, this repair or replacement h11 been connrvcttd In 1cc:o.rd1nce with Section XI of tht ASME Code. By tigning thit cenificatt, neither the lnsptctor nor hia fmployer makes any w,rrantv, 111:preued or implied, concern-ing tht rrp1ir or replacement dtscribed in thit Repon. Funhermore, neither the Inspector nor his employer ahall be li1blt in 1ny manner for any penon1l lnj11ry or propeny d*"'ffOI.a lo..!_ olan~ing from or conne-c:ted with this ln1P*~ifn-D111 S"- ;J- f.'9 ~ f.. ~ Commiuionl IJ B 70o C, -{l...!&_ SI/J (lftli,.<:I~ (Sltll 0, Pn,,r*IICI. Netoon*I ~ lllort: Supplemental ah"n In form of lln1, 1ke1ch*, or drewlnpa may be u*ed p1ovld*d CU 1lle h l:K In. X 1111\., 121 lnfo,me1lon In h*m1 1 through

  • on thl, Cine ropon 11 Included on .. ch thHt, end 13) uch thHt 11 numbered and lt\t n11mber of '""ta 11 recorded at th* top of thl1 form.
      . -:--,-                         ....... -                                                                                                                                        ATTACHMENT 2
                    . .. ..                                         ,,~   .
                                     \

FORM NIS-2 OWNER'S REPORT OF REPAIR OR REPLACEMENT As Required by the Provisions of ASME Code Section XI

    -1.        owner Vi rgi ni a Power                                                                                                       ~n--S'!    .......~-=-,,..,~.._9__~~~~

1 P .0. Box 26666 ShHt_..........___ _ _ of_ _ _..___ _ __ jAOOrna)

2. Plant Surry Power Station
                            .                                 Pl~

P, o. Box 315 Surry, *vA 23883

                                                           ,tAIIOreU)

Work Performed br-Y~A ........_t'Q.....,W_e....r________ _

3. ..,..,,., Repair Organiutioft ,.o No.. Job No. lie.
                                                         "'Same
4. Identification of System Co*::;;:! (k.,<d .
5. la) Applicable ConstNctlon Code B31-1 1SI 67 Editlon,..:.H:::..A.,___ _ _ Addenda, Code Cases -~N..,,A..,_____

(bl Applicable Edition of S,ction XI Utilized for Repain or Replac:1m1nt1 - 11..80, W8Q Addenda, Coda C.sn _....N.._A._____ I. Identification of Companents Repaired or Replaced, and Replacement Components Nam1of N1mt of Mfrs.Ser. -N1t'I. CRN Other Ytar Repaired, ASME Codi Component Mfr. No. Bd. No. ldentl- iu11t ReplKtd, ,tamped No. f"ication or i'l'n or Nol Replacement c-~,.

~ .....                           u6,r;
7. Description of Work tJ.w? ,¢.!)~,& ()~ Af?'-""4't¥:'I ¢4:"AfR A&#: Q/v' (2wr<~r (W,?,....~~~
8. Tests Conducted: Hydronatic D l'neumllic O Nominal Operating Pressurt D Other 0 Pressure psi Ten Temp,_ eF
9. Remarks t,)&1t. 1> 4 &-M,& 06i 4',?p,),!-y ,4,e~.,9
  • unr ,& Ch'/2..c< w#.&C.:'. µ~,;,-e*2, jApplic.at)lt ~I\Ulacturef"a Dara Aa:,0,,110 be at1Kh9dl >

CERTIFICATE OF COMPLIANCE repon are correct and this _ _--'-~-'t!=-;">~~-"'-~-=-----canform1 to Section XI of the CER Tl F ICATE Of INSPECTION I. the undersigned, holding I valid commission issued by the National Board of Boiler and Pressurt Vessel Inspectors and the Stitt or Province of VA, _ , employed by HS B I &I CO , 0 of Hartford I CT, have inspected the R~g..;*... IRep-a, I) o, Re~11cemen1(11l described in this Report on S:-':I . 19n_ ind state that to the ben of mv knowledge and belief, tbi1° repair or replacement h11 been connructed in accordance with Section XI of the ASME Code. By signing this certificate, neithe the Inspector nor his fmployer makes any warranty, upreued or implied, concern-ing the repair or replacement described in this Repo . Funhermore, neither the Inspector nor his employer shall be liable in tny manner for any per~nal Injury or property d1m"9' or a lou;,f 1nv kind arising from or connected with this lnr;:,,ction. O,te '2 - ':{ - ~7 ~ r!:...: ~ Commiuion, µ 0 7o D~ tiA ftf :3

                                                                  *                 (ln1~10f1
5.,ppl1mental ,h"n In form of 11111, 1k1tches, or drawln1,11 may be ueed provided CII aln h BX In. X 11 In.,

l51a1, o, Prc,.,i,c:1, National~ nformotlon In him, 1 thro"gh , on thl1 data ,opor, It lncf.,ded on each ahHt, and 13) uch *""' la numbered d lf\a number of 1hN1I 11 recorded at th* 100 of 1h11 form.

    *-~                                          .... :*     -                                                                                                                                                          ATTACHMENT 2
                               \
                                                  \

FORM NIS-2 OWNER'S REPORT OF REPAIR OR REPLACEME.NT

                                                                                 ~ Required by tht Provisions of ASME Code Section XI
   -,.           Owntr               Vi rgi ni a Power                                                                                                              Dtw           6:-          /8- 8Cj P.O. Box 26666                                                                                                                Shm                                  of._ _ _ _ _ _ __
2. "' Surry Power (N~ 5tati6o.....,.

Po ,

  • Box 315 Surry, VA 23883 111
3. Work Ptrformed 1,y_Y. .A..............S'.e..u........r________ 38QQQ 7 8 b0 I (N.,...,
                                                                      ...Same
     ,.          Identification of Synem , SER I/ 1c.JZ: W:M'f :R
                 ,., Applicable ConstNctlon Code 831-1 V.OC,raaj 19 67               Edition,..:.r~._A.,_____ Addenda, Code Casr,                                 -~N-A____

5. lb) Applicable Edition of Section XI Utilized for Rep1in or Replec1m1nt1 - 11.80, WBQ Adcltnda, Code Cam _..[:J.... A.____ I. Identification of Componenu Repaired or Repltctd, ind Replacement Componen11 N1m1 of Namt of Mfrs. Ser.

  • N1t'L CRN Other Ytar Rep1irtd. ASME Code Comoonant Mfr. No. Bd. No. ldentl- Buth Repleced. Stamped No. f1t1tion or (Yn or Nol Aeplacamtnt 3/IvI\L-l'IZ. tJ/r. /fA FE;RE:i itSol-l E:NW~IZ/o tJ/4 tJ/A, I-SW-5" "f?r;Pt,~tJ ;Jo"
1. Dflcription of Work ....1.cG=":f-,JL.<,;;.~*""(Jn,,.,__;;,,,.E:.:a._:J:..;At.~V;..F.,.:;.:,.*------------,=-.,,..----=~----------

I. Tem ConduC'led: Hydrostatic O Pnwmatic O Nominal Operating Preu1.1rw Other 0 Pressure psi Ten Temp._ 'F I. Remll'lu VAl.t1t:: fv-1*- - csy- :i~e,g,.3

                                     ~ Q b l l M&"<IIKIUfef°I D1iaJw:,c,n1 IO be                         111t&c'*'

CERTIFICATE OF COMPLIANCE

                                                                                                                               ._'R.u.:;;P-C-R'-La;..f\<e;.;...;~""-..:.;E;:;;-_,.i_~'------- conform, to Section XI of thl tepa,, C111ep1aca<neftll CERTIFICATE OF INSPECTION I. the undeni9ned, holding a valid commission Issued by the N1tlo~I Board of Boner 1nd Prenur1 Ve~sel Inspectors ind the S11te o,Provinceof                             VA,                                                      .employedbv           usn* I&I            CO,                                                                             of

_...H...a...r-'t...f..,o........_r.,,.d_,,__.,CI.JTL..J,.___h,ve inspected the 'Rfipt.,AqzM-E-fJf 1 (Rcpa11'(1J o, ~cpl1ctmenl(1I ducribed in this Report on S'-(1 ';,.81. ind natt that 10 the best of my knowl,dgt and btlief, this ;epair or replacement h11 been connNcted In 1cco,d1nce with Section XI of the ASME Code. By 1i9ning this certific.ate, neither the Inspector nor his lmployer makrs 1ny w1rr1nty, upre1sed or Implied, concern-ing the repair or repl1etment described in thi1 Report. F1.1rthermore, neither the Inspector nor hi1 employer 1h11l be li1ble in 1ny manner for any person~l ln~1,1,y or property d*fo\.19' ~'.' lo" oynv>Jnd,..trising from or connected with thi1 ln11P~cti0f\. Date s (&f. . 'i/'f ,~ L

                                                                                                    ""IPKIQ/1
                                                                                                                  ~ Commiuionl                                             rvG70(!) (              Uet£L\3 (Stilt DI Prg,,,,nc,. Nat,onal 8oat1lt 1\/on: S.. pplemeni.l '""" In form of llu1, 1k11ch*, or drawlni;ia may b4I 1.1 .. d proi,ld*d ltJ 1111 la a,, In. X '1 lft.,

121 lnformnlon In lnma 1 1hro\/gh

  • on thl1*C1111 ropo" 11 ,,.clud*CI on eech 1hNt, and (3) ucll allHt 11 "umbered and ,t,a numb41r of 1h"b 11 recorded at 1111*1op of thle form.

/

                                              .,~ .
                        \

FORM NIS-2 OWNER'S REfiORT OF REPAIR OR REPLACEMENT A.J Required by the Provisions ofASME Code Section XI

-,.                                                                                                         Sh,-i _ _.....,,_____ of__.___ _ _ _ _ __
2. Unh-..:==-------------------~
3. ) C-?6-/() - I Repair Or;anlulian P.0 No., .loll No~ 9IC.
                                                    ~rul1
4. Identification of Synem..c..-~..:<l-:.a~~*c..--<.:::i..L!::.~:,J,::.-_ _ _ _ _ _ _ _- . - - - - - - - - - - - - - - - - - -
5. Cal Applicable Construction Code d, ti, I 19 C, 2 Editlon,-..L:~,:;z....--Addendl, Code Cases _._,.t./-'-"~"'-----

lbl Applicable Edition of Section XI Utilized for Repain or Replacements - 19~, A.l,f'"n Addenda, Codt Casn Mb

6. Identification of Componenu Repai~d or Replaced, and Replacement Components Name of Nama of Mfrs. Ser. -Nat'L CRN Other Year Repaired. ASME Codi Component Mfr. No. Bd. No. ldentl- iuth Aepl1eld. Stamped No. f"ication or CY11 or Nol
7. Description of Work-------------------------"T"--------------

Hydrostatic O Pneumatic O Other 0

8. Tens Conducted: Nominal Operating Prnsur9 Pressu~ Alo) psi Test Temp.~*F
9. Remar1ts--------------------------------------------

lAPP!icabll ManulacMltf'I Daa Aeoon110 be allaCheelt CERTIFICATE OF COMPLIANCE 1r1 correct and this ..eu~ ,4(! ,{"14' vZ: (lepairorre conform* to Section XI of the CERTIFICATE OF INSPECTION I, the undersigned, holding I valid commission issued by the National Board of Boner and Pressul'9 Vessel Inspectors and the Stitt or Province of VtL

  • Hs B -r..t- r Co of ffa...-t F,, r-dJ cf, have inspe<:ted the.....i.;,=,fll.-L.!:U~~c;.!!!...+--dHcribed in this Repon on _ _ _ _ _

IRe air1s) o, ~e:,lacement(Sli .

                                                                                                                                         ...,,_5"~--~=1--, 19fi and state 1hat to 1he best of my knowledge and belief, this repair or replacement has been connructed in 1ccord11nce with ~tion XI of the ASME. Code. By signing this certificate, neither the Inspector nor his t!mployer makes 111y warr11nty, expressed or implied, concern-ing the repair or replKement described in this Repon. Furthermore; neither the lnipector nor his employer shall be liable in any manner for any personal Injury or property d 1 1 ~ l~s of any kind arising from or co.nnected with this Inspection.

Cate s-i1,~9 ~f. ~ Commissions µa?ot11 AJo..St/3 (lnspectOI) on: *supplemenul 1h"n In form of 11,u, 1lu1cha, or drawlnll" may* be UHd provided (11 aln 11 B~ In. X 11 In.,* (Slate P,v.,nce. Nalional o, 8oAl1I)

  ) Information In lt-ama 1 through
  • on this date upon la Included on ..ch 1hNt, and (3) eech 1hNt 11 numbered and ,t,a number of lhHta 11 racorded at the top of ihl1 form.
    ..   ~                           .... :*  .                                                                                                                                      ATTACHMENT 2
                  ....                                        "~ .
                                     '           FORM NIS-2 OWNER'S REPORT OF REPAIR OR REPLACEME.NT As Required by the Provisions of ASME Code Sec1ion XI
  ....,. Ownff        Virginia Power P.O. Box 26666                                                                                            Sh Ht                           of...................................._

CMGrna,

2. ,1,n1 Surry Power Station
  • Unh Af_e P,O. Box 315tNSutry, .{AOOraU, VA 23883
3. Work Performed bv-Y~A.....-,-l:10-k-l_e_r_____________ 38000 7[?6 3 s-
                                                     -.Same          ~"""
                                                                    ~_.,
4. Identification ofSynem , it:/? V,f"?8 \(IIAJ:.r/J,.

I. Ca) Applic1blt ConstNctlon Code 831-1 11 157 Edition,.H"'-A,___ _ _ Add1nda, Code Cases ......:.aN::..A,_____ Cb) Applicable Edition of Section XI Utilized for Rep1in or Aepl1cam1nu- 11...80, WBQ Addenda, Code C.m_...N... A.__ __ I. Identification of Components Ael)airTd or Repl1ced, ind Replacement Component1 N1m1 of Name of Mfra. Ser. .N,t'L CRN Other Year Aep1irtd,, ASME Codi Comoonent Mfr. No. Bd. No. ldentl- Buth RepllCtd, Stamped No. fic1tion OI (YnorNo) Aeplacament

 ~::.. , 1 TA,-etw(/kv HADWIJ..

Sn,.c.'q I #/4 Jr///- !II/A- ()/-:s#tt'-p_ 11:. fil/4 /.I e>> hcf' A/1/J I/ HA.I) Ill fl , r;l- *W-P-Nut #ex. <:/Je tie: I ;Y/11- 11/4 JI IA- In:. #/;t P..e.JJ lac -e. A1IA 3'

     ,,   f.j11e.           :,; l-f, t:/ithkt?r,i            ?P."1,5too /IA                          #/A O{-">W-P-J t.             /{////-       f.<-ep lru e                     Iii III
                                                 ~.
7. Dflcription of Work /l#/Ji/Y& ij/J,Pl/6' A5 .&B:tR. IA7"JV3/J Hydrostatic D Pneumatic O Nominal Operatin9 Prnsu11 D Other 0
   **      Tern Conducted:

Prusu~ psi T,n Temp, _ _ *F

   **      R1marlu f1c?P f<;;y-                       r  IT r.enef - &w           ,,,,pf      /-1,e'Jf A/4 1         S5 Y -     .2. 14 .r3 q ,
                         ~ppa:,lt t,ta...,IKIUl' .... t     C)a!A F\a:,on1 IO be 11\Khldl                                                        /

f<Z /,J- ht: ~ ,., &'; a -r ~ e, 5 Y - t z&q t s - I CERTIFICATE OF COMPLIANCE We Ctr1ify thlt the natemenu m~ In thil repon lrl correct end this R i; Pk At 6 M eN'T conforms to Section XI of the ASME Codt. (:'\ ~* (#~ t,7"or11p,acefflefG Signed R(/a,c~/0~ (Owne< Owner"& De1,g ISi TIit 5'/3/ Colttl

                                                                                                                                                   .,, n CERTIFICATE OF INSPECTION I, the undersigned, holdint I valid commission l11ued by the N1tloni1 Board of Boller and Pre11u11 Ve~sel Inspectors ind tht S1at1 or Provincuf                 VA      I
  • employed by BS a* I&I co e of Hartford, CT. h1veinspecttdtht /1.eplPce ;1(,eUl
                                                                             !Rlpa,1f1J Of Re::,l1c1tm1ftl(II ducribedlnthisRepor,on                                 S-'J/             ,;sfi ind n111 that 10 the best of my knowledge and belief, this" repair or replacement h11 been connrvcted In 1cc:o,d1nce with Section XI of the ASME Code. By 1ignir19 this cenificau, neither the Inspector nor his lmployer m1ke1 any w1rr1nty, u:pre1~d or implied. concern-dff"'ffl int the rtpair or replacement described in this Repor,. Funhermore, neither the Inspector nor his employer 1h1II be liable in any manner for any perso~I Injury or property                                         lon~anx~ind arising from or connected with thia lniptction._

D111 j 3/-JP'f ~ { (_~ pn1pe,c1Clf) Comminiona JJ{)70{)'f Vt.t 5'{3 (S1t11 o, f'ro,r,i,ce, N11,ona1 ~ Non: Suppl*manul 1h"t1 In form of llns. 1ketch*. or drawlnpe may be uHd p,o.,.lded (II 1111 h IM In. X 11 '"** 12> lnfoun*\lon In lftm1 1 throvgh 4 Oft this deta repo" It lnclvd*d Oft uch ahHt, and (31 .. ch 1h"t 11 !\umbered end 'Ct>* ftumber of 1h .. ts 11 recorded n 1h* top of thl1 form. r--~-

                               .*-   ..  -                                                                                                                                                                    ATTACHMENT 2
                            \

FORM NIS-2 OWNER'S REPORT OF REPAIR OR REPLACEME.NT As Required by the Provisions of ASME Code Section XI

.-,. Owner       Virginia Power                                                                                                                             Datt~~--0.._S_-~\'1.....-_.{._C,~~~~~

P. 0. Box 26666 ShHt-~------Of_ ___.....__ _ __ (AOdrna)

2. Plant Surry Power Sta IN~

ti an (J P.O. Box 315.(AIIOraut Surry, VA 23883 ,4 j) c.. .

3. Work Performed by_V,..A ........._._P...co.w
                                                             . ....e...r_________                                                 38QQQO) 6j7/f. 077 /17; 07i/'IO;                                              67~ f JC.

(Name) Repair OrganlZJllion P.Oi4.. JDb ND~ etc. I /

                                                    -..same (AOdresaj
4. ldentlfitation of Syn em Sl:ltu1u;; WPii~"'- [lAl)1An1>> IV\<:>u\TOI), PU/Ii f .S
5. la) Applicable Construction Code B31-1 19 67 Editlon,~f~-A______ Addenda, Code Cases -~N-A...__ __

(bl* Applicable Edition of Section XI Utilized for Repairs or Replacement, - 19..BO, wsa Addenda, Code Ca,et ....... N....A.____

6. Identification of Componenu Repai~d or Repleced. and Replacement Components Name of Name of Mfrs. Ser.
  • Nat'I. CRN Other Year Repaired. ASME Codi
Component Mfr. No. Bd. No. ldentl- aunt Repleetd, s,. . -".'ld No. fic1tion or N:, Not Replacement Cm/JC,, I\)~ (')~ ,u}

1-(/

                                          ,n/C!f)IJ/lt::-;:11 ,..,-"'16.~..,. 1'~'St<,N ~t/1"1/' ,f .JetzHN. RJ,1/~ /"?J /94/(,/~
7. Description of Work...:~=.....;...;;v"""....;.........;:;Va.....,r/':._"...;';.....;.7...._-_,~:.__ _ _ _ _ _ _ --'----------'="'---------
8. Tens C'.onducted: Hydrostetic O Pneumatic O Nominal Operating Pressure O Other g7' Pressure "is psi Ten Temp. IJ(f)'l *f ~
9. . Remarks PuM fJ!, urJi);R pII ~ CJvT ~.J. If J °I I - ) (SrK NO '-/IJG-..(J).6 jAppliUl>le lo\aftutac1uref"1 0.11 Re:,on110 be a111chedj CERTIFICATE OF COMPLIANCE
~~~~a~ateme:u;~e; th~eport m correct and this _ _.... J._~
                                                                                                                                   . .e."T~                  ..~~--ef_._
                                                                                                                                         .........~--or-,.a..e~-      ____ conform1 to Section XI of the Signed             U,/~X.fe:J;cC~

(Ow,,..orOwner'aDesig,_I ~tl ~ IST Tnll

                                                                                                                                /-&?./30 1[)11e(
                                                                                                                                                                               ,19      %'J CERTIFICATE OF INSPECTION I, th1 undersigned, holding                I     valid commiuion iuued by the National Board of Boiler and Pressure Vessel Inspectors and th1 State or Province of         VA,                                                               *employed by HS B" I& I CO,
  • of Ha rt ford I CT I h*ve inspected the
                                                                                               '?...;,; bee    IY\( ..:,\-- dmribed in this Repor1 on IRep1,rj Io, ~e::,l1cemen1(11J 5:-   3 0
  • 19fi .

and nate th*t to the best of my knowledge *nd belief, this repair or replacement hes been connructed in accordance with Section XI of the ASME Code. By signing this certificate, neither the Inspector nor his lfmployer makes any warranty, expressed or implied, concern-ing the repair or replacement described in this Repor1. Furtherm~re, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property d ~ : : a~ss of anv kind arising from or connected with this Inspection. Date S- Jo -8~ ~f. ~ Commission, A/CT ?06 9 V(!l SJ../.J (lnspo,c1CW) n: Supplom*ni.l ahNn In form of llns, aketch .. , or drawlnpo may be uHd provld*d (11 alze la BX In. X 11 In.,

                                                                                                                                                              .        (S1111 or Pn>,,,nc1. N1t&0nal 9oazO)
12) lnformulon In ltwma 1 throuph 4 on. thla data ropor1. l1 Included on . . ch ahNt, and-(3) each 1hHt 11 numbered and 11'>* number of 1hNU h racorded at th* toP of thla form.
                          \

FORM N1S*2 OWNER'S REPORT Of REPAIR OR REPLACEME.NT AJ Required by the Provisions of ASME Cod* Section XI ( ..,. D1te iJ,.o,v2y (!:,, /9~

                                                                                                                                                                ~~                      i                   .,__1______

2.

3. WOl'k Performed bv ii ( ~ A . - Po w e ~
f. t) -/5i (N.-J S V,;

w ov- rs O I"~ Q.I' M,, .3 j 6 00 "

                                                                                                                              ~;, Org,muliDll ,.,D No.,JoUo.. - . c..S '( _ 1 "1.5 90 B e   3 _,. 7
                            . * ,        ,     015,     .:3J;1/..._           tA.v-1"',Y ~,;l.58'f*3                           ,-: D. N~. ?s~Y_-Jo908~-/
  • SS'I;.. 1 !,OO/J.2. .. J
... ldentlricttion of Syn1m          gee le) Appli~bl, ConnNctlon Code 63 J. I 11**',U{4,t1Q11, .5pr:~',j 11 4     z                      Edition, N'A
                                                                                                                                                          < s Y - ',             7./,/fn            3-1 s}'- -IS' .3        s.s -11 Addende, Code Cases ....A(..__A...___ __

I. lb) Applic1bl1 Edition of S1e1ion XI Utilized for Repair1 or R1pl1e1m1nu :_ 11~. Wj'b Addtnd1, Code Cnn ......M_.'4....__ __

 &. Identification of Compon1nu Repairad or Replaced, and Repl1e1ment Components Name of            Name of               Mfn.Ser.                   -N111.                CAN                                                     Ynr                               Repafnd,                      ASME Codi Component               Mfr.                     No.                       Id.                No.                                                    liullt                            ReplaclCI,.                    Stamped No.                                                                                                                or                     CY11 o, Nol A epllClffllftt
7. Descriptio!'I of Work....:...::.=:jF...<:;.:.:;.=--14-...:;o..;.t"....;f-_.fr._i:,_J"_*_;?_~_':a_t:_llc'_lf;.:.__P....,_....;<!.;......:1...,'11~1'1..,_c;r_c:......\... ___~.......~~.......;;;~~---'-----

YG_u....l~""f._JIJ

8. Tens Condue1ed: Pneumatic O Nominal Operati119 Prnsurt O Other
                                                 - - - P I I Ten Temp.-*F
9. Rem,rks~~~-,.,---,.---,-=---,,-----,,-------------------------------

lo'l>Pliut>lt ~nulac1urtf"1 Da1a Repona to be attach9d) CERTIFICATE OF COMPLIANCE

Code. * * ~flt'Def;,..., w :11Jo~

We cer11fy th*t the natemenu mlde In this repon are correct and th1s----------,,---COnfonN to Section XI of die

     .                io,,,.,    Owner"*                                                  I      TIit\
                                                                                                                                       **pan~~~-

COalel J CERTIFICATE OF INSPECTION I, the undersigned, holdi~ valid commission Issued by the N1tional Board of Boller and Pressura Vessel Inspectors and the Stat1 or Provine. of

  • ti~

1

                                                                         . employed bv
  • fl ra I+ r ~ () of
   //4.ll'Tf:~.,...J., ~ f.        hr,,e inspected the                ~1?lo.c;>MPw1 I ep.il(1J o, ~piacemenl(ai described in this Report on                                                            /-IL         , 1.l.1 and nate that to the best of my knowle~ and belief, this repair or replacement has been connrvcted ln *ccordan~ with Section XI of the ASME Code. By signing this Cl!'nificate, neither the Inspector nor his lmployer mtkes *nY warranty, upressed or 'Implied, concern-ing the repair or replacement described in this Report. Funhennore, neither the ln'Pl(:tor nor his employer shall be liable in 1ny manner for any ~rsona! injury or property damage or a Ion of any ind arising from or connected with this Inspection.

Date /-//, - 8 'J J. /t> Commissions t/tt S'{:3 Jv{J 7/Jo 'f

              *                                                         (lnSPKIOf) upplemantal 1h"n In form of Usu, 1katch*, or drawlnpe may be uud provided (1) size                                                                                         la'"

(S1a11 o, Prowincc.11:al,onal 8ouG) In. X 11 In., rmulon In 11'1n\l t through , on thl1 dna rapor, 11 Included on uch 1hNt, end 13) **ch 1hNt 11 numto.rad number of 1hMt1 11 r*cord*d at th* 1op of thl1 form.

                           \

FORM NIS-2 OWNER'S REPORT OF REPAIR OR REPLACEME.NT As Required by the Pro,l1ion1 of ASME Code Section XI I

  -1.
2. Plant s'-'-""'" '

Powev- S-~,w (N~ 11/ Ullh~-~---~--~----~~~---------- 80,t3ox:31~,,,;::;.r""Y va....;J.389.s J ,..

I. Work Performed by \/1;1::d {&,4. -P6wer Wo-*~ Oir. el' /Jc. 3go06 73 '];}.::,
                                  /J A       17        4Hafflll c          \/                   "-ptir!;1rgfl!IZllioll,.0No..JobNo,.91C.
                             .    --'> vox3~u.1-l'"y 'c.t,1.3883                               ,-,.o.,'A/o. SY-/;J.033S-
4. ld1ntmcationofSyn1m. ~ecu:., ~ e > o 01. .S+-eaM. 6-e~e2.v~+o,,.)

I. ,., Applicablt ConnNctlon Codi S 3 L, ! 11 bz Edition, A Addenda, Code Cases-~--- (b) Applic*blt Edition of Section XI UtJllud for Rrp1in or R,pl1e1m1nu- 11~. WjO Addenda, Code C......,Al......,'A _____

15. Identification of Compon,nu Repaired or Replaced, and Repl1~ment Components N1m1of N1m1 of Mfn. Ser. -Net1. CRN O\her Ynr Repaired. ASME Codi Component Mfr. No. 8d. No. ldentJ. liullt Replaclcl. Stemped No. f"icltioll or cv.. orNoJ Replacement I ,a-oft 1-1./ u E /IIC.H
                      ':>"~Oy!io,1 b ,..,_-_ c:.
                       . -                      ----            *-            -       !fl.f>Tllli
                                                                                       .....,ucu          --             ~~Pkc.~t..,4'41 !lo*

7. 8. 9. CERTIFICATE OF COMPLIANCE We c1t11fy that the n11emenu mlde'ln this report are correct and thls _ _ _ _ _ _ _ _ _ _ _ _ confonn& to Section XI of die ASME Code. /":t/i ~ - // tepaif or , e r , ~ Signed ( f< 1:}1°'1:D.:.t~&. f) { I CDIIIJ I/ //0. z-q

                                                                                                                                   , 11 .........-,.+-

CERTIFICATE OF INSPECTION I. the undersigned, holding I valid commission Issued by the National Board of Boller end Pressure Vessel lnspecton and tht State or Provinct of *Va- . employed bv

  • Hsa ;t t I CD of l-ltv-1ForJ I et. have inspected the R.ee1M£MfNt:

IFle irtsl f'!eplacemcnl(1i o, described in this Repon on 1-1, .19.gi ind nate that to the best of my knowledaf and belief, this repair or repl*cement h11 been connNcted In accordan~ with Section XI of the ASME Code. By signin, this certificate, neither the Inspector nor his c!mpfoyer makes any warrant'(, expressed or implied, concen~ for any personal injury or property Cate 1--//,,- f?1 d~Jss ing the repair or replacement described in this Report. Furthermore, neither the Inspector nor his employer shall be li*ble in *ny manner

                                                  ~~1.* ~
                                                                    ~f an;t kind arising from or connected with this Inspection.

Commissions V6- Stf:J µ(3 70<J'I (lnsl)(<tot) upplemenul 1h"n In form of llra. 1ketch*, or drawlnpa mey be uud provided 11 I size la IM In. X 11 In..

                                                                                                                           !State or Pn>wmce. lllahonal 8oa,G) metlon In h..-na 1 throue"'
  • on thla ctau repor, 11 Included on uch 1hNt, and 131 each 1hNt 11 numt,ered umber of 1hMb II recordad at the tDP of thl1 form.

2. 3.

4. ld1ntJf"ic.1tion of Syn1m <a.a., ~ r C oc:>ia/li-t-
5. (a) Appliublt Constn,ctlon Codi "' 11 f.p 7 Edition, II' A- Addenda, Codi Casea ............,_____

Cbl' Applicable Edition of Section XI Utlllz1d for Aepain or Replac1m1nu- 11~ IJ.J',(0 Addenda, Codt enn ......N .......A...___ IS. Identification of ComPonenu Rep1i,-d or Repl1nd, and Replacement ComPoMn11 Name of Namtof Mfrs. S1t. -Nat1. CRN Other Vnr Repahcl, ASME Code Component Mfr. No. Bd. No. ldentl- lunt ReplacteS, Stamped No. f"icltioft or (V11 orNoJ

           "'.a~,

Rapl1e1ffllftt M*~ c 2>P\ G 11,CI"" 1r;n-~,- siwhb 'i?.,V" 1~ et.r 11 JI"' - - - JiS}-:;./6 UI' )o&<I)

                                                                                                                     --     p. /Ef/..kre'/f,f£.'lllf         A/0
   ,.         Description of Work         R r..epb.,{.,eecJ....   ,,;fl  vhbe0 fJ!*-/15';          5 lvd       h     5J1~6l, 112.. Ir M- '). obtf ( JJw)                      '
8. Tens Conducted: Hydksutic D Pneumatic D Nominal Operating Pmsur9 0 Other a
                                                  ~--,-P*I TestTtmc,.-*F CERTIFICATE OF COMPLIANCE We certify that the s111emenu made ln this report are correct and this ASME Code. . .                                               *
                                                                                                    /9. 15 f /. f+ C E /Ill f: Nf conforms tepaifor~

10 Section XI of tht Si~ned

                       ~                L        )¥..,C(LJI}

(Owner or Ownet'a D e s i g / * ~ k~ TIiie (Dall) U_-i .11 B"j

                                                                                                                             /

CERTIFICATE OF INSPECTION I, the undersi9ned, holding e valid commission luued br the N1tionel Board of Boller and Pretsur9 Vessel lnspecton and the Stata Ol Province o( ~/ (L

  • employed br
  • Hs a :r..&-,k Coo of flll:---TEo.J)e;
  • hr,,einspt"Ctedthe y:c.-p{o.c-e ~~iCJT IRepair(sJ o, ~:,iacemen111J1 describedinthisReponon I-JO .,~

and state that to the ben of my knowledge and belief, this repair or replacement hH been connructed In accordance with Section XI of the ASME Code. By _signing this urtificate, neither the lns~ctor nor his l!mployer makes any warranty, expressed or 'Implied, concern-ing the repair or repl~ement described in this Report. Furthermore, neither the lnr.pector nor his employer shan be liable in any l'l'IIIMet' for any person.al- injury or property~ O!,! ll)u A*~~d arising from or connected with this,lnspec,.ion. _ Oete /-/f>- ~q , ~i--~ (lns~ICX, Commiuionl Vb.5H3 N07oo 9 (S~1e P,o,,rince. Nat,onal 9oa"'l Of P11  !:.,ppl*m*nul 1hMn In form of llns, ilr.*1ch*, or drewlnpa mev ~ u1*d provided (1) alze la ' " In. X 11 In., m*tlon In !Tama 1 thro.,gh , on thl1 Clau npor, 11 Included on ..ch 1hNt, end (31 uch 1hNt 11 numbared num~r of ,h .. b la r*coreled *t th* toP of thla form.

    . -~#'                                               .... : . -                                                                                                                                                    ATTACHMENT 2
                              -....                                                          ,,~       .
  • -,. Owner Virginia Pawer P.O. Box 26666
                                                         '             FORM NIS-2 OWNER'S REPORT OF REPAIR OR REPLACEME.NT As Required by the Provisions of ASME Code Section XI IAOC!rna) o.i._ _ _~~A.. ;;.. ~ l......,e>f..__ _ _ __

0...... Shtt1 _ _ _ _ _ _ of_ _ _ _ _ _ __

2. Plant Surry Power Sta (N~

ti an Unh ()J../li:.. P.O. Box 315,lAOOt9UJ Surry. VA 23883

3. Work Performed t,y_V...A . . . . .-*...t'O.......W....e. r. _________ 3BOOOJ1BZ1 (Name) Fie pair Or;111iu1ion ,.o No~ Job No~ ate..
                                                                              "Same i,.ooraa,                             .
4. Identification ofSynem Rf At.,flJ/l. eope,A-1-r, - Uwo u.N::92,.pL f;;<Jt,t/ .
5. (a) Applicable Construction Code B31-1 19 67 Edition, HA Addenda, Codi Cases ___N __A______

Cb) Applicable Edition of Section XI Utilized for Repain or Aeplac:1m1nt1 - 19...80, wan Addenda, Code Casn~N....A._____ I. Identification of ComPOnenu Rep1i~d or Replaced. end Replactment Componen11 Name of Namtof Mfrs. Ser.

  • Nat'I. CAN Other Veer Repaired,, ASME Code Component Mfr. No. Bd. No. ldentl- au11t Replectd, ,tamped No. f"ication or ~*tea or Nol Replacamtnt
               ,~~                                                                                                                       o(- ;ee,-uc r/

Nu.,' JC C/ri))IN4l- /v /fr #dV'r l':J57C...

                                                                                                                                                                          "jUi, p/'rl(i2_£
                                                                                                                                                                                      /

I

                                                                                                                                                                                                          ' " fvtJ c'4P 5ltt.iw UPI\ IUIL {,o,                                                                                    fJ~             ,AfP,         ii                                     II
                                                                                                                                                                                                               µ~
                                                                                                                                                                                                                                 ~

I

7. Desc;iption of Work N /,Jt,J~T" uzA Jc.
a. Tests Conducted: Hydros11tic O ,neumatic O ominal Operating Prnsurw 0 Pressure psi Ten Temp._*,
9. Remarks /n'vt Po, 4°i. -l°'/"2V~(p
  • cM ~C.ci,6:.w fl>#-
                                         !"pplal)le Ma1111la llfet'I 0.11 Ae:,ona (o be IIIIChedl S5'1-      l"I b5'Sj CERTIFICATE OF COMPLIANCE We c1rtifv that the natemenu madeln thii report are correct and this ~ / 2 . .                                                                         /gR£dk.£ <'S'fbs                  conform; to Sectbn XI of the ASME Si9ne6 Cede.a*~*/"~                                                                               ~/               TST (tipa;,or **P'acemenll 2/?P            *               , 19 8"7
                                   ' i o , / ~ ;,;;i ~ I                                                                          Tn11          .       (Dl\eJ CERTIFICATE OF INSPECTION I, the undersigned. holding a valid commission issu~ by the National Board of Boiler and Pressure Vessel Inspectors and thl State orProvinc1of,_                                _.V....A...,,..________                                                        by      HSB" I&I        co~                                                                    of

_....H...a...r_.t...f.. .,o. . ._r...d._.*......,C...TL.L,_have inwec1ed the__.,,::::----+-=-z()i IRrpa,r(s) ____tAU _ _*s:-c'fl>:-a°Hcribed in this Repor, on

                                                                                                                             ~e:,11c1men1(1I
                                                                                                                                                                                    -----=3.,,.l_...~__-o_ _ , ' ~

7 and state that to tht best of my knowledpe and belief, this repair or replacement hes been connructed in acCOtdance with Section XI of thl ASME Code. By signing this certificate, neither the Inspector nor his fmployer makes any warranty, upressed or implied, concerr.- ing the repair or repl.c;ement described in this Report. Funhermore, neither the Inspector nor his employer 1h11l be liable in any manner for any personal injury or property d'?:Ii' a l~sojan",'. kinA arising from or connected with this Inspection. Datt ~- :JD - f? ~ l_. eru... Commissions P/J 760 'f t/CL-,r':( 3

                                                                                                                "IPKIOI) re: Supplom*ntal 1h .. n In form of 11,u. 1ketch*, or drawln;o mav be uHd provided 1111IH 11 BM In. X 11 In.,
                                                                                                                                                                   .          !$Ille Of Pri>w*IICI. N1hon1I     BoatOI lnformnlon In lnrn1 1 through , on this Cina upon 11 lnclud*d on ..ch 1hNt, and Ill Hell 1hHt 11 numbered nd It>* number of 1hNb 11 racord*d at 1he toP of ml, form.
  *-~                      ...... -                                                                                                                                                                                         ATTACHMENT 2
              .....                                           ,,~      1
                           '             FORM NIS-2 OWNER'S REPORT OF REPAIR OR REPLACEME.NT As Required by the Provisions of ASME Cod, Section XI
 -,. Owntr      Virginia Pewee P.o. Box 26666 o,..________.1....;...1        /i1'J.-/f1
                                                                                                                                                                                                      .......:...-____________         ~

ShNt __..........._____ of____.........________~ jAGOrn.aJ Unh_...;C)~/v~/::.=:;:;- _______________________________________~

2. "' Surry Power Station (N~

P,O. Box 315 Surry. VA 23883 ,iA001911j

a. Work Performed i,y_V...A ................PQ...k....l...e.r~-------
                                                                      . CN-i                                           lllepait Ot;aniulion                          ,.o Ho.. Job No. etc.
                                               '-Same
4. ldentlfic1tion of Synem ~_., ge.c;.e:for Coo /5c, T
5. ,., Applic1bl1 CoNtrvctlon Codt B31-1 19 67 Edition.... r~....A,_____ ...ddenda, Code Cases ____N__A_______

lb) Applic1bl1 Edition of Section XI Utilized for Repair, or Replac,m,nta - 11..80, wan Addtnda, Code Cam __.. N..... A.._____ I. Identification of Components Aep1irrd or Repl,c:ed. and Aeplat"lment Components Nam,of N1mt of Mfrs. Ser. -N1t'L CRN Other Year fbpeirtd, ASME Codi Comoonent Mfr. No. Bd. No. ldentl- Bul11 Replectd, Stamped No. f"ic1tion or (Yn or Nol Aepl1c:em1nt f\/-J.i~ / c..,~i'-,.1

111.114;5'\-,~

I 3,e-g :i tto ;vA- ;ti.A- flC.-S\/- 1.ss,c. /1/A- f'('/4~. L~) VD

7. DHc:ription of Work ...-----'--~:74--...;_J....1.~=i..;;...:.:;;;;;.......:.....:..:....;-,4.:........ ..!./h:..::...:/...:t;..:."';.."'-7----------------------

I. Tem Conducted: Hydrostatic Pneumatic O Nomin,1 Operatino Pressurt O Othtr 0 Pressure UJ.r psi T,n Temp . ...a.2.. *f I. Remarks ________________________________________________________

                    ~~1,1a...,1ac1urllf'10.1aRc:,cn11obe111ac"*'                                /Jo(-/(!..,;

f o-it- SS f .1.. I "7-'-/ S l.. CERTIFICATE OF COMPLIANCE

~~~' nm/I/~~ In this repon 11r1 correct and thls ____ t--- conforms
                                                                                                                                          .,_A.:.::~c:~:..::.~:L!&l::;i;;~;..;:~=-...
                                                                                                                       .....;=-;...t~,~"./1--                                                                      10 Section XI of the Signed~d<i!~p"                     £~t io-....'orowner, De                    ,..,
                                                                      '.A...ff'/                 ISI 1111 Vu<;:j/

CDa*eJ

                                                                                                                                                         /t'c r-                            , 11 t?')'

CERTIFICATE OF INSPECTION I, the undersigned, holdi119 1 valid commission Issued by the Natlo~I Board of Boller end Pressul9 Ventl Inspectors and the Stall or Province of VA, *employed bv US B I &I CO , 0 of Hartford, CT. h1veinspecttdtht ('eR)p.c..fMet-T IRtp1,,t1J o, ~t;>l1t1menl(1I describedinthilAeponon . 7-/1 .,1.fi and na11 that to the best of my knowled9e ind belief, this repair or repltcement h11 been connructed In acc:ord1nce whh Section XI of the ASME Code. By signing this certifiutt, neither the Inspector nor his fmployer m1krs any w1rr1nty, expressed or implied, concer..- ing tht repair or replacement described in this Report. Funhermort, neither the Inspector nor his employer 1h1ll be li1ble in any manner for any pe"on1l Injury or property d a r f 9 ' ~ o~*"J-'Jin,1 arising from or connected with thi1 lnsp1ction. D111 7-. t1- S>'( ~rl- ~ Comminionl /Jf3 7tJtJ9 J)a..__s'"<{J9oa,G flnlr;>N:1111) !51111 or Pro,,onc:t. NaloOt\fl lllon: Supplemental ahHts In form of 11111. aketeh*. or dr1wlnge m*Y be uHd p,o,,lded (IJ 1111 h BM 1ft. X 11 In., (2) lnform1\lon In 1nm, 1 1hro11gh

  • on 1h11 data npor, It Included on och 1hN1, and (31 ..di 1hHt l1 n.,mber*d and 1h* number of 1hHt1 l1 raeord*d 111h1 1op of 1h11 for"'*
   . -~I"                                                   ...... -                                                                                                                                    ATTACHMENT 2
                                                         \

FORM NIS-2 OWNER'S REPORT OF REPAIR OR REPLACEME.NT AJ Required by the Provisions of ASME Code Section Xi *

 -,.         Owner                     Vi rgi ni a Power P.O. Box 26666
                                                                                     ~rftll
2. Plant Surry Power Station (NAlftlj Unit-'--'--------------------

P.O. Box 315.(AOOre&II Surry. VA 23883

3. Work Perform~ t,v_V...Au.a.,_._t'O......_w...e..r_________

(Name)

                                                                      *--Same
4. Identification of Synem
                                                                       ,., ~ / ) .

u~a,"',c....,,..- L'c,oµv&

   !.       la) Applicable Construction Code                                       B31-1              HI    67                            H Editlon,........A

________ Addenda, Code Cases --'-N""A.,____ lb) Applic:abla Edition of Section XI Utilized for Repain or Replac1m1nt1-19..BD, wan Addenda, Coc:11 c.... _....N...A..____ IS. Identification of Componenu Repai,..d or Replaced. and Replacement Components Namtof Name of Mfrs. Str. -Nat'L CRN Other Ytar Repaired, ASME Codt Component Mfr. No. Bd. No. ldentl- Buttt ReplK9d, ~ta!TIPfti No. f"ication or frn or Nol IIP-i -...-- IJP,. Replacement

7. Dncription of Work_.:L...._........,,,__~=~=--u.:.--<~"-J..LJ..=__.~;.,u;;.=-'-""'-..::.::-~~~;=..=--,,1----------
8. Tms Conduct~: Hydrosutic Iii Pneumatic O Nominal Operating Pressure 0
  ,.                                                               Pressurt]IOt Rtmarlu JrJ#4,1yx,f/'%,u-LLJ{,1£l~f2.-) t C.5./Z,1--Jff2-f psi Ten Temp,Atn4i(--, *F
                                       ~pplic.at>lt ~"'-'lac111fllf'I [)Ala ~ 1 1 0 bs I l l ~                   I      '                            f CERTIFICATE OF COMPLIANCE art correct and this                £1!..,pa,,

CL /r?Ct!&ev-J T QI' IIP'lcetnlftll conforms to Section XI of the

                                                                            ~<-=;....::"-75---"'-=-......,.......__ _ _ _ (Di1e1   '{[;,&/J/?                             ,19 CERTIFICATE OF INSPECTION I, the undersigned, holding I valid commission lssu~ by the National Board. of Boiler and Pressure Vessel Inspectors and the Sratt or Province of_-'V....A.. . _.- - - - - - - -
  • employ~ bv lfS 8" I& I CO , of

_._..H_a.._r....t ...f....o....r....d..........,,c....TL..J*.___h,vc inSl)Kttd the ,.-ee\o.., 1RtP**'111 eJM ef.()t.s Of ~t:,l*ctmenl(III dHcribed in this Repon on ----=b:...--":J-:.....-~---. 19_S9_ and nate that 10 tht ben of my knowltdgt and belief, this repair or replacement has been connl'\lcted in 1cco,danc:e with Section XI of the ASME Co~. By signing this certificatt. neither the Inspector nor his l!mployer makes any warranty, expressed or implied, concern-ing the repair or replKement described in this Report. Furthermore, neither the Inspector nor his employer shall be li,blc in any manner for any ~rsonal Injury or property d\~Jl91} o1'~s of any kind arising from or conne<:ted with this lnsptc:tion. _ Cate b- 'l-3 ~ iii 9 J~ l. * ~ Commiuionl fi) B7M 1 l/0,.. S</ J (ln1pe,cl0f)

Suooltmantal ehMta In form of llsu. *ke1ch ... or drewlnpe mey be UHd provided (II 1111 It IX In. X I I In.,

jSlale Cl P'n,,nt,ct, N,1,onal Bo&tdl lnfo,m1don In h*rn* 1 througl'I 4 on thl* due 11por, 11 Included on uch ahNt, and (3) .. ch ahNt la numbered and tt,1 numbe, of ehMb la recorded et th* 100 of it.le form.

   . -:-,.                         .** .. -                                                                                                                                              ATTACHMENT 2
                                                                  ,,~ .
                                 \

FORM NIS-2 OWNER'S REPORT OF REPAIR OR REPLACEME.NT AJ Required by the Provisions of ASME Cod, Section XI

-1.        Owner          Virginia Power P.O. Box 26666 jAO(lrnaJ
2. Plant Surry Power Station (NAffllll \ .

P.O. Box 315.{ACIOraUI Surry. YA 23883

3. Work Performed by_Y....A ........_._f;'O.......w_e_r_________

CN-.J

                                                   . .Same
                                                                        ~
 . 4.* ,: Identification.of Synem c;o,.,,~ou<,!.IV r                                 Cau-t>>6'
5. * (a) Applicabie Construction Code 831-1 19 67 Editlon,..:..H"'-'A'--_ _ _ Addenda, Code Cases _ ......N . .A (b) Applic1bl1 Edition of S1e1ion XI Utilized for Repain or Rtpl1e1m1nu- 19..BO, wan Addenda, Code Casn_....N....A.._____

S. Identification of Componenu Repaired or Replaced, and Repl1c:1:ment Components Nam, of N1me of Mfrs. Str.

  • Nat'I. CAN Other Year Repaired, ASME Codi Component Mfr. No. Bd. No. ldentl- Bulh ReplKed. tta~

No. fication or  ; ;*es or Nol Replacement

                                                             /J~

Pitfl'h/ ~ 0

7. C>Hcription of Work Cddillt!- r:-o E tr S a~tf V J'rc.?g, { e.,c_ ., Lao )> )

I. Tnts Conduc,ed: Hydrosutic l8J l'neum1tic, 0 .Nominal Oper!tin11 Pressurt O Other O r, Pressu~ 3/0L psi Ten Temp.M,trtr"*F

  ,.       R1marlu        IA1;::_~.:._Sj. !'!""&;;,*;'( ;f!=-~""l¥if-~ C.Sf.2£/7,£'2-7:J 0

C.fy.2£1z.r2 -':, C(y2.f"19,{:2-<( CERTIFICATE OF COMPLIANCE

                                                                                                                &>~           dh!,,t((:{N C:
                                                                                                                       .,pa,, or repiac.emenQ conforms to Section XI of the
                                                                                                                      .J:v.112 (DIii)
                                                                                                                                                      . 19      rr CERTIFICATE OF INSPECTION I. the undersigned, holding a valid commission lssu~ by the National Board of Boiler and Pressurt Vessel Inspectors and tht State or Province of                 VA.                                                employ~ by            HS a* I &I     co                                                                           of R@ C e

_._H-a...r~t-f......o.r_.d"-"'

                      . ._c...I~---h*ve inspec1ed the                                   a.c.<?-/1111 ewp
                                                                                                         .L     described in this Report on 1

(

                                                                                                                                                                        ~ _ -~3                    £?a
                                                                                                                                                                                              , 19'1..J.

fR,p1a;f1s) o, ~,:,11~1men1(1l1 and nate that to tht but of my knowledge ind belief, this repair or replacement has been connruc1ed in accordance with Section XI of the ASME Code. By signing this c:ettifica1e, neither the Inspector nor his i!mployer makes any warranty, expressed or implied. concern-ing the repair or replacemen1 described in this Report. Funhermort, neither the lni.pector nor his employer 1h11l be liable in any manner for any ~,sonal~njury or property d ~ ~ $ l f ~y kY,d arising from or connected with 1hi1 lniptctie>nt Datt b J.3-~CJ ~ d-, ~ Commissions J.}(3 7o{)C, IJCl rf;I./ 3 (ln1~10f) ($1111 or l'Tl),,,o,ce. Natlo<\&I Soa,,11

S11pplemenul .,h .. 't'I In form of _Ilsa, *ke1ch*, or. drmwln1,11 mey be und provided 1111IH h IIM In. X 11 In ** *.

nformulon In h1rn1 t 1hro11gh , on thl1 due repor, 11 Included on uch *hNI, end 131 uch *hHt 11 numbered and 1'\e n11mber of lhNtl 11 recorded at 1h1 top of thl* forrn.

        . -~I'                                   ..... -

ATTACHMENT 2

                                              \

FORM NIS-2 OWNER'S REPORT OF REPAIR OR REPLACEME.NT AJ Required by the Provisions of ASME Code Section XI

       -1.      Ownei:             Vi rgi ni a Power P.O. Box 26666                                                                                                             ShNt~~.....______ of~--.........~ - - - -

jAOdrna)

      ' 2. Plant              Surry Power              Station IN.,...                                                Unh--~~'./::~o-v-i~r-*        -~=---*---------------~

P.O. Box 315 Surry. VA 23883 .{AOOrall) Work Performed by_V...A . . . . ._._):10......,w....e. .r_________ 3.

                                                 .                '5ame
                                                                                            ~ .....                                   Repair O,v1n1Zali1111 f'.O
                        .                                           <"'                    jAOOlffll     ~              ,
4. Identification of Synem .J!?,.d tfr'i.. J. ,ed e... ;,zt6 ,it/
5. (1) Applicable Constrvctlon Code 811-1 19 67 Editlon,. . :.Ha:. A,______ Addendl, Code Cases __N::..A______

(b) Applic1bl1 Edition of Section XI Utilized for Rep1in or Repl1e1m1nt1 - 19..80, wan Addenda, Code Casn ......N ....A._____

6. Identification of Comp0nenu Rep1irtd or Replaced, ind Replacement Components N1m1of N1m1 of Mfrs. Ser. -N1t'I, CAN Other v,., Repaired, ASME Codi Component Mfr. No. Bd. No. ldentJ. Bulh Replaced, $tamped No. f"ic1tion Cit ri'n or Nol Replacement.
    'tr,>~ ..C,n,.o-*                    p/,,;                            ul4                         -v4          tt1is      LI~-., "t:?:i          Nia            ...tl t!P~~ ...eA'.;J
                                                                                                                                                                                                              /_
                                                                                                                                                                                                        /,J/J:2.,
7. Description of Work ~,>,~~6J /,',,,hA#4' .t,;1
  • c7..>'./ .tk,/4 /'1/zf-/~2 di.... ~ t'flJl!..f};
8. Tens Conducted:
  • Hydrostatic O Pneumatic O* Nominal Operating Prnsurw O rOther 0 Pressure psi Ten Temp ____ 'F I. Rtmarla...,...~-.~---,---,,......,,.--,.,------,---,.........----------------------------

IApplic.al)lf M,nc,lacturel"I 0.11 A.;,ona 111 be a111Ch9d1 CER Tl F ICATE OF COMPLIANCE Wt unify that the n11remenu made In this repon 111 correct end this_...::R e'""@--Cl.1._'r_______ a,nfonn1 to Sf!ction Al of thE!

                                                                                                                                           ~:zror ASME ~ -

Signed ~1:~ pl ~;;;. ~ . Desi~neeJ

                                                              -~                                                    IS I Tn11 YJi,./.Lb _

CD,1a1 epia~

                                                                                                                                                                                .,,1{...._

CERTIFICATE OF INSPECTION I, .lht undersigned, holding I valid commission issued by_ the National Board of Boiler end Pressure Vessel lnll)Kton and the Stitt or Province of,___ V

                                      ...A ........- - - - - - - -
  • employed by HS B" I &I co e of r d_..__..C....T'-JIL-_have inS?Kttd the Rnea.. ~ r
      ~H-a...r_.t. .f..,o........                                                                    IRr~sJ CH ~e:,11cem1n1(11l dncribed in this Report on                                        t, - I~          * ,g_gj Ind state that 10 tht best of mv knowledge and belief, this repair or replacement his been connrucled in 1ccord1nce with Section XI of the ASME Code. By signing this c:ertifiate, neither the Inspector nor his fmployer mikes 1ny warranty, upressed or implied, concern-for 1ny personal Injury or proper,y d1'mage or                                            ':?-:1' ing the repair or replacement described in this Repor,. Fur1herrnort, neither the Inspector nor his employer 1h1II be liable in any manner
                                                                                                             ~~rising from or c:onnKted with this Inspection.

D11t 4?-/l- £9 * ~£,L. ~ (lnSPKIClf) Commiuions ,(Jt) 200 Cf (51111 or V4 ,£t[3 Pro,nftCI, NallO'\III ~

5.,ppl1m1nt.l sh"ts In form of ll1D, 1k11ch*, or d**wlngo may be u11d provided 1111111 h BK In. X 11 In.,

lnfoun11lon In 119me 1 1hr11"9h

  • on thl1 Cine repor, 11 lncl.,d*d on 11ch ahNt, enel 131 ..ch thHt 11 n"mbered d lh* n.,mt,er of 1hND 11 record*d at th* IDP of thl1 form.
                                                     .*~ -. -

ATTACHMENT 2

                                                  \

FORM NIS-2 OWNER'S REPORT OF REPAIR OR REPLACEME.NT AJ Required by the Provisions of ASME ~

  • Section XI Owner Vi rgi ni a Power P.O. Box 26666 Shfft_........._~--Of~-......~ - - - -

jAOdrna)

2. Plant Surry Power Station C)IJE Un~~~-------------------~
                                      .                                   (NameJ P.O. B6x 315.(A00'911J                   Surry, VA 23883
3. Work Performed by_V,..A ........_,_P...co...w...e. r_*
                                                                                        . --------                                   38DDD <t 19 c; 3                          b"lcl/l.

(N-) Repair Organiulion P.O No~ JOb No~ etc.

                                                      .               --Same
                                                             .                           IAOd~
4. Identification ofSynem C:Qrvd>a tJi}.\' Ci> OC...H.J & S'f,.ffi:')VJ
5. la) Applicable CoNtnictlon Code 831-1 19 67 Editlon,_f4""'A,___ _ _ Addenda, Code Cases _.,_N"-A.,___ __

lb) Applic11bl1 Edition of Section XI Utilized for Rf/pail'I or Replacements - 19..80, WBQ Addenda, Codt Cases_..N.... A.._____

6. ldentifiution of Componenu Rep1irrd or Rep!aa:d, and Replacement Components*

Name of Name of Mfrs. Ser. 1 . Nat'I. CAN Other Year Repaired. ASME Code Component Mfr. No. Bd. No. ldentl- Bullt

  • Repleced, . Stamped No. fic1tion or (Yes or No)

Replacement

7. Description of Work __..=----=--=,...,..... . . . . =-=....._-"---""-...;:;...:.""""=c..-...,.;:c.::;.;..""'"'""""---""'-'---=-------""g-_7._-_-..;::?c..:b,_lf_ _ _ __
8. Tests Conducted:

9. CERTIFICATE OF COMPLIANCE We certify that the n1temenu made 1,1 this report are correct and this _ _R..__:e-1-e~W~-IV\-e_..,,_t' _____ conforms to Section XI of the ASME Code./1 "if ~ ~~pair or replacement! Signed f.J.iJ,( *nt~ jor,,., or Owne

  • IQ-I TS I Tnie ~**I
                                                                                                                                              ' - / .'.)              .19 <t:°i CERTIFICATE OF INSPECTION I, the undersigned, holding I valid commiuion issued by the National Board of Boiler and Pressul9 Vessel Inspectors ind the Sr1t1 or Province of,__V.__.Au..a.,- - - - - - - -
  • employed by HS 8° T& I CO, of

_._.H-a....r...,t...fwo....r,....,,.d_.,___,.CuT'-'*.___have inspected the y,g\c.r... "'),f. ......., ( R ~ o r ~e:,11cemen1(11l ducribed in this Repon on _ _ _ _ ___.h~-.. .L'--'-1__ , 1981 ind nate that to the ~n of my knowledge and belief, this repair or replacement has ~en connructed in acc:ordance with-Section XI of the ASME Code. By signing this cenificatt, neither the lnsp~ctor nor his l!mployer makes 1ny warranty, expressed or implied, concern-ing the repair or replacement described in this Repon. Funhermore, neither the Inspector nor his employer shall be liable in any manner for any perso:*1 i~~ry or property d~or~cy of any- kind arising from or connected with this inspection. Om {p /3 fJ9 . ~~ ~ (lnsl)KICW) Commissions Vtl ?M>'/ Ja.St(3 on_: Supplement.I ehNn In form of llsu, 1ketch**, or drawln1,11 may be uHd provided (11111111 B~ In. X 11 In., (S111e 01 Pn,,,,nce, NII IQnll 8oA,d)

12) Information In h*m* 1 through , on thl, _dete report 11 Included on .. ch 1hHt, end (3) . . ch eh .. t le numberad end lh* number of *hMb h recorded at the top of thl1 form.
                                                        -~* ... -                                                                                                                                                          ATTACHMENT 2
                                                                                      ,,~ ..,
                                                  ' \

FORM NIS-2 OWNER'S REPORT OF REPAIR OR REPLACEME.NT AJ Required by the Provisions of ASME Coda Section XI

  -,.             Owner                    Vi rgi ni a Power .                                                                                                               -:sur-.1e:

oatt ____....:;._., __________

  • 1~is o <o ;~-~-...... ~-..__------~

P.0. Box 26666 Shfft--~..______ of~-----.._------~ jAOdrna)

2. Plant Surry Power Sta ti an Unh~---------C>_rJ_c" _______________________~
                                           .                                    (Name).

P.O. Box 315.(AOOraU) Surry. VA 23883

3. Work Performed by_V,...A ........_,_P.,.co...w...e....r_________ 38000 $?\ 7 3 I 4Natn1) Repair Or;aniulion P.O No.,Job No~ etc.
                                                                          --Same
4. ldentlficationofSynem .Cot't'\'/lo~~ C4oc.1i..,<, snfr?H c(/Nt;"".rF/(l)/11 /(Ifie..)

7

5. la) Applicable Construction Code 831-1 19 67 Edition,l~A Addenda, Code Cases _ ....N ...A.._____

(b) Applicable Edition of Section XI Utilized for Repairs or Replacements - 19..80, WBQ Addenda, Coda Casn _...[:J.._.A.___ __

6. Identification of Componenu Repai~d or Replaced. and Replacement Components Name of Name of Mfrs. Ser. -Nat'L CRN Other Y11r Repaired. ASME Code Component Mfr. No. Bd. No. ldentl- aunt Replaced, Stamped No. fication or ,YnorNol Replacement Su()Pari r ~ I"'. 4 rJ/A iv/A Ill /VI
                                                                                                                                                         /A          t--4J/a-au-=r I
                                                                                                                                                                                                                    *AJO I         )/4                                                                                  I
                                                                                                                                      ? I}
                                                                                                                                        'fA
  • ,n -- - 'J

( [\ 'I ('j() I.A 1/.I 'IA J(J

                                                                                                                                                                               -,b CERTIFICATE OF COMPLIANCE Code.m~

We cenify that the natemenu made In this repon are correct and this

   ~ME                                                                ~-                                                                     £~$Cr'd/~           --t
                                                                                                                                                 ~pa;r or 1ep1acenie11Q conforms to Section XI of the Signed                              ~ W\..,_ _
                                      .         io-- or Owner's De ip,...I '--.,

ISI Thll

                                                                                                                                              @1-L- O(.

Colt*J

                                                                                                                                                                                 , 19 CERTIFICATE OF INSPECTION I, the undersigned, holding I valid commission issued by the National Board of Boiler and Pressurw Vessel Inspectors and the State or Province of,__VLJA.. . ._.________ , e                                                                      loyed bv         HSB" I&I CO,                                                                                        of

_._.H...,a....r....t._.f. .o

                             .....r....,,,d~,__.C._..T._.__have
  • in1Pt-c:l_ed the Aebee /J1('.;
                                                                                                         !Rep *rjSJ or ~e~l1cem1ntf1U dHcribed in this Repon on _ _S:--<..v:c.*_          .........;<..a.,.__....;o:.c..=.._, 19tl ind nate that 10 the ben of my knowledge and belief. this repair or replacement has been connructed in accordance with Section XI of the ASME Code. By signing this certificate, neither the Inspector nor his ll!mployer makes any warranty, expressed or implied, concer~
                                                                                                    ~?:f ing the repair or replacement described in this Repon. Furthermore, neither the lnr.pector nor his employer shall be liable in any manner
                                                                                                                 ~")ltd arising from or connected 17ith this lndection. .

Om t . . (:- f 1 for any personal injury or .Propeny d,,:~or V~I,.... ~~ Commiuion1 fuB~ //)a (- Uc'- 5t(J

                                  *                                                                     ,(lnspec1Qft n: Supplement.I ahenw In form of lln:a, sketches, or drawl,:,s;a may be uaed provided (11 alu la 8:K In. X 1 t In.,

(Stale c,, Prc,,*nce, NallOt'III Bo&,11) 121 Jnformulon In lt9mt 1 through 4 on thla data rePOl'l h Included on .. ch ,h ..,, and (3) Hch thHt 11 numbered and th* number of 1hNt1 11 recorded at th* top of thla form,

          . -:-.                         . .-~  .. -
                                                                               ,,~ ...
                                         \

FORM N1S*2 OWNER'S REPORT OF REPAIR OR REPLACEME.NT As Required by the ProYisions of ASME Coda Section XI

         -1. Owner_ __./j,_*      """"'_:e""G....._;~~v-'(.,.,&~--:.*~-"';;;;..::,W,._..,,1;...>>._._______________
                                "'                                                                 (Namej
                               /"..()             &,;{      ;

2 6~ 66IA(!drna) ShHt--......,~-~of_ _.__ _ _ _ _ __

2. Plant _ _..s<.,...:::..d-a..<;,,0.,>-l--'G
                                                           ........1.=:.!!:,:.4!!=..-,>>.u."A,.,,....r,"'~""~-...,....----

e0. &t 31l'Ju.<<f, d2.i'n1 ck~asl '

3. Work Performed by __{M"'-"'"--fiz....,.."'""""'&"'"'41'"'--------

(Namel

                                                                   '">Arlt.<
4. Identification of Synem CAOClrna) Coel!.l'A,;
5. Ce) .Applicable Constnictlon Code d, Zl-1 19 6 2 Edition, /r/ ~ Addenda, Code Cases - - ~ ' - - - -

Cb) Applicable Edition of Section XI Utilized for Repain or Replacsmentl- 19..ae'., Wir't2 Addenda, Codi Caan ,,.,, &?

6. Identification of Componenu Repai~d or Replaced, and Replacement Components Nam,of N1me of Mfra. Ser. -Nat'L CAN Other Year Repairod. ASME Codi Component Mfr. No. Id. No. ldentJ. Buth Repli,ced, Stamped No. f"ic1tion or IYn or Nol Replacement I 8' 11
       ~h"ZtNJ/ ~,,,~        !J.,12.,1 ~~ .......                    )~d                                   1<14;           /4 1-ec.-/ot/               #&               l~l~p*..,~~'(_
                                                                                                                                                                                 '>e.4-Jp,Nr NO
7. Description of Work _ _ _.J.h~~~~;:2::2.,_ _(..t.~* 4'!::.ee/:..:~~---------~..,..:::....-........,,------------
8. Tens Conducted: Hydron*tic O Pneumatic O Nominal Operating Pressurw Pres:wre____ psl Test Temp. _ _ _ *F
9. Aem.,lu _ _____ ----=-----------------------------------

l"PPfica!,le MAnulac:turet"I O.ui Repon1 to be IIUlcheCII CERTIFICATE OF COMPLIANCE We cenify that the natemenu m.tde In this repon are correct end this-"R=-....~.::¥c*,1-,..""'C-¢"""' .....,.~4

                                                                                                                                                                 ...w.._....,_~---COnform1 to Section XI of the ASME     Code/1* .                                                                                                                     (lepairor1ep1a~

Signed  :¥t/- £ ~ 4 . 4 , / (Ow~r>e7* Duif),...I _:T~_c- c....-.s Tnll

                                                                                                                                               ,?lj/

to-111

                                                                                                                                                                                   .,9 n CERTIFICATE OF INSPECTION I, the uridenigned, holding
  • valid commission Issued by the N11tional Board. of Boller and Pressurw Vessel Inspectors and the St1t1 or Province of ti4,.
  • employed by fl s a r ~ re Q . of fla,,.j for-d J et have inspected the {?,.4(4c.@M f?tl IRlpauts) o, Re:,laceme11t(1I de,cribed in this Repon on _ _ _ _ _ _j.,__--"'3../__ , 19!j_

and n11te that to the ben of my knowledge and belief, thi; repair or replacement has been connrucied In ac:co,dance with Ses:tion XI of the ASME Code. By signing this certificate, neither the ln1pec:tor nor his ll!mployer makes any warranty, expressed or implied, concern-ing the repair or repl11eement described in this Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner . for any per1onal in~ury or propeny d f l ~ j of~y ~nd arising from or connected with this ln'l)ec:tion. _. . Date '3-3( g1 ~ l . .(ln1i,.c10f) . ~ Commislion1 JJB7t>o9 /)a JL/J (State or Pri,.<,nce. National Board) on: Suppl*m*nul 1h"n In form of lln1, 1ke1ch*, or drawln1,11 m*Y be uHd p,ovld*d 11) 1IH 11 8:K In. X \ 1 In.,

2) Information In h*m1 1 through
  • on thl1 data rePOrt 11 Included on . .,h 1hHt, and 13) ..ch 1hHt II numbe**d and It>* number of 1h"t1 I, recorded at the top of thl1 form.
                                                                                                                                                                                             ~. , . **, .,..
                   **.**                               *~ .
                                  \

FORM NIS*2 OWNER'S REPORT Of REPAIR OR REPLACEME.NT As Required by the Prowisions of ASME Code Se~ion XI Shff1 _ _ _ _ _ _ _ ot_..,.._ _ _ _ __

2. Plant
3. WorkPerformedby /4:, ~;&~ I , JYooo '-/?~//

U..., ,{ (Nllffll) Repair()rgan&utionP.OHo~Jotl No~eu:.

       ...                                                    IAOdralJ Identification of Synem....!..e!:.~aa~~~~......!::£/,.2£.~~-,,----------,--------------,----
5. ra) Applicable Construction Code 19 62 Edition, It/ Addenda, Code Cases -"""'"""'4-----

Cb) Applicable Edition of Section XI Utilized for Repain or Replac1menta - 19.£tl, W{(O Addenda, Codt Cases" &::','4,z

       &. Identification of Componenu Repaired or Replaced, and Replacement Componenu Nam1of              Name of              Mfrs. Ser.             -Nat'L                  CRN          Other            Vear                     Repaired.                     ASME Code Component                  Mfr.                 No.                      Bd.                 No.       ldenti,           Buth                     Reploced.,
  • Stomped No. f"ication or (Yn or Nol Repl&cement 1rjf,rr,!,M,~ ,

11,,h,e, Ue.uo., .i,_..,,.,_, i Ph ~6- ,vj. J-/'f:~~~ A/~ L..f,)r~N<fv'§" ,;,,A

7.
  • Description of Work _ ___,_/2,......;;&;;.;.;;,....;~;;.;.;....;:;U'.=,'~__..""""'~~:..e-____________-r-______________
8. Tens Conducted: Hydrostatic O Pneumatic Nominal Operating Pressurw Other 0 Pressure psi Ten Temp. ____ *F
    -9.       Remarks~--::---,....,..,..-,---...,.....,=---=-----:-----:------------------------------
                         "-PP'ic.allle Manutacturer"a Dai. Repon110 be atlact,e,dt CERTIFICATE OF COMPLIANCE
.~o ~ ~ e n made u In this repon are correct and thls _____k_c,_e =""~-~t-~-&z 01
                                                                                                                                       ......f...v.......C:

___ conforms to Section XI of the Signed ~A,d/ tow- or Ow rs Oe,;g,,.., .:Z:-S'/ ~~6 Tn11

                                                                                                                    , i'  &L (Dl1e1
                                                                                                                                                               ,19 .?'$

CERTIFICATE OF INSPECTION I, the undersigned, holding a valid commission Issued by the National Board of Boller and Pressurw Vessel Inspectors and the State or Province of t/t:L . , employed bv

  • f/58 k -+-.:t (_b O * * * , of
        !/0..1--Tfor d./!f                 have inspected the                          tJ.C      ""

IRe ai'1sl or ~e;,1acementC1JI demibed in this Repon on

                                                                                                                                                                         .         1-3 / , 19-8'.9 and state that to the btn of mv knowledge and belief, this repeir or replacement hes bten connructed in acc:ordance with ~\ion XI of the ASME Code. By signing this cenific:ate, neither the Inspector nor his t!mplover makes 111y warranty, expressed or implied. concern-Date       '3, 3 /-g'q
                                                     ~~:s ing the repair or replacement described in this Repon. Funhennore, neither the Inspector nor his employer shall be liable in eny manner for any petlonal injury or propeny J~.r;_
-:anx:d arising from or connected with this Inspection.
                                                                                   ~

Clnsi;,,,clOf) Commissions fJfl7t)D 1 t./ec.. 5""c.q (Stale or Psi,,,,ne1, National Bo.Id) on: Supplem*nul thNta In form of lhu, tit etches. or drawln111 may be u,ed provided (11 aln 11 BK In. X 11 In.,

2) Information In ltama 1 through
  • on thl1 data rapo" h lnclud*d on .. ch 1hMt, and (31 .. ch thHt It numbered end it>* number of thNtl la racord*d at th* toP of thl1 form,
   . -ft' ATTACHMENT 2
                                                                              ,,~   .
                                                    \

FORM NIS-2 OWNER'S REPORT OF REPAIR OR REPLACEME.NT A.J Required by the Provisions of ASME Codi Set1ion XI

 *1.           Ownff                  Virginia Power                                                                                                             4 ~3-3'7 o,n______          ;._'-----------

P.O. Box 26666 Sh.n-~...__ _ _ ot____~ - - - -

                                            .              .                            (AOClrna)

Surry Power Station O t.J"yz_

2. Plant
                                      .                        .            ""~                                                  UnIt  --=---------------------
              .                       P.O. Box                     315 Surry,
                                                                          .{AOOtHII       .

VA 23883

3. Work Performed by_V...A_._........ e...r_________
                                                                    ._ PQ"""'w...                                                         38000 0'?/3(..

CH-> Repair Ort1An1Uli0n P.O No., JOII Ho~ etc.

                                                                       --Same
  • jAOCl,aaj
4. ldentlfic1tion of Synem U[l"'f*t,v. rt~..iJi- GO oL. { u ~
5. la) Applicable Construction Code B31-1 19 67 Edition,.:..aH._A,___ _ _ Addenda, Codt Cases*,-_. . . :. aN::. A,_*- - ~

(b) Applic1bl1 Edition of Section XI Utilized for Repail'I or Repl1e1m1nt1 - 11.80. wan Addenda, Codi c.... _.... N...A._____ I. Identification of Comp0nents Rep1ired or Repl1ced, ind Replacement Components Nam1of Name of Mfrs. Ser. -Nat'L C:RN Other Year Repaired. ASME Codt Comoonent Mfr, No. Bd. No. ldentJ. Buth RepllCfd. Stamped No.* f'ic1tion or * * (Y11orNol Replacement Of-{.{.- VAL.VE M.w~"f.:Jf- 1~~1ffl1 f.JA µPr 56'1 f-/A ?rr'Plki?~b f\Jo I

  • 7.

8; 9. Tests Conduc,ed: Remarks ilft(.,t/£. Po ~ lo:;;<.,. Description of W o r k - - - - - - : = - - - - - - - : = - - - - - - - - - - - - - : : c ' . ~ - - - = - - - - - - - - - - - Hydrostatic O ll'neumatic O Nominal Operating Pressurw BJ Other 0 PreswreJJPf'. psi TenTemp . ~ e F SL l"PP'Qllle MAnutach11er'1 Daia R.::,on1 10 be at19CNdl

  • CERTIFICATE OF COMPLIANCE Wt certify that the natemenu_rriado In this report art correct and this* &f~ * *conforms to Section XI of the ASME~-~

Signed~-;::_

   *            .                          eo--or~
                                                                       . .~ - -

ISI

  • Tnia 4£a ~

(repa,,or11pcaumenG

                                                                                                                                                                          .,, IT1
                                                                                                 . CERTIFICATE OF INSPECTION I, the undersigned, holding I valid commission .issued by the National Board of Boiler 1nd Pressurw Vessel Inspectors 1nd the State or Provinceof_                           _.V....A.. _*..________ , employed by HSB" I&I CO.                                                                                                                   of a ...r ...t ....f .o_._r.,,,d~,__,.C:...£T_..

_.__..H... .. __ have inspecud the W&-P~ IA~lf.°*'1*1 o, ,~:,11cemer,1(1l1 de.cribed in this RepOl'1 on ..;......_ _ _ _ff_,_-_.s.__-_ _ , ,,n and state that to the ben of my knowledge and belief, this repair or replacement has been connructed*in accordance with Section XI of the ASME Code. By signing this cenificatt, neither the Inspector nor his lmployer makes 1ny warranty,.u:prened or implied, concern-ing the repair or replacement described in this Repon. Funhermore, neither the lnspec:tor nor his employer 1hall be liable in 1ny manner for any pe,sonal~~u,y or propeny_da~ of.!{'V ~ind arising from or connected with this Inspection. Datt

  • tf- ~ ff' 1 ~ (lns~uw)
                                                                                                          ~*                       Commiuions              AJ13 7t> o f Va. £'::(_3 (S111e o, Pn,.,nc:e. NatlQnll 8oarG) n: 5.,pplemental 1hNt1 In form of 11111, 1ketch*, or drawlnpo mey be u,ed provided 1111IH It IIM In. X 11 In,,                                                                                                 -.

lnforrnatlon In h*rn* t thro.,gl'I , on thl1 data upon It lncl.,ded on uch 1hNt, and 131 Heh thNt 11 n .. rnberad nd It>* n.,mber of 1hMb I* recorded at th* top of this form*.

                         '           FORM NIS-2 OWNER'S REPORT OF REPAIR OR REPLACEMENT
                                               /u Required by the Provisions of ASME Code Section XI l,\adress)
2. Plant G .1-J:1::(( /pu.,.er S-ra -:/1<M 7 IN~J P. o. /Jex .?IS - ~ l/lf z:!$f .J (AOdreu)
3. Work Performed by_....:..V.,.f__._8_.,o:.::;!:::UC/c:=><"'---------

(Namtl Repair Organization P.O No~ Job No~ etc:. (AOClresaj

4. Identification of Synem Cher,;~ ,t CI/LJ C4 44 2
5. Ca) Applicable Construction Code (!.:rt./ 19 /,., 1 Edition, ./ltA Addenda, Code Cases V/,A-(b) Applicable Edition of Section XI Utilized for Repairs or Replacements - 19~, Wi~ddenda, Codt Cases """""/./_,_/~A._ __
6. Identification of Componenu Repaired or Replaced, and Replacement Components Name of Neme of Mfn. Ser. -Nat'I. CAN Other Year Repaired, ASME Code Component Mfr. No. Bd. No. ldenti* Bunt Replaced, Stamped No. fication or (Yes or Nol Repl ac:ement r-We-F vatL,,., &ruk>v 02 0/'170 µ//1 µ/A l -C-.H-fU- l:!f'1.8 /JIA '
                                                                                                                            ~
                                                                                                                                *         ,oA   d         *µo
7. Description of Work ~ G O va.M
8. Tens Conducted: Hydrosutic O Pneumatic O Nominal Operating Pressure O Other 0 Pressure psi Test Temp. _ _ _ *F
9. Remarks 'f.C>, Sy Ofl?{eS (AppltCAt>le Manutacturer-1 Oa1a Re;,ons ID be attached)

CERTIFICATE OF COMPLIANCE We unify that the natemenu m ASME Code. e In this repon are correct and this '4f~~epair o, rel)l,I~ conforms to Section XI of the CERTIFICATE OF INSPECTION I. the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State or Province of Ila... . employed by *1/sfJ ::r+t: CD of

  /1,a,..TParJ)d'                 heve inspected the          R~LHet'1           e111T demibed in this Repon (Re **rt*)"' ~e::,l1cement(1D                         ,

on /1).. ::3 / , 19.&'.t. ind state thet to the best of my knowledge end belief, this repair or replacement hes been connructed in 1cc:otdence with Section XI of the ASME Code. By signing this certificate, neither the Inspector nor his t!mployer mekes any warranty, e"prened or implied, concern-ing the repair or replacement described in this Repon. Furthennore, neither the Inspector nor his employer 1h1II be liable in any manner for any personal injury or property dap'~~ xr a t~s of II~ k~d erising from or connected with this inspection. Dm /0-31-8? ~f ~ Commiuions JJ87oo9 .,<Jo.. S"f:J (lnsc<<tot) ott: Supplemenu.l aheen In form of 11112, 1~e1chn, or dr*wlnpa may be und provided 111 ,la 1, BX In. X 11 In., (S:11e o, Prc,.,nce. N1honal ~

12) lnform*tlon In ltwm, 1 throu~ 4 on thl, data report 11 Included on **ch &hHt, and (3) **ch thNt 11 numbered and tto* number of &hNb I& recorded at th* top of thl, form.
  • ATTACHMEt-.T 1I
  . -~.,.                     .*~ .... -
                            \

FORM NIS-2 OWNER'S REPORT OF REPAIR OR REPLACEMENT AJ Required by the Provisions of ASME Codt Section XI

-,.       Owner       V 112..§ I N I A                  pow2-- t2.                                                       0a            \o- 28-88 te _ _ _ _ _.....;;;......::a:,._....;;;.._ _ _ _ _ __
17. o . -F':::P)l YIR b tp J P..t l"~oND, )

VA- Shet1 _ _ _1_ _ _ of_ _ _ _ _ _ __

                                                                                            . Unit----------------------

3. Repair Otganizalion P.O Ho 4. s. Identification of Synem (1) Applicable Construction Code fvlA--:H !2 ~ 1* I 19 (o 7 M & > Edition. lf.iA Addenda, Code Cases ---'~'""---- (bl Applicabl1 Edition of Section XI Utilized for Repain or Replacements - 19i{Z:i vJ0 0 Addenda, Code Caser_~-H-~-

6. ldentification of Componenu Aep1ired or Replaced, and Replacement Components Name of Name of Mfn. S1r. -N1t'I. CAN Other Year Repaired, ASME Coda Component Mfr. No. Bd. No. ldenti- Built Repleced, Stamped No. fitation or (Yes or Nol Replacement YlSG Vr'4.k5.~ AA R 1!J0 - - H,$-SI/-IOlf ,-
                                                                                                                                /2.EPI )!{J:::l-tt:lJ1                     -

p 1-S (_, D/2f.$.S~ AA~3'6 - - il4$-$V,/OI.A - ~PLJ..-CEMr::w- - Dtsc.- Tlil.0'SER ,AAr<..37 - -  !.,(',-S\/,fO I(., - ---PI.-Al.brvtSN-r 12.t; -

7. Description of Work 126:PL.Al-G'D DI<;, L- ON 1\-01.. \ ~ ~p...µ B. Tens Conducted: Hydrostatic O Pneumatic O Nominal Operating Pressure 0 Other 0 Pressure_ _ _ psl Test Temp ____ "F
9. Remarks---------=-=-----,----,,-----------------------------

IAPP!icci. t.4Anufacturet'1 DALI Aei:,ons 10 be at1ach9dl CERTIFICATE OF COMPLIANCE f e In this repon are correct and this 1wl<< U1AJ lfepair or repia:emenQ conforms to Section XI of the

            -----l'-"--"~------~-=-~---=--(_o_-_1.>_I                                Tnlt                 eo.1e1
                                                                                                                             - -
  • 19 Sr CERTIFICATE OF INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressurt Vessel lns.pKtors and the Sratl or Province of 1/o___ *employed by
  • II S' (j .:t..f;-r C Q of ti<<r-\Fo ,- dJ ct. have ins.peered the Re~ (4,ceef.!is IR*~*,,tsl °' ~e~11cemen1(11]

ducribed in this Repon on /{)- 3(

  • 19.&t tnd state that to the ben of mv knowledge ind belief, this repair or replacement hes been connruc:ted in accordance with Section XI of the ASME Code. Bv signing this c:enific.are, neither the Inspector nor his l!mplover mikes any warranty, expressed or implied, concern-ing the repair or replacement described in this Repon. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or propeny d a ~ s s of 13y kind arising from or connected with this _in_!Pection.

011te / O.;J 1-8'-g ~ f. ~ Commissions uUG 7ou9of, Vt:<.. 5"lf:3 (lns~tot) ($1111 Prv.,nce. N1hon1I 8o&J1!) Nota: Supplemenul shNta In form of lln1, sketches, or drawlnpa may bl u11d Provided (ti sin Is BX In. X 1 t In., -. (2) lnform11lon In h*ms 1 through

  • on this data report h Included on och shHt, and (31 uch shHt 11 numbered and 11>* number of shNb 11 recordad at Iha toP of this form.

AT!ACHMEr-iT II

 . -:8,t*                     .** .. -
                            \

FORM NIS-2 OWNER'S REPORT OF REPAIR OR REPLACEME.NT AJ Required by the Provisions of ASME Code Section XI

-1.         Owner     \JI F< Gt l l',\ IA       pow I:= 12..

(N'!ffi91 9#>.{ZP,o. Box lfD(p(,,,(& (l1c.l-lH.0ND) YA

          -                                                   CMO*es&I
2. Plant 5uiz.iz_~ poV\/~1A-uoN f.o Boe 3 \0" *, ::;LJ ~ 1 vA -z._-s1:is s
3. Work Performed b/]tz.~sr~ fN'Dt,)$1JZ::l ~s Repair Or;Ani.z.llion PNo~ .loO No~ etc.
                               . AL-b:)CA--1'.L'D ~ ) LA (AOO,alj                     '
4. ldentificationofSynem HAIN $1:;AH C-L ASS IC S. (al Applicable CoNtruction Code 1:;, :3 (
  • I 19 .(p 7 Edition. N I A- Addenda, Code Cases N /A lb) Applicable Edition of Section XI Utilized for Repain or Replacem11nt1 - 19 .80, vJB ~ Addenda, Code Cases ~/,A
6. Identification of Components Repei~d or Replaced, and Replacement Components Name of Name of Mfrs. Ser. -Nat*I. CAN Other Year . Repaired. ASME Codi Component Mfr. No. Bd. No. ldenti- Eiunt Replac:ed, Stamped No. fication 0, (Yes or Nol Replacement
   'i)ISL             11>~.s~e...          ,4-A-Po 3                       -                    -                H~-SV-1~                           -          iet-PLA-(8,1 ~T'"                                        -

1?1s c., ~Sl2_ A-AN8 7 - - ,-i~- :c;v-103' - RCP LAQi-,tWT - 4pf{l-1'1 B '=' - - M~-sv-102.c. - RZ::P LAC£ vlfr,...rT -

     'DI SC...         Pe£SSlf2...

v,~*c. Ii) Q£ SS ~.J'... A.AN 'B5 - - M~-Sv'-lo4C - ~PL~ - Dl4C.. ~S.SE.12.. ,AAN e,g - L.... M,?-SV- !cSf - Rr:P LAC..f:.Kffo.l - 1)i~ DJ<.£.~£-~ AA Poz.... '

                                                                                                    ~

N,S-Sv- (O?.t - R.t..P L.-J,,.c._1i:.1-vsr -

7. Description of .Work_f?..._~ __P_L-_A _ _M_A-_1_N__s_TE_-_A.._\l.l\.

___C...;;;;...;;.£,_;D;__,_1)_1.;;..-;;,..;;;c..,_sa...*--O-N _ _c.._ 0 _1)~G-,_.:;;.5_A-H_.;.....:::E.;...;;...I_,t_S_ __

8. Tens Conducted: Hydrostatic O Pneumatic O Nominal Operating Prnsurw O Other 0 Pressure psi Ten Temp. _ _ _ *F
9. Rem1rks...,...~-~--,,......,.-.,..-:,--':""'"-~,---.,..-,-----------------------------
                     ~pp1icalllt MAnvtacturef'1 D1111 Rei:,o,,110 be attKhed)

CERTIFICATE OF COMPLIANCE Ji We cenify that the nateme ti made In this repon are correct and this ,~{f,td lM ~ conforms to Section XI of the ASME Code.

  • rorrep11::emenQ CERTIFICATE OF INSPECTION I, ti:,e undersign11d, holding
  • valid commission issued by the National Board of Boiler and Pressurw Vessel Inspectors and thl! State or Province of rla . employed by__,._ -'~"'-=o_________ o,

__,_f/,_,S:...8=-..c..::t...__.1--==;[._* flo..rtf-ord.;<~f. have inspected the R-eJJ \o...ce/l"lew+s (Rl;,uts) ~e;,lacemenl(sl) o, demibed in this Repon on /O - 3 f . 19_8g_ and state that to the best of my knowledge and belief. this repair or replacement has been connructed in acc:ozdanc:e with Section XI of the ASME Code. By signing this cenific:atr, neither the Inspector nor his L!mployer makes any warranty, expressed or implied. concern-ing the repair or replecement described in this Aepor1. Funhermore, neither the lns.pe<:tor nor his 11mployer shall be liable in any manner for any person~ inju_'.: or propeny da?~ o;, alojf ~ anx_ kin~ arising from or connected with this inspection. Datr ID 3( 8&' . L ~ r;I.. ~ Commissions AJ87oc'f Va,6tf3 I (lnsi:><<IC>f) . (S111e or P.'o,,,nce. Nahonal 6oa,G) Non: Supplemental. shNn In form of lln:s, ske1cha, or drewlnr;a may be used provided (1) aln la BX In. X 11 In ** *.

12) Information In lnoms 1 throuph
  • on this data repon la lncludad on Heh shHt, and 131 uch shHt la numbered and it>* number of ahNb Is recorded at tha top of this form.

ATTACHMEt--T ll

                           \

FORM NIS-2 OWNER'S REPORT OF REPAIR OR REPLACEME.NT AJ Required by the Provisions of ASME Code Section XI

-,.      Owner       V l R..§ I 1--1. l,A         Po-W ~f?..

(Namej

                                                                                                                    ~tt _ _

Sheet _ _ _ 1_0_-_2_s_-_~_8=------- 2-___ of_ _z..... ____~

          'P.O. 60:X, lb&, /o&,, R.t CI+ HO ND , VA 2.
3. p. o. t;.':f - Ofo75S Repair Organiz.alion P.O No~ JoO No~ e1c.
4. Identification of Synem , MA-I J:°2~/L\ i'vl. C,L,-J:,.f,S, :tr=--::
s. 11) Applicable Construction Code B:g, I. I 19 lo 7 Edition, N /A- Addenda, Code Cases ___fv""+tl/.A'"----

lb) Applicable Edition of Section XI Utilized for Rep1in or Replacements - 19.ee_, Wt, c) Addtnd1, Codt Cases --'~N...,l...,A-- __ l

6. Identification of Componenu Repaired or Replaced, and Replacement Componentl Name of Name of Mfrs. Str. -N1t'l. CAN Other Year Repaired. ASME Codi Component Mfr. No. Bd. No. ldenti- aunt Replaced. Stamped No. fic1tion 0, (Yea or Nol Replacement 1>1?C... 1)12fS4t. (2.. AAPOI - - N5-SV-tl3A - i'.<'z.PL-Atf_ 1-,t r:J.JT -

Vl'?c... D~$E12--- A-Al-.lC! l - µ,~~v-,o~ - r2f:.P L-AL,£:... 1-lE_NT -

      ])1 SC...     -m,.%12'.-          AAN'3o                 --               -       Jv!'$-Sv'-10~         -           f2£PL-AC.£. fi~T                       -
     'i),sc..       'Cl?i. £, s.8Z-- AANq2.                     -                 -      µ~-sv-104£             -          ~PL-ACE.f.-tLN -.                      -         -

u 1-6,C... 1)Rz:.S~Fe- AAN 0~

                                                                 -                ~
                                                                                         /1.<5-SV- Io ':5P      -         l<E"PU.C..EI--I !=NT                   -

1)1 Sl. D!Zf..~~:g_ A/J.Nz.tp ~

                                                                                   -    IUt,. *::N- !Dl\.A     -         'f2-E?Pl-ACE He1J-r                   -
7. Description of Work 'REf L.ACED .Dtscs D~ MA-I~ STE?\-il-l.
8. Tens Conducted: Hydrostatic O Pneumatic O Nominal Operating Prnsurw 0 Pressure pal Ten Temp. _ _ _ *F
9. Rem1rkt _ _ _ _,.,.___,,------::,---=-----,,-------------------------------

IAPPlic&Dlt Manulac:luret"1 D111a Jwpon11o be a11KheGI CERTIFICATE OF COMPli,IANCE e In this repor1 are correct and this !P-/Jloo ~~ conforms to Section XI of the CERTIFICATE OF INSPECTION I, the undersigned, holding I valid commission issued by the National Board of Boiler and Pressurw Vessel Inspectors and the Stitt or Province of /la_ employed by * !ISflL+r & of f/q_rffotd.Jc:{. ha11einspe<:1edthe (a.ce (Re 1,,ts) ivf.s

                                                                         °' ~e::,11cemen1(11l describedinthisReponon                                 /{)-JI       .,sif.L and state that to the best of my knowledge and belief, this repair or replacement has been connructed in accordance with Section XI of the ASME Code. By signing this ceniticate, neither the Inspector nor his l!mployer makes any warranty, uprened or implied. concern-ing the repair or replecement described in this Report. Funhermore, neither the Inspector nor his employer 1h1II be liable in any manner for any personal injury or property da18¥' ~}f~f!JIY Jt',d "'ising from or connected with this inspection.,..

Oatt /Q-3(- )? ~ J~~l.__ ~ Commissions f/5 7(JD 9~q_Nat,onal 5:i/38oa"'l (lnspe,c1ot) Non: Supplemental ahNn In form of 1111:1, 1k11cha, or drawln111 may be uHd provided (ti 111111 BX In. X 11 In., (S111e or *nee.

12) Information In lnma 1 throuph , on thla data rapon 11 Included on .. ch 1h-1, and 131 uch ahNt 11 numbered and tt>* number of lhMb 11 recorded at the toP of thla form.

I ATTACHMENT II FORM NIS-2 OWNER'S REPORT OF REPAIR OR REPLACEMENT As Required by the Provisions of ASME Code Section XI 2. 3. Repair Org.anilltion P.O No., Job No~ etc. (AOdress)

4. Identification of Synem t
                                                        ~ /"N ,,;-
s. la) Applicable Construction Code .i.JI, I 19 lz 7 Edition,~~-=-:----,c=Addend11, Code Cases ......,;0.c.c...:"'--,,,......--

lb) Applicable Edition of Section XI Utilized for Repairs or Replacements - 19~, u!Ro Addende, Code Cases  ;&-'

6. Identification of Components Repaired or Replaced, and Replacement Componenu Name of Name of Mfrs. Ser. -Nat'I. CAN Other Vear Repaired, ASME Code Component Mfr. No. Bd. No. ldenti- eunt Replaced, Stamped No. fication or. (Yes or No) uPtLJ - - -- -* J..c'/1-foP - Replacement
                                                                                                                           &/?J1£/,0
7. Description of W o r k - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
8. Tests Conducted: Hydrostatic O Pneumatic O Nominal Operating Pressure 0 Other 0 Pressure _ _ _ _ psl Test Temp. _ _ _ eF
9. Remarks..,.,...-::-...,..,-:-:--.,.--...,...,:::----=----,---------------------------------

(Appliuble Manufacturer's ~ta Repons 10 be attached) CERTIFICATE OF COM~IANCE We cenify that the stateme s made in this repon are correct and this ,/{~;4(/< conforms to Section XI of the (repair or replacement) ASME Code. * , ~ (i Signed ' \ . () ,

                                                                                                                                          ,19 (Ow                                                        Hie               (Oalll)

CERTIFICATE OF INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State or Province of @. , employed by llf/J f ct:£ a.* of

     &&°&A".o         7 I ez:          have inspected the       tf'cr?k<<'

IRep,.irjs) or ~e::,lacemenl(s)J described in this Repon on //- ~ * ,sf~ and state that to the best of my knowledge and belief, this repair or replacement has been constructed in accordance with Section XI of the ASME Co~. By signing this certificate, neither the Inspector nor his employer makes any warranty, expressed or implied, concern-ing the repair or replacement described in this Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property dan:71or aJess,ff a~rising from or connected ~ith this inspection. ~ Datt! /1-':h, f ! ~ i. ~ Commissions !J{31fJO 'f Va. St.( .3 (Inspector) Non,: Supplemental 1heen In form of llsn, sketcha, or drawln1,11 may be UHd provided (1) sin Is 8% In. X 11 In., (S1 .. 1e Dl PrnY*nce, NalioNI 8"""') (2) lnformetlon In lt11m1 1 through 4 on this data npon h Included on each sheet, and (3) each 1hHt 11 numbered and th* number of 1hHb la racorded at th* top of this form.

                         \

. -*---==-======-F-O_R..,M=-=N-=-IS As Required by the

                                                    ...*23's:O==-W-N-E,.,R-'     Prorbions of ASME S_R_E..,.P-O-R-Ta;:D-F==-=RE""'P...A-IR-=-O-R  Section XI Codt...R.,.E-Pl-A-C=E=M=E=*N=T-=-===---=-==-
 ...,. Owntr      Vlf'.O III\,'*""- £.(-ecA r: ,c.,.                  !YJ Ou, C:mfB fly (Ii/'                                Da,e,--,./V;;..1J!:::'.,&.V...;;;,e...::.1..,,~h..:.Q..:;v_.;.l-,.,1,1~l:....9~~..:::2)=----

p* () B ~ X ...,tr-. " (:, h t:fame> I ShNt.-------*-------~ I

2. Plant 6t.£-rvy ,P4we~6~-f,"cJvti Unll---=1.'---------------
           ,P. O, B, ox 3J.~w;!_~.,,.r -Veto, ,1.-~ere,1
3. Work ,,rformed t,y V,K1"1~ec: f,...,c.. ':ttJ f,,wet- Co, OS'7 ;JS/
                                    $aw.<..            4NatneJ                                           "'".. Orgamut11111,.0 No.. JoO No,.N.
                                                     ~
4. ldtntlf"ication of Synem_.....:...'----,,.,......,,.........,_ _ _ _ _ _ _ _ _ _ _. . , . . . , _ - - - - - - - - - - - - - - - - -

I. 11) Applic1blt ConstNctlon Code 8 31, l 19 k 7 Edltloft, Al fA Addenda, Codec.es _£_7,-;;,*,;?.._..,._ _ lb) Applic1bl1 Edition of Section XI Utilized for Repain or R1plac:1m1nu-1t$Q, tvc;s"O Addendt,Code Cun #/'A-- I. Identification of Componenu Flep1irwd or Replaced, and Repl1ctrnent Corns,onents N1m1of N1m1 of Mfra. Ser. -Nat'I. CRN Other v.. Rep,~ ASME Codi Component Mfr. No. Id. No. ldlntJ. lulh ReplllC9CI,. Stamped No. ricnion (Yn o,Nol Ot;f, . Jjo CERTIFICATE OF COMPLIANCE In this report are correct and thls __ ~_-e.__..f_et_i_'_______ f' confonns 10 Section XI of die ppaifor~ CERTIFICATE OF INSPECTION. f, tht undersigned, holding I valid commission Issued by the National Board of Boller ind Pressur9 Vessel Inspectors and the Stan or Province of

  • Vo... .. employed by
  • tis f1 F+I eo of tla.rTfo"" d1 c.f. have insptettd the -'2 Ct.~r IRe~i 1)111 ~placemcn1(11)1 dmribed in this Flepon on 0- A , 198' f ind nate that to the best of my knowledge and belief, this repair or replacement has been connNcted In accordan~ with Section XI of tht ASME Code. By signing this certificate, neither the lns~ctor nor his t!mployer makes 1ny warranty, expressed or Implied, concer~

ing the repair or replacement dtscribflf in this Report. Funhermort, neither the Inspector nor his employer shall be liable in any mal\nlf' for any personal injury or property daw ~ ? ~ s i n g from or connected with this lnsPt~iOft. D11, /J g~ ~ L ~ flnspe,c:1111) Commissions N{170B

                                                                                                                              '           C51a1e
                                                                                                                                                   'f VC<..Nalional Ill f'n,,,lftR.

S'f.38oatd) uppl*m*nal '""n In form of Usu, 1k*1cha, or drawln;a may be uud provided (11 aln la 1>5 In. X 11 In.. -. m*tlon In huna 1 1hrou9h

  • on 1h11 dau report 11 Included on Heh ahNt, and (31 **ch ahNt la numbered umber of 1hMts 11 r*cord*d *t th* top of thla form.
  .  -,~.                         . ... : . -
                                  '            FORM NIS-2 OWNER'S REPORT OF REPAIR OR REPLACEMENT As Required by the Provisions of ASME Code Section XI 2.
                                        '             (Addreaa) f
3. Work Performed by tf,i: f4wt.LC Repair OrpAnlution P.O No~ Job No~ etc. /
                                                  '-      /      {Name)
                                                         .:.Qwte,'

4.

                                                            . "'""resa)

Identification of Synem_.,p..=!..!.i.,L._.,..i;a:,-=Li*~-\~=c::;.~-=-..,,,,.."--------~------------~----

5. (a) Applicable Construction Code 19 Edition, _ __.U~-=--- Addenda, Code Cases ..r.;....:.,.._ _ _ _ __

(bl Applicable Edition.of Section XI Utilized for Repairs or Replacements - 19h. Wt,u Addenda, Code Cases ...Vi.....,'lf,___ __

6. Identification of Components Repaired or Replaced, and Replacement Componenu Name of Name of Mfrs. Ser. -Nat'l. CAN Other Year Repaired. ASME Code Component Mfr. No. Bd. No. ldenti* aunt Replaced. Stamped No. fic11tion or (Yes or No)

Replacement

                                                                                                                                                                                                             -=-

l\

  • 7.

8. Description of Work . .,1a.: :.: ,1U1<--'..:.{--==L-.,-,..::;.::..,.-A:.!i=--if'---'--,fl-1---A--r-=----"---=-"--"-'-.:::G_--=~=------+*.:..f3=------'-'.--'"""._):t:.!...--'tr/.:;.;t-c.:*:{j;-=-=L.'----l~o*C-I,,'--- Tests Conducted:

'\

Other 0

9. Remarlcs-11-'f.S<C....,...,,_4___:::_p.:.-1-J.,.:.<c'"-""-=-'t--l'--"-l'-~'-+--=-...::..+--L.,__,'-"--..c....L-'1,-"'='""--'--"-'"-"--f-~,._,_-=_,__,'-!-..,_,_......,___.,..-..JJ=<""""-"""'"'--,l'--
                    ;,,.pplicable l.'ianutacturer's Data Re CERTIFICATE OF COMPLIANCE e In this report ere correct and this                           ~      lA.u lt1.~

(reir or repl11cement) conforms to Section XI of the CERTIFICATE OF INSPECTION I, the undersigned, holding a valid commission Issued by the N11ti:°'I Board of Boilyr and Pressul'9 Vessel Inspectors and the State or ~rovince of Vil-* .employed tiv tt.S B X ~ :L Cv, ot

      -IJad-fft' J         /
                            , Cf. have inspected the ~/.tµ,wu.;(*         I  ePAir(s) or ~eplacement(1D described in this Report on                                                    /-        10 , 19_K1 and nate that to the best of my knowledge and belief, this repair or replacement has been constructed in accordance with Section XI of the ASME Cod!!. By si9nin11 this certificate, neither the Inspector nor his employer makes any warranty, e,cpressed or implied, concern-ing the repair or replacement descn'bed in this Report. Furthermore, neither the Inspector nor his employer 1h11ll be lieble in any manner for any personal injury or property damage or 11 ~s!1 any kind arising from or connected with this inspection.
                                                                               ~ M
  • 1 Date * /- io -~, ~ Commissions 1}0,. Sl.f 3 ,-J(J )00 i
   *                                                         *            (lnspeet0f1 ott: Supplamenul 1heen In form of 11~1:1. sketches, or drewlngs may be used provided (1) 11:ra 11 BM. In. X 11 In.,

(State or Province, NAtionAI Boan!) (2) Information In Items 1 through 4 on thl1 data rapon II Included on *11ch 1hNt, and (3) each lhNt Is numbered and the number of 1heats 11 recorded .at th* toP of this form.

                                                                                                                                                                                                                       .L. TTACHMENT II
                              '             FORM NIS-2 OWNER'S REPORT OF REPAIR OR REPLACEME.NT As Required by the Provisions of ASME Code Section XI
 -,. Owner \/, ',?, G-/NIA                 8z1,,LE N,*                                                                                              Date~/~/_*-~;}..,._,__.:;l,"'---~j;--<<:.......'5'".e:....._ _ _ _ _~

eo. 130)( &.

                                         ;()             r (Name)

(d, (,, (,,. A1u-lJ'-1DN1) VA- ? (Address) ' 3;;:i.,(e Sheet _ _ _:.../_ _ _ of_.,___ _ _ _ _ __ Plant *61...1/'?BY COWE(x ST/tTION Unit _ __._ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ 2. (Name) p.o.BoY. 3JS i$r,ta8Y \M:. ;;13 s:::~°5 (Address)

3. Work Performed by VA:
  • Po I.VE'. R

{Name) 3$00 0 t  !./'6"94 Repair O,vaniz.ation P.O No., Job No., etc.

                                               .... 5Al'1F-(Address)
4. Identification of System l=El=D Wl'tTER, {FW)
5. {al Applicable Construction Code B 3t i 19 C 7 Edition, NA- Addenda, Code Cases ~N~~lt~---

{b) Applicable Edition of Section XI Utilized for Repairs or Replacements - 19.fil2.., W<?'Q Addenda, Code Cases~N'.~A:~---

6. ldentification of Components Repaired or Replaced, and Replacement Components Name of Name of Mfrs. Ser.
  • Nat'l. CAN Other Year Repaired, ASME Code Component Mfr. No. Bd. No. ldenti- Eiuilt Replaced, Stamped No. fication or (Yes or Nol Replacement Vl.,t.. \I c XI 1-FW-l'foV-HI.

IC r'l/4t.fl'AP.l.et

                                                      -             I             -                -             l*FW-15/F                       -                R EPA-IK'E                 D           I          /YO I                                                                     I                                                                                                                                 ..

I I

  • 7.

I .. I Desc ri pti on of Work --'--"'-.L...J!.J=-"'-'--'""--"LL..-"'-.!......s>..:""'--¥.J..>..,~Ll../!_'-"'....!."-"-ll.l-.,.-".!LJS'-La.le!...G'-'='--'U:e.!!.:..J.2.£:?>a11=.....L..,CL.<'..!L-'--X>-'-L-l:.!.J.<.'I_ __

8. Tests Conducted: Hydrostatic IB" Pneumatic Nominal Operating Pressure Pressure 13S-l psi Test Temp.Lllt'.lL. ° F
9. Remarks---,---,-,--,-.,.--,----,--=---=-----:----:-----------------~--------------

(Applicable Manulacturer's Data Repons to be attached) CERTIFICATE OF COMPLIANCE Dn~/1 \' . ade in this repon are correct and this _ ____.~-"'.x.,-"-lf-"'Wlc,,:/.....,___ _ _ _ _ _ _ _ conforms to Section XI of the (r pair or replacement) CERTIFICATE OF INSPECTION I, the undersigned, holding a 11alid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State or Pro11ince of th- *Amployed by fts (j J:.+ r C {) of H~""T Fo .. d Ct. ha11e inspected the l\:'e pa. ,'r IRepair(s) or l3eplacement(s)J described in this Repon on _ _ _ _ ,_/~/-~_!l.~3~--, 19 r~ and state that to the best of my knowledge and belief, this repair or replacement hes been constructed in accordance with Section XI of the ASME Code. By signing this cenificate, neither the Inspector nor his employer makes any warranty, expressed or implied, concern-ing the repair*or replacement described in this Repon. Funhermore, neither the Inspector nor his employer shell be liable in any manner for any personal injury or propeny damage or a loss of any kind arising from or connected with this inspection. Date //- 1. 3 - g> ;j ~-j_* Corb Commissions l,V (J 700 ~ VIA., S-1 3 (Inspector) Nore: Supplemenul sh""n In form of lln:i, sketch.,., or drawln"' may be u1ed provided (1) size I* BX In. X 11 In., (Slate o, Province, Nalional 6oarcl) (2) Information In Imm, 1 through 4 on thl1 dota repon II Included on each sh...,t, and (3) each sh&et 11 numbered end the number of 1h&<!'t:l II recorded at the top of mil form.

I FORM NIS-2 OWNER'S REPORT OF REPAIR OR REPL1CEMENT As Required by the Provisions of ASME Code Section XI -,. Due / '1- -

2. Unh_........_ _ , , - . . - - - ",- - , - - - - - - - - - - - - - - -

1.-v

                                                                                                                                 \ I
3. Work Performed by i/Jf: <<

CAddrNal' f'WJA:: 3g~~o 7 l/ c/3,~

                                                <°A~-)                                        Repair ~nlulion P.O Ho~ Job No~ etc.
                           .             "-     ~ '1l 4:-:'
  • 4. Identification of Synem ; R~t:i/aJ: 19(cf{7 0

fl,w i) uA Editlon, _ ___,,~TT,____ Addenda, Code Cases -M ........A--._____

s. (al Applicable Construction~~/]

(b) Applicable Edition of Section XI Utilized for Repairs or Replacements - 19h, Wt;So Addenda, Code Cases -16'-"~,_____

6. Identification of Componenu Repaired or Replaced, and Replacement Componenu Name of Name of Mfrs. Ser. -Nat'I. CRN Other Year Repaired, ASME Code Component Mfr. No. Bd. No. ldentl- aunt Replac_ed, Stamped No. fication (Yes or Nol
                                                -                             -                                                                              {r
7. Description of Work-'~~XI;~L_!.J'..LJ:Mµ~~?--~~~*1:.uf!:l~~~~,:c_.P::::.=::_~~~~:.::.-ILJ,_!.._,~:_.:=-----------
8. Tens Conducted: Pneumatic Nominal Operating Pressure Other Pressuj. psi Test Temp. _ _ _
  • F
9. Remarks fud&. - $,'.~ - /1.-

(Applicable Manufacture,., Data Repons 10 be allachedl CERTIFICATE OF COMPLIANCE ~ /yfMY IJ..el4

  • made In this repon are correct and this ~ lo l:l IJ'\4:,,.,.:r (re -,orreplacemenQ conforms to Section XI of the Si51ned t . 98 19 CERTIFICATE OF INSPECTION I, the undersi51ned, holding a valid commission Issued by the Natlo I Board of Boir and Pressura Vessel Inspectors and the State or,~rwince of VJf- . *employed b¥ s C (/ of
   *IJ<Ultf cJ , Cf, have inspected the ~l,o.u wu.;("-

W"

                      '                                           pairfl) or ~placement(s8 d~scrlbed in this Repon on                                   - /             19 g8 and nate that to the best of my knowledge and belief, this repair or replacement has been connructed In accordance with Section XI of the ASME Code. By signing this certificate, neither the Inspector nor his employer makes any warranty, eJtpressed or implied, concern-Date        * /~-(      4-if     ~                ~ l. ~

ro~ in51 the repair or replacement described in this Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or. propeny d a ~ ? of any kind arising from or connected with this Inspection. Commissions {IJ[j)CJOct v~Sef 3

                             *                                (lnspec1oi,                                                 (St.ate or Prowince. Nalional 8oaJII)
    ~:* Supplemental sheen In form of lln:s, 1ketchas, or dr*wlnpo may be UHd provided (1)                         *lz*  Is 8>S In. X 11 In.,                                      *.

nformatlon In Items 1 through, on thh data repo" 11 lnclud*d on ..ch 1heet, and (3) each shHt Is numbered d th* number of shNb h recorded at th* top of thl1 form.

ATTACP.~lENT II

                            '              FORM NIS-2 OWNER'S REPORT OF REPAIR OR REPLACEMENT As Required by the Provisions of ASME Code Section XI 2.

3. RepairC>rganlzalion P.O No., Job No~ etc. 1Ad9Je5$l ..4--- L*

4. Identification of System w Vlf tJ bJM,1 jJ1,v ~ f
5. la) Applicable Construction Code 19 67 Edition,-~~~--Addenda, Code Cases~)/.~~----

(bl Applicable Edition of Section XI Utilized for Repairs or Replacements ..i.Q, WBo

  • Addenda, Code Cases_,_V._.1}:_,__ _ __
6. Identification of Components Repaired or Replaced, and Replacement Components Name of Name of Mfrs. Ser.
  • Nat'!. CAN Other Year Repaired, ASME Code Component Mfr. No. Bd. No. ldenti* Built Replaced, Stamped No. fication or (Yes or Nol Replacement 21JWih~ fo,.~ Vl\ol'l'fc.1.4 4-oy't'~ .
                                                -              '   -             -        t~Ke-!f~       1,ro -            P,l,n~W\.~

I "j.J~ 7. B. 9. CERTIFICATE OF COMPLIANCE ade in this report are correct and this ~ ltla W l ~ (reir or replacement) conforms to Section XI of the CERTIFICATE OF INSPECTION I, the undersigned, holding a valid commission issued by the Nation I Board of Boilvr and Pressure Vessel Inspectors and the State or rrovince of V,4- * . employed by 5 > Cd of

      -u<<d-fcrY' J '. cf.                have inspected the  r-:t.L~~-

I epa,rjs).or ~eplacemen\(s)] described in this Report on /:J.-/9 . ,sll and state that to the best of my knowledge and belief, this repair or replacement has been constructed in accordance with Section XI of the ASME Code. By signing this certificate, neither the Inspector nor his employer makes any warranty, expressed or implied, concern-ing the repair or replacement described in this Report. Furthermore, neither the Inspector nor his employer shell be liable in any manner for any personal ~jury~r property da~age ~r a Io~ *en):'.-:{in_? arising from or connected with this inspection. L Date * /:).. /9 gs,, {~ J, ~ Commissions /J/3 7Dc 9 VC<.... S ( 3 (lnspectOI) Non,: Supplement.al ,h...,u In form of llns, 1k11tchm, or dr11wlnpa m*V be u1ed provided (1) 1lz11 l1 B>S In. X 11 In., (State Di' Pro-,ince. N&liooat Boartl) (2) Information In ltama 1 through 4 on thl1 d11ta rapon 11 lncludad on each 1heet, and (3) . . ch ah&et 11 numberad and th* number ~f 1h!9b 11 recorded at th* top of thl~ f~_!"ffl_.

ATTACHMENT II

                            .*~ : - .-
  • -1.
                          \

FORM NIS-2 OWNER'S REPORT OF REPAIR OR REPLACEME.NT As Required by the Provisions of ASME Code Section XI Date i 2 .,.. I i..... <3 g Sheet--~~---of_ ___._ _ _ _ __

2. Unn-,1-----------------------~

I 3fJooo f 3 '/ r7

                                '             (Add res.s)
3. Work Performed by 1/fl , fdWkr
                                           '-     ,,..       tName)                                    Repair Organization P.O No ** Job Na~ etc.
                                                  ~awiv (Ad~)                  ~
4. Identification of Synem "" ~n.A-J1 - 0, iJ {1,'Wf
5. (a) Applicable Construction Code 19 Edition,-~//"'-'--'---- Addenda, Code Cases ~)/.'"'-'-/9--~----

(b) Applicable Edition of Section XI Utilized for Repairs or Replacements - 19.M, Wfio

  • Addenda, Code Cases-,:.l(,..L'l9:_,__ _ __
6. Identification of Components Repaired or Replaced, and Replacement Components Name of Neme of Mfrs. Ser. ,Nat'I. CRN Other Year Repaired, ASME Code Component Mfr. No. Bd. No. ldenti- Built Replaced, Stamped No. fication or (Yes or No)
                                           <;,t~      J..i)                                                                      Replacement y /4-l., V_.(_     1t..1v,,f P,,Jr        t,J-M,o,°;l-/
                                                                                       --     J-CC-18.f'            -           P.,nlc.u~w
                                                                                                                                ,-   I jc,/f
7. Description of Work---JHP"-=""°---'~:....i/:....,f,;=-----------------------------------
8. Tests Conducted: Pneumatic O Nominal Operating Pressure O Other D
                                                 --+"""1---PSij ~est Ter:p* /VI)~ °F
9. Remarks.;,........:...,:c.....:"--..1,...a..;,._+....~L.1.L..L-'L.2...._=;......c;;;;_--14,L.tS.,,.....::.--,.1~-=..Jf,<Jr;)..,,,'------------------------

CERTIFICATE OF COMPLIANCE We certify that the statem n this report are correct and this ~lA.a W I ~ (reir or replacernenl). conforms to Section XI of the ASME Code:* CERTIFICATE OF INSPECTION I, the undersigned. holding II valid commission issued by the Nation I Board of Boilyr.11nd.. Pressure Vessel Inspectors and the ,~tate or rrovince of Vlf- * .employed bv 5 > C rl of il<ad-f11Y' J I

                         *Cf,          have inspected the         ~lCA:t.e~

I epa,r(s) or f3eplacement(sl) described in this Report on / ) - ~.'() , ;~~ and state that to the best of my knowledge 11nd belief, this repair or replacement has been constructed in accordance with Section XI of the ASME Code. By signing this certificate, neither the Inspector nor his employer makes any warranty, expressed or implied, concern-ing the repair or replacement described in this Report. Furthermore, neither the Inspector nor his employer shell be liable in any manner for any personal injury or property di'\89/i:: lo;s of any kind arising from or connected with this inspection. Date /l-~o - E?2 ~ (lnspecto<) J. ~ Commissions IJ/3 2co l Va__ St.f,3 Note: Supplement.al sh""n In form of llsu. sketch111, or dr11wlni;,s mav be u1ed provided (1) sin Is BX. In. X 11 In., (State or Province, National Board)

12) Information In lnams 1 through 4 on this data report la lnclud*d on aech sheet, end (3) **ch sh...,t Is numti.red end th* number of sheets la recorded at the top of this form. ___._ .. -.. *-----

ATTACHMENT 2

    • -1. own., Virginia Power P.O. Box 26666
                                                     '       FORM NIS*2 OWNER'S REPORT OF REPAIR OR REPLACEME.NT AJ Required by the Provisions of ASME Code Section XI
                                                                                                                                                ~ff~--~/i"-"/6._'f--_1~ - - ~ -

ShHt~.........__~~~Df________~ - -

                                                                                  ~ma)
2. r1ant Surry Power Sta ti on C)li)~

(N~ . Unh~--........- - - - - - ~ - - - ~ - ~ ~ - - - - - - ~ P.O. Box 315 Surry, VA 23883

3. Work Performed bv..cYuA..La.,,........_S'e......, t___________

INlll>I> 38000 7572~

                                                                --same
4. Identification of Synem \AOC!ratl . &Jo-...., do'vJ/\
5. la) Applicable Construction Coc:tt B31- l. 19 67 A,_____ Addenda, Code Cases _....,NA'----'--

Edition.....1~.... (b) Applic1bl1 Edition of Section XI Utilized for Repair, or Aeplac1m1nt1 - 11...80, WRQ Addenda, Codt Cases ...... N...A.____

15. ldentificition of ComPOnenu Rel)1irrd or Repleced, and Replacement Components Name of Name of Mfrs. Str.. -Nat'L CAN Othtr Year Rep1i,.d. ASME Code Comoonent Mfr. No. Bd. No. ldentl- Bulh Aeplectd. Stamped No. ficttion or (Y11 or Nol Replacement VP\./ v e Ca,wq~.,,(..
                                                                    ~/k                /VIA- MA                      t-B~>i.f           ,AJ/A-          R.e-/J~,::_e)._
                                                                                                                                                             .                        A/o

/

7. Dneription of Work tZePJ~-e U.)i1e I. Tests Conducted: Hydrostatic [i;r rneumatic 0 Nominal Operating Pra1u'9 0 Other 0 I.
                                                                                                                                                                                                           =

CERTIFICATE OF COMPLIANCE We certify that the nattmenu m~ In this repon are correct and this Me:.~cf4r:' conforms to Section XI of"'- ASME Code. *-

  • hPMor**~

Signed ~r/!~,< P:-~* De*,p-J ISi Tllli

                                                                                                                                                                    ,19     ri CER Tl FICA TE OF INSPECTION I, the undersigned, holding a velid commission issued _by 1ht National Board of Boiler and Preuu'9 Vessel lnspec1ora ind the Stitt or Province of_                           _.V....A
                                                   .......________ , employed by HS8' I&I CO,                                                                                                           of

_H......a.r. .t. . f. ....n.._r. d...,,.._..C

                                   . ...T__.*..___h1ve inspecltd the                    Re,Q\g. c.e Mev+/-                  drmibed in this Repor, on ________8..._-.....                   1....I_, 19.ll
                                                                  *                   . IRr'$"a,&11J DI ~r:,11~tm1n1(11l and 11111 that 10 the ben of my knowledge ind belief, this repair or replacement h11 been connructed in acc:osdanct;c,with Section XI of m~*

th*e ASME Code. By signing this certificate, neither the ln.pector nor his ,mployer mikes any warranty, uprened o*r implied, concern-i"9 the repair or-repl1eement described in this Repon. Furthermore, neither the Inspector nor his employer shall be liable in 1ny manner for any personal injury or propeny ~n~kind arising from or connected.with this ln1Ptction. - O,tt $?- ff' £9 ~ ~ Comminion1

  • IJt3 7D1S1t1at) 1or 1/a Na,..,,,.,
                                                                                                                                                                                ,) lf J8oatGI
    *                                                                                   (ln11>KIOl'J n: S.,ppl1meni.l 1h"" In form of ll1u, 1~Hch*, or dr*wlnpo mer ba ui,CI p,ovld*CI 1111111 h IX If\. X 1t lft.,

Pn,,,,nc,. nformulon In lftm 1 1 through , on 1h11 dat* npor, 11 Included on Heh 1hHt, *nCI 131 .. ,11 1hNt l1 numbered lh* nurnbar of '""b 11 **corded at th* 1op of 1h11 form.

                                   ..** :*    -                                                                                                                                              ATTACHMENT 2
                                   \

FORM N1S*2 OWNER'S REPORT OF REPAIR OR REPLACEMENT As Required by the Provisions of ASME Cod, Section XI

   ....,. 0wn.,    Virginia Pawer P.O. Box 26666 jAOOtnaj Surry: Power Statjon
2. Plant e.o. Box 315 Surry, YA 23883
                                                       ...~
3. Work Performed t,v..Yu.A~, ,......Se
                                                      . . . . .111.....r__________                                    38DOO              7 f'3~ ~

CN-i

                                                   --Same
4. ldendrication of Srnem CA,ao~ R. eq0-fw.-. loo/W\. 't
5. laJ ,t.pplicablt tonstrvctlon Codr 831-1 19 £7 Editlon, ....H...A.____ Addenda, Code Casts __N::..A,_____

(b) Applicable Edition of Section XI Utilized for Repairs or Replae1m1nt1 - 19...80. WBQ Addenda, Cod, C.t11 __.N..,.A.____ I. Identification of Components Rcpairtd or Rtplec.d, 111d Replacement Components Name of Name of Mfrs. Ser. . N1t'1. CRN Other Year Rcpmirtd. ASME Code Co"'Oontnt Mfr. No. Bd. No. ldentJ. Sulit RepllCtd, Stamped* No. f"ication tll (Yn o,NoJ R eplacemtnt 11.4"w"f v;,L N"'-'r s C:(l"'!J,..J ())_o qq10 /Ii/ /\lilt 1-~L-* WG"'".11. fa'. ~ t,i.ce/ 0 er/ S1\J s Ii w*-{ ett-..1 h't 3Jt~<lbJ J; J,, Jr J., t ~ 1* Description of Work _ _ __.~~q~c~..-::...:...~..i...--*_G;;;...'l....:::S;..fa...:c;..::lS~----------~~----------

    **      Tem Conducted:                    Hydro11auc                    PnNmatic        EJ        Nomi,.I Operating Prn111r1              0 Othtr 0 R1rnerlu _ _ _ _p_,.._'"'-"....2.-,U,..""'_PI_'_T_er_t_T_,m_p___d":_"                        __*_,____JJ.....;_"'___n, _/J_o_F_c_s_Y_-_)._/_C,_'f_Y_)_______

I. f"ppliwllt Ma11Ulac:turet'1 O.ia A.~110 t u t ~ ..f 'f",.,tf)S pl;) :Ii- SS "I -)...). '/).) fr CERTIFICATE OF COMPLIANCE

                                                                                   .                                      J                 T Wt certify that 1hwmenu m                              In this report ar, correct end this                     "rfli     C ~      -l,\,

t'tpa,tOl 1 1 ~ conform, to Section XI of 1M ASME Cock.

  • Signed ~

io-- ar Owftera *" n CERTIFICATE OF INSPECTION I, lht undmigned, holdi119 1 valid commission issued by the National Board of Boller ind Pr11su'9 Ve111I Inspectors ind the State Ol Province of_ _.V....A

                                 .......________ , employed bv HSB" I&I CO.                                                                                                                       of Ha rt ford. CT.                        have inspected lht              re       q_c.-e-...t.t, 1-         ducri~ in thil Repon on _ _ _ _ _...                        8:;..-.......t.l_,
                                                                                                                                                                                            . ,tti.
                                                          .                    !Rt a,lf1J o, i;:,1aceff1Cnl(1I                                                 .

and n1tt that to the bcn of my knowltdet and brlid, thii fi'P1ir or replacement h11 been connrvcted in ,cco,dan" with Section XI of the ASME Code. Br 1ipning this c:enificatt, neither the ln11)fctor nor hi1 lmployer m1kt1 any w1rr1nrv, tJtl)reued or implied. conc:erfto int the rrp1ir or repltcement ducribed in this Rrport. Furthermore, neither the ln&prctor nor llis employer shall be li1bl1 in ,nr """" for any Ptrsonal injury or property~:::,: oJ,;r,y Jr,tnd arising from or connected witll thil lnlPtiZ"" D11t ff--t{ - 81 ~ii  !~ Comminions J)!l?oar ~ S't/:3 (ln1po,e1ot) Non: $.,pplement.1 aheu-. In form of lln1, 11tetch*. or drawlnpe mer be und provided Ctl 1111 h 11, In. X 11 II\., 151111 ar Piv,,,nc,. H1ho*"' ~ flfounetlon In lftm1 t Uuo118h oil Oft thl* data uoor, 11 Included on ..ch ahNt, *nd 131 uch 1hHt 11 numbered e number of 1hMt1 Is recorded at th* to&> of thla form.-

    . -~                                                                                                                                                                              ATTACHMENT 2
                                  \

FORM NIS-2 OWNER'S REPORT OF REPAIR OR REPLACEME.NT A.J Required by the P1ori1ion1 of ASME Code Section XI

   -,.      Own,r      Virginia Power P. 0. Box 26666
                                                                                                                                      .Dai._7,_/~_/?q               _ __

Sh.-t~------Of~---~~~~~

2. r1ant Surry Power Station jAOOtn&J U n h ~0
                                                                                                                                  .. 113
                                                                                                                            -~~~/~V~'-------------~~

Ck~ P.O. Box 315,V.OOrallJ Surry, VA 23883

3. Work Performed t,y __V ......_PO_..w...e...r________
                                          ...A                                                                 38000 7 '7])/

CH->

                                                   '-Same
4. Identification of Synem l1J Applic:1ble Construction Code B31-1 IAOCltall SJ'e~,.,.

19 67 r J,,111t'c.i to f'- Edi;ion,, ....H.._A_______ Addendl, Code Cam _ .....N ...A______ 5. lbl Applicable Edition of s,e1ion XI Utilized for Rep1in or Replacamantl - 11...80. wan Addenda, Coda Cam _..N... A______

s. Identification of Comp0nentJ Rep1i1Td or Repi1ced, and Replacement Componen11 N1maof N1mt of Mfn. Str.
  • Nat'L CRN O,ha, Year Repaired,, ASME Codi Comoonent Mfr, No, Id. No. ldentl- liulh Replaced. Stamped No. fication or (YnorNol Replacement ji.,.,,f...;a, e 1-SJ.-:J.l!,
  'Yy;Jv. t                  S,..eci'>i/f-:1 0)..\)/'1"11               .NI A /JIit                                  JJ//t              (-ef)}aceA                         i1/D lk..J.1,.1"' (
   ~tjt 7        "ItJj              So,*t;.Jt,. ~ 75"fJ.S l 0                .NIA JIii+.                  /-SJ""?JJ          /11/A-           i'<7/J/<tc    r:- ti.           ,,,l/D
    ,. DncriptionofWo,k _ _ _ _ _ _....,.._ _ _ _ _ _ _.....,,___ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __

I. Tem Conducted: Hydrostatic W';neumatic O Nominal Operating Prnsurt O Other 0 P-, ... n.r psi TenTemp_.-.,'} *, I. R,~rks __________ .5_-_*__5_-~------------~--------------,.,-.~....Y ......' .__Av._~_t__f_o_Ft_c:_s_*J_v_..;.._,_3_1_7_!_2*_______~

                                                      - i..                                                                     "

IAPP'~~1111facturef'1Da1alw:,on11o1>e~ ~ /I Si"i)s fo jl 5S y - /'i"OoCf). CERTIFICATE OF COMPLIANCE We certify that the n11emenu m~ In this rtpon are correct and this g.._~t',1:4,; ~~ conforms to Section XI of the ASME Codey)* __ / ~ t*pa,ro- **P'acetNIIO Signed ~r kc (O,r"9fci-~ ISI TIit: def ," / tn-1*1 CERTIFICATE OF INSPECTION I, tht undersigned, holding I valid commission issued by tht National Board of Boiler end Pressul'I Vessel Inspectors and the State or Provine, of_*_.V....A ......__________ employed bv HSB' I U CO, of Ha rt ford. CT I have inspecltd the Rdti..u: M:eiv+/- IRcpltc11 o, ~c;,lacemen1(1I . ducribed in this Repot1 on P-(J .,,..Kl and natt that to tht ben of my ltnowl,dgt an~ belief, this repair or replacement h11 been connrucied in accordance with Section XI of tht ASME Code. By sipning this c,nifiaie, neither the Inspector nor his lmployer makes any warranty, uprtsied or implied, concerft-ing the repair or replacement described in this Report. Furthermore, neither the Inspector nor his tmplorer shall be liable in any manner for any penonal injury or property d " !:"'?Ofl,J~rising from or connected with this lnsi,t~ion.. ' . Datt f-(/ -rg'j ~sb_ ~ Commiuion1 /J81t)oq I@. '5:lf 3

                .                     *                          *         (lnSP<'CIOI)
5.,pplem*nt.l thNn In form of 11111, tletch*, or e1,.wlnpo may be uHCI p,ovleled (1) tlH h IM 1ft. X 11 lft.,

(S1a1t or Pn,,, ..,ce. Naho,,al Boal1:II nformnlon In 1'9mt 1 1hrous,tl , on thl1 Cina repo" Is Included on Heh 1hN1. end (31 .. ell thNt 11 numt..r*CI lh* number of 1hNb le r*corel*d a11he 1op of ml, form.

ATTACHMENT 2

                              \

FORM N1S*2 OWNER'S REPORT OF REPAIR OR REPLACEMENT As Required by the Provisions of ASME Code Section XI

  -,.      Ownff       Virginia Power P. 0. Box 26666                                                                                                           Shl'ft ____.______~of____,__.________~

CMO*eul Surry Pawer Station Unlt~~_.O.._*fl/___._t:_r~~~~~~~~~~~

2. ,,ant P.O. Box 315 Surry, VA 23883
3. Work Perlormed br VA, ~wet ~.,..., ~~-~

38000 7 8'3 '7 {)

                                                                                                                         ......w~0,v-..,"-~--,ioft--,-.o~-.---Jo0""""'~--.e1e.--------_.;.--~--------
                                                '-Same 4.

5. Identification of Synem

           ,., Applic1ble Construction Code B31.;.1 IMO<atl 19 67 g  t?ctc     0or Edition .....

Co /W"\.'\ c r~....A...____ Addend1, Code Cases_.__N__A.____ (bJ Applicable Edition of See1ion XI Utilized for Repain or Aeplac1m1nt1 - 11..80. wan Addenda, Cod, C.sn_.,N,..A._*_____ I. ldentific,tion of Compenents Aep1i1Td or Replaced. and Replacement Componen11 Namtof Name of Mfrs. Ser. -Nit'L CAN Other Year Aep1ired. A.SME Codi . *. Co"'Oontnt Mfr. No. Bd; No. ldentl- Built RepllCld. Stall'IPN No. f"ic1tion or (Y11orNol Replacement jVVt\<;,. .!II/A ).J//t e }qceo{ Sl\i\OS Jv/A Jtl1)r

7. Description of Work / ,

I. Tem Conducted: Hydrostatic ej7 . Pneumatic O Nominal Oper1tin9 Pre1111rw O* Other Q Pressure ,rJ,:" psi Test Temp.~*F

  ,.      A,~rlu                                                                                                                     NIA.~ e~csl-1!1'/?I
                    .-~--c~--,W.,.,--r,c,...,.flC-,..,-.,....,.,...,Da=--ui-=~-:,cw,---,..,.,o..,.be-111....,IIC~l,eGl~--------5.-m--D-s--P~o-.t:_5.,...         __;;_>_'---J.-.2~'-/_2.._.)_{f CERTIFICATE OF COMPLIANCE
~'Q27-,. In~b ,,.m, "' ,o, K*;~ ~-----f'-~_,;fi,-'*'-'g-;-o,-:-~__,,~. ."-=-nG------.-,."';~ ,o S."ion XI of ...

(Ow,,..;~,..I Tl!b = CERTIFICATE OF INSPECTION I, the undersigned, holding I valid commission l11ue,d by the National Board of Boiler and Pressurw Ve11el lnspKtors tnd tht St1t1 0 o, Province of VA, , employe-d bv*--lu.iSw.B1J.--i..l8...*1.._I_Cw.D........- - - - - - - - - - - - - - - - O f Hartford, CT. have inSi,emd the ref la.c..e.'11\_e.A, t *de&eribed in this Aepon °" jRep1,r11)0, ~e:;,11e1m1nl(1I . *

                                                                                                                                                                                       '"6-11 *,gji and n*ate that 10 tht ben of mv.. knowledpt and belief, this repair or rtpl1cement h11 been connructed In acCD1dance with Section XI of the ASME Code. By sipning this cenificatt, neither the ln1pector nor his lmployer makuany warranty; e,i:preued or implied. concern-ini .the repair or replacement described in this Repon. Funhermore, neither the Inspector nor his emplover 1h1II be liable in any manner for any person~injury or propeny d~~ :' a. ny kind arising from or connecte-d with thi1 ln1Pt~ion.                                                                                    _

Den ?r (/ -&q ~ Commiuiona /J/3JtJtJC[ [/4. f(tfJ

                     .    *                                               (lnsr;,e<:ta,)
Svpplem*M*I 1h .. n In form of Ilia, 1k*tches, or dr*wlnlill m,v be uHd provided C,J 1IH h IM Ill. X. 11 111.,
                                                                                                                                           *
  • 151111 or l'n>w*ftCI. N11,ona1 Boal1II formatlo" '" lnm* 1 1hro11eh , on this data nPort 11 lnch,Cl*CI o" .. ch 1hNt, and Ill .. ch 1hNI 11 n .. mt>er*d
  • n"mber of 1h .. 11 11 recorded al 1he 1op of 1h11 for,n.
          .
  • f,. *** 4 :* -

ATTACHMENT 2

                                                         \

FORM NIS-2 OWNER'S REPORT OF REPAIR OR REPLACEMENT AJ Requirtd by the Provisions of ASME Code Section XI

        ..,.        Own~                   Virginia Pawer P.O. Box 26666

(.f.Odra,.aj

2. "'"' Surry Power Station .........

P.O. Box 315 Surry, VA 23883

3. Worlr. P1rlorrntd t,y_V...A.ui.,...... ~M.U r________
                                                                                    ...Ul CNII/TIII 1aaaa ~ass 2.
                                                                                                                                         "9paif ~IUlielft ,.O Ho.. Jo0 Ho. lie.
                                                                           --Same
          **5.      ldent1ric11ion of Srnem                                                 "°°-ei                      Dff )1 Jr--

s;' e. )'ec-1 iG/\ la) Applicable Conswctlon Code B31-1 11 67 Editfon.....r~"-A,_____ Addenda, Code Cases _..,_N""A.._____ lb) .Applicabl, Edition of Section XI Utilized for Re;,ai11 or Aeplactmtntl - 11..80. waa Addenda, Codt C.sn _..N.... A..____ I. ldentifiaition of Comi:>onenu Repairtd or Replaced. ind fleplecement ComPontnU N1mtof N,rne of Min. Str. -N111. CAN Other Year Repaired, ASME Code Co,noonent Mir. No. Bd. No. ldentf. iulh RepllCICI, Stamped No. f"ic11ion or (YnorNol Replacsment ()2.) gll-\ OS 1\,,....tw"'-<.

                                                      <J>et<<i,lt,       0£0702<!)                   ;J/A-- /{I/A                 I-SJ  -J..y;_        M'A-        ){!'fJhce~r:                 Ala

{ __(fl) 1.!1< .,-5

7. Oncription of Work 6p,h"5pcc,t Uvi.J'c.

I. Tcm Conduc,td: Hydronatc'GY" Pneumatic 0 Nominal Oper1tin9 Pressurt 0 Other O. Pressure +11£ psi Ten Temp.~ *F I. Aeiqrks-------~---,,,-----,-----,----------..:_~v.'-""-~------------- f1v.. tAS la=F sS'Y -~lo '-/Jq

                                           ~~                  Ma11Ulac:1 ....,., Cll"UI ,_.~. 10 be I t ~

CERTIFICATE OF COMPLIANCE Wt ctnify th'1 the n1t1me11u midi In this rtpor, ~,. correct and this ASME Codt~* ~ I' Pl/y "C d conforms to Section XI of the

                                     ~t-~
                                                                                                                                              ,.,,p&11or1e~

Sigfttd TSI ,L6. (/ . ,. i:9 jC)w,,.. or I ~S'0-1 TIii "to.tel CERTIFICATE OF INSPECTION I. the undmig,,ed, holdine I valid commission issued by the National Board of Boiler and Prnsu,- Vtsstl lnsp<<tors end lhl Srate Ol Provine, of_~Y-A....._ _ _ _ _ _ _ _

  • employed by usa* I &I co ft of
c. r. . ..___h1v1 inu,e<:ttd the NP{tt H...a...r...t...f....o....r..,d._.,.......

C- -e.if IR~a,r(sJ o, ~:i*aumeftl(SI described in this AtPoF1 C H l - - - - - - " ~ ... . ,,fi

                                                                                                                                                                                                 --1.I_,

ind 1111, 1h11 10 tht best of my knowltdgt and belief, this repair or repleccment hu beefl connrvcttd in 1ccord1nct with Section XI of lh! ASME Code. Br sipnine this crnifiaitt, neither the Inspector nor his fmployer malr.rs enr w1rr1n1Y, up,nsed or implied. conctrfto ing the rep1ir or replaeement described in this Rrpor,. Funherrnore, neither tht Inspector nor his employer shall be li1bl1 in 1nr manner for any personal injury or propcr,y t 1 ~ ~ ? o f *~ lr.i~ arisin9 from or connected with thi1 lnsp1C,i0ft. D11t ~-lt-81 V~&...- ~ C.ommiuion1 NfJ-]ooC( l/C1L.5"Lf3 Non: 5.,pplemantal '""-n pn11><<1Cf) Jn form of lln1, 1ketch*. or dr*wln;. "'*r

                                                                                                                                                                  $1a11 or Prt>o,nc:1. He honar lloA"'I ba 11 . . d provided (111IH h 11" 1ft. X 11 IR.,

C2J ll'lforll'letlon In h*rn1 1 throvgh

  • ol'I thl1 data npor, 11 Included on uch thNt, and 13) Hell 1hHt 11 numbe**d d " """'t..' of tPINb 11 recorded at th* tOP of it.I* form.
                                     . ,** :*  -                                                                                                                                                  ATTACHMENT 2
                                    \

FORM NIS*2 OWNER'S REPORT OF REPAIR OR REPLACEME.NT AJ Required by the Prowi1ion1 of ASME Code Section XI

         -.1. Ownll'. Yi rginia Power                                                                                                                     .......~_':?._~_~_1~~~-

o1n___._.;?';- P.O. Box 26666 sh..w _______ of___________ ~

2. P11n1 Surcy Power Station Ck~

(MOrnaJ Uh n Wb

                                                                                                                              --.1~..:.;...---------------------------

P,O, Box 315 Surry, VA 23883

           ,. Work P1rlormtd          by_,V...,A.......,_.~        t'._________

CH~ 38DDD 2 ~ 'f ,J'j

                                                          ""Same 5.

ldendfic1tion of Srnem laJ Applic1blt ConstNctlon Code B31- l IMO~ 19 67 f<ee c.J"o (' C Editlon, .....U Ob ,~.-t __A;____ Addendl, Codi Casrs _...,N,..A___ (b) Applic1bl1 Edition of S,c,ion XI Utilized for Ae;,1i11 or Aeplac1rn1nt1 - 11..80. WRQ Addenda, Codi Cases_...N... A._.___ I. Identification of ComPOncnu R~1irrd or Repl,~d. ind Re;,l1ctment Cornponenu N1meof N1mt of Min.Ser. -N11'L CAN Other Year Rep1il'ld., ASME Codi Conioonent Mfr. No. Id. No. ldentl- iullt Rcpl"9d, $temped No. fication or NnorNo) Replacamenl (6() S1-1D ~ rl~wor-e.

                                  <ne, ,,, \t, 2'7&-fJ.Sl,o                    ;J/Jt /t/1Jr                       ,..,.Rc-135 A'.lt Pt, plru 1 ~                                Alo
                              \.\_o,J.wc,-{

__ (__a'} t,)v....'15 c;nec.-..,.\\-;1 0 J-oJ~17 ;11/lt Alltt- I-/Z.l--13.f !VIA- /l~pJ,tetA I

                                                                                                                                                                                          /VD
          ,. Oacription of Worti __*~:.:.:ti~v--=:,~r;.~e?~~~'"P-!_..i.:();.::c-,,,:::.:,c:c::k~*._;./.c:=Ht=<o;:ala... .f____________'="_ _ _ _ _ _ _ _ _ __

I; Tem Condl.latd: Hydron11ic1§7 Pneumatic O Nominal Operating Prnsul9 0 Other a Pituun 2/1{' psi Ten T1mp ...,a2.. *F SJ4 D/ 0 ::d:- C<' y -)60()4 2

         ** A1mMltl------------.---------------------J                                                                                        ____,[__0 1
                                                                                                                                                             .;>J tvt:r
                                                                              '°
                           &A,lplic&lllf lolaflUIKt...., oaia "-=* 11e _ , , . .                                               kc,\,     t-:> f O               <--f ;>q 1

conforms 10 Section XI of the CERTIFICATE OF INSPECTION I, lhe undersigned, holding I valid commission i11utd by ',tit National Board of Boller and Prtssul9 Vtssel lnspecton ind lht State 0, Provincuf VA e

  • employed tr, usB* I& I co e of Hartford. CT, h1v1 inq,emd the Oet>\ "'c~ Meut jRcpe,l'(sJo, i;:i11ceme111(1I described in this Repc>r1 on g-11 '11f1 and 11111 1h11 10 lht btn of my knowl,dg, ind b,lief, this r,p1ir or 11pl1cement h11 bern connn,cted In 1ccord1nce wi1h Section XI of lht ASME Code. Br sipning this cenificl1t, neither the lnsPtctor nor his lmployer rn1kt1 any w1rrentv, uprened or implied. concern-ing lht repair or replacement described in this Report. Funhermore, neither the Inspector nor his 1mplorrr 1h1II be liable in 1nr manner for 1ny personal injury or property ~191!\:?s:'f ?::?::ising from or connected;vj: thi1 ln1Ptetion.!

D111 ~ ... / { - ~ ~~ll"IDKIOII J.... ~ Commiuionl J03. 200 r LL6... 513

     *flioft:  Supplemental 1hNta In form of 11111, 1ke1ch*. or drawln1,11 "'*W tie ueed p,ovlded CU 1IH h IX 1ft. X 11 II\.,

1$1111 Cl P>ri,.,11et, N11..,,,.19o&t11 12> lnforrnnlon In 1,-rn, t through , on 1h11 dna npon 11 Included on Heh 1hNt. end 131 HCh 1hMt 11 n11rnber*d d lt\e ru,mt,er of '""ti 11 recorded at th* IOP of 1h11 form.

                                   .... :*   -                                                                                                                                                         ATTACHMENT 2
                                   '              FORM NIS*2 OWNER'S REPORT OF REPAIR OR REPLACEME.NT AJ Required by the Prori1ion1 of ASME Code Section XI own11: Vi rgi ni a Power P.O. Box 26666                                                                                                                      ShHt _ _ _ _ _ _ of_ _ _ _ _ _ __

(AOdrnaj

2. ,,ant Surry Power Station Unh _ _ _ _

()/\If.

                                                                                                                                                        .......:a..-...:--------------~

CH~ P.O. Box 315 Surry, VA 23883 77S 'i,

                                                         .{AOOraa,/
3. Work Performed.by..;V... A.._.......l:'P......kt...e. r. ________ 3aooo CName!
                                                       "-Same 4..

5. Identification of Srnem la) Applicabl, Constn,ctlon Code 831-1 CAOcliaal Rt?c-1.."r

                                                                                                     ,SI 67 C "L  {q i,l:i    f'    -?fF"":'1 Edition, .....H.~...___/
                                                                                                                                                 . . _____.Addendl, Codi Case, _..._N....A....____

fbl Applic:abl1 Edition of Sei:tion XI Utilized for- Repail'I or Replac:1m1nt1 - 11..80. waa . Addenda, Cod, C.set ......N

                                                                                                                                                                                                        ....A_____
s. Identification of Components Repaired or Replaced, and Replacement Components Nam,of Name of
  • Mfr:s. Ser. -Nat'L CAN . Other Year Repaired, ASME Codi
    ** Coff\Qonant                Mfr.                           No..                       Bd.              No.             ldentl-               Bulh                   ReplKtd,                 Stamped No.                             rec,tion                                           0,                (Yn 0tNoJ Aeplac:emtnt
                          ~o,,..<;\.-1                                                                                  1- i:'> -1'\o<.1 -

St~ol::. l'rtl'-,,!)r.'. I~,.,.' D7f~ 1i1b tV/A- NIA 1sfA /11'/A- f ,. .frfau er-/ No f Description of Work _ _ _ _ _Q_r..,.P_l I __

                                                                                     '! __            ' ...)_s_______________________

c..._r___~;;...L"""* 7. I. Tests Conducied: Hydrostatic O .' Pneumatic O Nominal Operating Prnsurw O Other D R1markl _ _ _ _P_re_s_su_re.....,,...--,,--P1-.,.I_T_,s_t_T_em_p_._- _ _*_F_ _ _ _ ...,.s

                                                                                                                                                         . . .1.. __J._s_*_f_o_*#_c_)_*__y_-_)_o_l_0_7_<-I___
                         ~c.at>lt Ma"Ulacturet'1 Daia lw:,0,,1 to be a t ~

CERTIFICATE OF COMPLIANCE f:t"~k °""'-0 I ASME Code.

  • si11Md
                           -e1 We ctnifr that the natemtnu made In this rrpor, are correct and this
                             ':Ad...~~
                                             ,#~

rt_ A#L rsTIit=r 1 C. i,,pa;,

                                                                                                                                        #,c; r'
                                                                                                                                                   °' reoiaca<NftG
                                                                                                                                                                                 ,11
                                                                                                                                                                                    '°nforms to Section XI of tht
                                                                                                                                                                                       !1 IC)wne< cr    0w,..;;;.;,;;;,                                                                                !Da**I CERTIFICATE Of INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Veuel Inspectors ind the Sratt Ol    Province of_~V...A      ......_________ , employed bv                                                       uss* UI co;,                                                                                of Ha rt ford
  • CT. have inspected the
  • crtl"' c &v- u.,:f jR,s:4u1s1 o, ~,:,11cemcn1(1I described in this Repon °" !f-11 . ,sil
  • and n1111 that to th, ben of my knowledge and belief, this repair or replacement has.been connructed in accordance with Section XI of the _ASME Code. By s*ipning this cenifiatt, neither the Inspector nor his lmplorer makrs 1ny w1rranry, uprened or implied. concern-for any personal injury or propenr Datt . ff- I' - 8 ~ ~~ ~
                                                                                ~!'~

ing the rep1ir or repl1eement described in this Repor,_ Funhennort, neither the Inspector nor his employer shall be liable in anr manner

                                                              ~T                                 aPiY kind arising from or connected with this lnsp~~ion.

Commiuionl N(1; 7t>CS****qer Pri,.,ncc.iLHtho,-.1 6 l)a._ 4: 3 8oAIGI

        *   *                                                   .                      (ln11>K1CW) n: s.,oolemeni.l ahMt-1 In form of 111.~. ,ketch*, or dr1wln111 rn*r be und o*ovld*d (I) tin h I~ In. X 11 '"**

r,forrnatlon In hern1 t through

  • Of'I thlt data noon 11 Included .on uch 1hNt, and (3) **ch 1hHt 11 nurnber*d wt>* r,umber of 11'1Nb 11 racord*d 11th* too of 1h11 forrn.
     .. ~                     .... :*   -                                                                                                                                       ATTACHMENT 2
                             '               FORM NIS-2 OWNER'S REPORT OF REPAIR OR REPLACEMENT As Required by the Prori1ion1 of ASME Code Se'1ion XI
   -1. Ownft    Virginia Pawer P.O. Box 26666 jAOOrnaj
2. r1ant Surcy Power Station P,&111111 P,O. Box 315 Surry, VA 23883
3. Work Performed by ..Y ...A r________
                                          ......._._Sie-......llJ
                                                              ....                                               38000            7 '1 SJ -b CN-i
                                                 '-Same 4.

5. ldentlfic1tion of Srnem ral Applic1blt Conrtn,ctlon Code B31-1

                                                                   ~rall 19 67 SJ'-c.   'b        J'"'_iY     ci ,(') /'

Ecfitlon, ....H __A.____ Addendl, Code Cases ___N__ A______ fb) Applic1bl1 Edition of Section XI Utilized for Repairs or Aeplactmtntl - 19..80. WBQ Addenda, Code C.set _.....N.._A.____ I. Identification of Compenenu Aep1irtd or Replaced. and Rcplactment Components Name of Name of Mfrs. Ser. -N1t'I. CAN Other Vear Rcp1i,.d, ASME~ Comoonent Mfr. No. 18d. No. ldentJ. Bunt Replaced. Stamped No. f"ic1tion or rYnorNoJ Replacement j .i>)Jf'

 /1 ";J~ 't 5         C""11~\
                           .2,.cl~'lr."q 62 o3bc?                       NIA-            !11/A         ) -j'
                                                                                                                          ;VIA          ff'p/orr r- t*(                   Alo
} fSi.,.J1             /-1,w,h..-.re                                        ~              l                                                 J;                             J.,;
                            )P*c.;:-.,1/h      Dho7~D                                                     tJ,                 ~           I i-"

I. CERTIFICATE OF COMPklANCE We certify th'1 the n1t1menu rnadt In this ,sport.*,. correct end this Crf Cjc eIv'\. U\ -J- conforms to Section XI of the

                                  ~                                                                                **PAlf o, 11~~

ASME Code. Signed ~- (. P.* or

                                                  ~

I De1ip-l ISI TIii

                                                                                                                     '4. t/

(DI *I

                                                                                                                                                 .,, rr CERTIFICATE OF INSPECTION I, the undrr1i9ned, holding I valid commission iuued by the National Board of Boiler and Pressurw Vessel lnspecton and tht Stat, o,Provinceof           VA.                                              ,emplo~bv             use* I&I co.                                                                         of Ha rt ford e CT
  • h1v1 inspected the ff' D q{' ""'- 'Co\; I jRcpJ11f1J o, ~~llcetNnl(II descri~ in this Report on f- (/ *19~

end nett lhat to tht bfn of rny ltnowlrdilt end belief, this rrpair or replacement hes ~en conni'Veild in 1cco,danct with Section XI of the ASME Code. By ai9ning this unificatc, neither the ln1c,tctor nor his lfmployer makrs 1ny w1rranty, u:prrned or implied, concern-

                                                     ~'.Bf').";

ing the rtp1ir or rrplKement described in this Report. Funhermore, neither the Inspector nor his employer shell br liable in tnr manner ki~ arising from or connKted with this lnip1 on. . _ for 1ny personal inh1ry or property 0111  !?-11-f?~ ~ d(IPIIPf<IClfl ..:~ Commiuions IAJ870o1 0ILtA.oYl lliotw: Supplemental ah"n In form of lln1, aketch*, o'r drewlnpi mey be UHCI provided (11 aln II I"' In. X 11 In.,

                                                                                                                                  .-     jSl*II DI l'rt,.,,,c:1. Nal   ..8o&7GI I lnformetlon In 1nm, 1 11\roue'I
  • on 1h11 Cine npon 11 Included on och ' " " '
  • enc, 131 ucll ' " " ' 11 numt>er*d 1'1* 111,mber of 111Mb 11 recorded u tll* 1op of it.la form.
   . -t'#-

ATTACHMENT 2 .

                                    \

FORM NIS-2 OWNER'S REPORT.OF REPAIR OR REPLACEME°N'f As Required by the .Prori1ion1 of ASME Code Section XI

  -1.      Ownff        Virginia Power P .0. Box 26666                                                                                             ShHt_.,.,,.~---of_ _ _ _ _ _ __
2. Plant Surry Power . Station p,.,.,.,

IMC)rna) O:AJ£ Unh-----.....:::~=----,------------ P.O. Box 315 Surry, YA 23883

3. Work Prrformtd by..;Yu8..u..,_._~

UJr---,--,-------

                                                      .............. CN-i 38DDD         7r ~1; S
                                        .         -..same
4. Identification of Synem IMO~ So(te.\.?: } 11)' c'. cj,O A~ . .
5. ral Applieablt ConstNctlon Code B31-1
  • 19 7 6
  • E~tion, l~A c
  • Addtnd1, Code Cases _ ......N A______

(bl Applic1bl1 Edition of Sec:tion XI Utilized for Re;:,1irs or Repl1e1m,nt1 - 19..80. WBQ Addtndt, Code Cam_._.N.._A._____

   .G. ldentifiution of Components Re;:,1irrd or Replaced. and Replacement Components Nam1of                  N1mt of               Mfrs. Ser.
  • N11'L CAN Oth1t Year Repaired. ASME Codi Comoontnt Mfr; No. Id. No. ldentJ. Bulh Repl~ Stamped No. f"ication .or cv .. or Nol Replacam,nt
 ~      '511-tJJ                                                            AJ/A-                     r-s'5-f p            N. If.                                                          /()-0 1

ff, f!f,lL' )J/A /-5"1:-ff !1/IA /VO

7. Description of Work_* _ _ _R...._.ef-'-l1__c.__ -e_-=G_,li):;._* . -~-J-=~- r_..'7_c_.*/\____..}.....t_C\l\.,_9_-<_ _ _ _ _ __

h:_+/-. .f'--. 0 /__ I. Tens Conducted: . Hydronatic Oi::i' ll'neum1tic O Nominal Operating Prnsurw Ql Other 0 I. R1mark.s ________ ,re_s_su_re__~--=----P-*I__T_*_11_T_e_m_p._(#_~_1"' __*_,___..J_f;_~"-J....,_,.... D_=ll'>......-(:_5...,.Y,.........-_J.__ 1_'-/_J'__/ _____________

                                                                                                                                                                       } __

(Applic.&DII ~11Ulacluret"1 Data A.:,on110 b u t t ~ 'Jfe;._)./..,~ 0 'P-.SS - J_ JJj_'f~

 --===============:..:..=========== .                                       CERTIFICATE OF COMPI..IANCE
~~~~/1 nat;n~u

('~pkce,,_,,ec, made In this rcpon ar, correct and this _ _ __t'-,pa;t""+._.,.°'.1.:'*""1>1a~ce"".,... J f 1i11-IIQ.__ _ con orms to Section XI of the. Signed "4/-L (Ow,,.. 0t Ow~ 44<<!/ 119,_I . rsr Te=1; .. 7

                                                                                                                    &~

iDl**I 12- *" n CERTIFICATE OF INSPECTION I, 1he undersigned, holding I v1lid commission issued by the National Board of Boiler and Preuurw Vessel Inspectors and the St1t1 or Province of_ _.V....A......________ , employed by HSB" I&I ca. of Ha rt ford. CT I hive in1Pt1:ted the -fff he.~~ "t- dtscribed in this Report on g'-/S:: , 19.8..1 IRepa,rts)o, Re~l1etmenl(SI

  • and 11111 that 10 tht btit of my knowledge and belief, this' repair or replacement has been connrueted in accordance with Section XI of the ASME Codt. By 1i11nin11 this ctnific.att, neither the Inspector nor his lmployer makrs *any warranty, uprrned or implied, concern-ing the repair or repl.teement de1cribed in this Repon. Funhermore, neither the Inspector nor his employer 1h1II be liable in any manner for any personal injury or propcnr ~o~ ofriy Jc1nd 1ri~ing from or conne,;ted with this lnsp*v:*

Om 8'-(£- ~'1 ~(ln1i;,e,e10I) ~ ~ Commiuions /J/J 76() j t.l. S-1.f 3

S11ppl1m1nul thNn In form of Jin~. 1ke1ch*, or Clrawlnpa may be uaed provided (ti 1IH h l:K In. X 11 In..

C51a11 o, "'1:,,,,nce. Na1.:,na1 IO&JGI nfor".nallon In l'l'lml 1 lhrougtl 4 on thl1 Cllle IIPOrt II lncludad on ..ch 1hNI, end (3J HCII 1hNt 11 n11mbered s:h* 1111rnbar of ll>Nb 11 recorel*d at Iha IOP of thl1 for,n.

                                  .... :* .                                                                                                                                       ATTACHMENT 2
                                  \

FORM N1S*2 OWNER'S REPORT OF REPAIR OR REPLACEMENT As Required by the Pro,isions of ASME Code Section XI

        ...1. Owner    Virginia Power                                                                                         D,w. _____       ~....._~. .~
                                                                                                                                            '.8:/___          . . .~~~~

P.O. Box 26666 Sh~---------Of______________~

                                                                    ~rnaj
2. P11nt Surcy Power Station ()* Ip Unh ______~r~v';__-----------------------------
                                                     .... ~          '

e.. 0 Boxls 3 Surry, YA 23883

3. Work Performed t,y_.V..,A.......,_.~.-.. ......t'~=---,-------

p,,-, 38000 71 b c./ J

                                                 ""same
          ~-

5. Identification of Synem laJ Applicable Construction Codr 831-1 IAOOIWI 19 S1ft lz ffi, e c-iftiJ\. 67 EditkN(.._l~::..A,__ _ _ Addendl, Code Casts _ _.NA ______ (b) Applicable Edition of Section XI Utilized for Aep1i11 or Atplae1rn1nta - 11...BO. wan Addtrda, Code Cases_...Ni..A._______ I. Identification of ComPOnenu AepairTd or Aepl,c.d, and AeplaC"tment Compon1n11 Name of N,meof Mfn.Ser. -N111. CAN . Other v,., Aep1il'9d. ASME Code Conloonent Mfr. No. Id. No. ldtntl- i,llh Aepltctd, Stamped No. f"ication Aeplace ment (Yn or Not

        ~;J.,_ t:        tl~w"'":f
                                <.Ot<1.. \ti    Ob/1~'72                  .N/.A- NIA                 t--s > -P-1!!,

IllIA R,..j) /4.C ec!i _;f/n

                          .tlew!....,I.V'~ '                                                        l-5> ~fri/5,,
       %$~Jj                  <:n~rh>lh J~~                2~/       1111/t- JJl/t                                    /VIA-                (<~J>kct2)                  /{)o 1.

'l Sitned

                          ,~,   W-k~4/

CERTIFICATE OF COMPLIANCE

         =~~~~11 "7'~'t / ~ Ithisnrepon 1r1 correct and thls ___f'._.q..,1-;'-'~-;--~--e,....__-.-,.;.;;p1a'-______

rsr 46 '"

                                                                                                                                     -~-*
                                                                                                                                                  .11 conforms to Section XI of the n
                             ,o..-aro-.r1De1,v                                               TIii              '  ltle**I CERTIFICATE OF INSPECTION I. the undersigned, holding          I  valid commiuion iuutd by the National Board of Boiler and Pres1u19 Vessel Inspectors and the Stall oc Province of        VA,                                          *employed bv USB" I &I CO.                                                                                  of Ha rt ford , CT.                have inspe-cttd the r ef/1 (, ~ !(\ \

JRt p ,1111 o, ~u11cemenl(1I descri~ in this Aepott on 8- A£ . ,1.!.l and 11111 that to the belt of my knowl*d;* and belief, 1his repeir or replacement h11 been connrvcted In 1ccord1nce with Section XI of the ASME Code. By sipning this certifiute, neither the Inspector nor his ,mployer makei any w1rr1nty, 11:pre11td or implied, conctrfto int the r,p1ir or r,plecement described in this Report; Furthennore, neither the Inspector nor his employer 1hall be liable in any manner for any per~na~injury or property d a ~ s of 1 ~ 1 i n 9 from or conne-cttd with this ln1P1C1i°1'"/ _ D11e f /..\ - 8'( ~i, ~ Cornmiuion1 /J(J J lJ6 9 V~ $ tf3 pn1~10') *

  ** lllore: .S11pplemen111I ah"n In form of 11111, 1lie1ch*, or dr1wln111 mar be UHd provided CU 1111 h IX In. X 11 In.,

151111 a, Pri,,,,nc1. N11oon111 eo.'111

U lnformetlon In 119rn1 1 lluoufh , on thl1 data r*Port 11 lftcluded on Heh ahNt, ancs 131 eacll thNt It numbered d 1'\e number of tllMta 11 recorded at th* IOP of thlt foun,
                                   .... :* .                                                                                                                                           ATTACHMENT 2
                                   '           FORM NIS-2 OWNER'S REPORT OF REPAIR OR. REPLACEMENT Ai. Required by the Prorisiont of ASME Code Section XI
    ..,.      Ownll'. Virginia Power                                                                                                            ~/7/g-q 01tl~-----------------~-

P .0. Box 26666 ~.-t-----------Ot ___......________ jAOClreuj Surry Power Station ()/1.)1.;-' ri,nt P.O. Box 315 Surry, VA 23883

                                                     ~ ......                                              Unh---------------------------------
3. Work P1rf ormed t,y...JVu.A............Se
                                                     .........111.....r__,__. ,. . .________

(H_,

                                                  ..Same
4. ldentlficttion of Srn,m Cal Applic1bl1 ConatNctlon Code IAOOl'lall 831-1 sff'vic 19 67
f. LJo.,Ie .r U.,.A.,________ Addendl, Code Cases __N._A..____

Edition,.... 5.

            *Jb) Applic1bl1 Edition of S1e1ion XI Utilized for Ac;,1i" or Aeplac1m1nt1 - 11..80.                                        wan         Addtndt, Code C.stt..-..N...        A.______

I. Identification of Com~ncnts Ac;,1ind or Replaced. ind Aepl1e11ment Components Name of N1mt of Mfrs. Ser. *Ntt1. CRN Other v,.,. R11P11ired, ASME Codi ColllOOntllt Mfr. No. Id. No. ldentJ. Bulh RepllCtd, St1mc,ed No. fic:1tion or IY11 o,Nol Repl1cemen1

 - ul1\ \J -t Uf,I"""                           L/00L/7J1>b                   ;(//Ir         Wik         (-S '-' -JJ:!   #;4                   K~l~c_,r{                   /VD tl I.\~                                                                                                                   I t/..,__iiJ e                 'J.,vC         YooSi.i5'D~                                       )                                                    1                            I e2: , f *"'P -e 1

Hvtll},A),., C.

  • 3?8'5'/FO I
                        \.\...,\.\/,/<"-I.
    "st..*nl~                 SO e. ...,.JheJ   3~j')S/
                                                                                                ~                                                  \J                             ~~
                                'iJC1.,1s.\b ()}o I Cf1 3
                        ~.,._JV"'(,
  fl
    * -tx ,.tJ-,,ti                                                                ~I                                         \\.,

7* I. CERTIFICATE OF COMPLIANCE repor, 1111 corrtet 1nd this c~./lt C ~ i;\_ y conforms to Section XI of w t*PM OI rtp&ace<Mftll CERTIFICATE OF INSPECTION I, the under1i9ned, holding I valid commission iuued by the National Board of Boiler 1nd Prnsuiw Vtsstl Inspectors and 1h1 State o, Provinct0f VA, , employed by HSB" I& I CO, of Hartford. CT I h1v1 inse>t<Utd the r('.~ /1 C. ~,(/\,;- IRcpa\~11 o, ~:,11ceme"lfSI dtmi~ in this Acpot1 on $- I~ . ,, B~ and n,tr that 10 the ben of my ltnowl,~t ind belief, this repair or repl8cement h111 beefl connrvc1ed in 1cc:ord1n~ with Section XI of 1ht ASME Co'*. Sy ripning this cenific.ne, neither the ln1ptctor nor his t!mployer m1b11ny w1rr1nty, up"ued or implied. concern-for 1ny personal D111 Q. . /~ g? or propcrtr de~? ing the rtp1ir or replacement drscrib*d in this Report. Furthermore, neither the Inspector nor his cmplorer 1h11l be liable in 1ny manner i~:ry

                                                           ~~ ~
                                                                                          , ~ s i n g from or connect~!: this lnsPtction.

Commiuion1 /JjJz.1tJo<f 1/a,_,.f"':{3 flnll)Klot) 1\/otw: Suppl*m*ntal ,h .. n In form of lln1, *~**ch*, or drewln1,11 mar be und p,ovld*d (1) 1IH h IX In. X 11 II\.,

                                                                                                                                              &51111 o, Pn,,,,nc:1. N11,on1t l!lo&rdl 2J   lflformadon In lftlftl 1 rhrovfh , Oft thle data r*por, 11 Included on Heh 1hNt. ana (31 uch 1hHt 11 nurnt>er*d If\* 11umbar of 1PIMt!I 11 Hcord*d at th* rop of 1h11 form.
    * - ;-6,-                                    .... : . -                                                                                                                                      ATTACHMENT 2
                                                                       ,~~      ...
                                                                                                                                                                                                ;). c(}
                                                 '            FORM NIS-2 OWNER'S REPORT OF REPAIR OR REPLACEMENT AJ Required by the P10Yision1 of ASME Code Section XI
 ...1.            Own!!:              Vi rgi ni a Power P.O. Box 26666                                                                                                ShNt_..........___ _ _ of_ ___._ _ _ __

i,.Dc!rnal

2. r1ant Surcy Power Station IN.,.,..

Unh~______.,()++-fl,/._J;::._-:-_ _____~ ~ - - - - - - - - ~ P.O. Box 315 Surry, VA 23883

3. . Work Perlormtd by__;VuA...1.41_._........

rooore&1J w....e...r________ (Name) _ 3800D I I 8"7 l _,same

4. Identification of Syn em V.OOrall ~~ J" "i'cc-./,.i .I\
5. la) Applic1blt Construction Code 831-1 19 67 Edition, ....n"'-A'--___ Addenda, Code Cases _..;..N__ A______

lb} Applicable Edition of See1ion XI Utilized for Repain or ReplactmtnU - 19..8.0, WSQ Addtnda, Codt C.IH-J.JN..,A____

s. Identification of Comp0ncnts Rep1il"fd or Replaced, ind Replacement Components N1m1of NerM of Mfn. S1r. -Nat'L CAN Other Year Repaired, ASME Codi Comoontnt Mfr. No. Bd. No. ldentl- Built AepllCtd, Stamped No. f"ic:ation or IY11 or Nol Repl1c:emtnt
                                               ,,~I                                                                     /-& I,.)* f-t./t-
                                                }.,__-l;\,,.,  41 V-J t, 1.so                                     It                                                                 ~(;?

i:} ;'),;,s '-/Jl ~ lrfro CERTIFICATE OF COMPLIAf'jCE We etrtify that the nattmenu made In this report 1r1 correct ind this ASME Code. r-eJ)/ctcf.,,,-e--'L te~or repiac.ttnellQ f- conforms to Section XI of the S i 9 n ~ - - - - - - - - - = - - - - - - - - - - ~ ~ - - - - - = - - - - - - , - - - - , ,t _ __ p.,,... or O-ner1 D2sog,,..l Tl!!: (Dl1e1 CERTIFICATE OF INSPECTION I, Iha undersigned, holding I valid commission iuurd by the National Board of Boiler 1nd Preuurw Vessel lnSl)Ktors tnd the Sratl o, Prov inn of_ _.V. .A

                                              .......________ , emplore<! by HS[3" I& I CO.                                                                                                             of
 .......H...a. .r_,t
                 . . .f...,o....r...d_,_c'-"T.J*.___h1ve inspected the I rj))({c-e,,.,-....~ \ described in this Repon on fRtpl,r1s1 o, ~* ;,taetme "l(s!l    .
                                                                                                                                                                                    !-16            ,19.U and 11111 that 10 the bt1.t of mr knowledge and belief, this repair or replacement h11 been connruc1ed in 1ec:ord1nct with Section XI of 1hr ASME Codr. Br signin9 this certificate, neither the Inspector nor his i!mployer makrs anr warranty, upreueci or implied, *concern-ing the repair or repl.teemen1 described in this Report. Furthermore, neither the Inspector nor his employer 1h1II be liable in any manner for 1ny per~n1I :jury or property d ~ o ~ _ Y                                                            :1d     arising from or connectrd with this lnsi>tctiO, 0111                   fts R9                                        ~~                                                    Commiuionl              µv21109Ya..(ll5 flnsc,e;:1c.,
Supplomantal ahou-. In form of ll*u, *~*1th*, or drawlnpo mar be u**d provided (I) 1ln h I~ In. X 11 In.,

(51111 or Pri,.u,e1. Nal~ llo,a'1II nformnlon In lnma 1 through 4 on thl1 dn* roper, 11 lt\clud*d on each ahHt, and (31 aach ahHt I* numbered lt'o* number of ahHb 11 recorded 11 the top of ml, form,

  .. - :-#'                                                                                                                                                                                            ATTACHMENT 2
                               . *...                                          ,,~ ...
                                                                                                                                                                                                                  /of~
                                              \

FORM NIS-2 OWNER'S REPORT OF REPAIR OR REPLACEMENT AJ Required by the Prori1ion1 of ASME Cod, Section XI

   --,.              Ownff            Virginia Power P .0. Box 26666                                                                                                  ShHt---~---Of~--------
                                                                                        "'°°rna)
2. ,1,nt Surry Power Station IN.,...

Unlt~~--,.:;()_;..;J"-'/;'-.::~~~~~~~~~~~~ P.O. Box 315 Surry, VA 23883

3. Work Periormtd by_V....A ........~t~--------
                                                         . . . . . __._~                                                            . 38000 ?7R"7C
                                                                   .                   <N->                                         Repair ~1n1Ulion ,.,0 No.. Joo Na. llC.
                                                .                   '"Same
4. Identification of Synem IAOC!rull ** S'.J'e+ Ln ,
                                                                                                                                     '1            e(L'l'i I\,
5. ft) Applicable Construction Code B31- 1 19 76 Ecfition.~H=fi:~-*_._ _ _ Addenda, Code Cases --"N"-A'-----

(bl Applicable Edition of Se~ion XI Utilized for Rep1ir1 or Repl1e1m1nt1 - 19..BO, wsa Addtnd1, Code C:.m ........ N....A.____

s. Identification of ComPonenu Repai~d or Replaced. and Replacement* Components Namaof Namt of Mfrs. Ser. ,N11t'L CAN Othff Year Repairad, ASME Codi Co"'oon,nt Mfr. No. Bd. No. ldentJ. Built Replec.d, StatnPN No. rec,tion or (Yn or Nol Fi,pl1c::ement
                                                                                                                           ).;.._tt~f-1.A D

CERTIFICATE OF COMPLIANCE ['f'(. f"fC.e,-..'-, ASME Codt. Signed

                                        */1 We certify that the n1ttmenu midi In this report are correct and this W.- ~
                                                     ~                ~

4./ ISI 4t1, cL-

                                                                                                                                                         }: .

tpa,,o,,1p11Clffllfdlll conforms to Section XI of tht to-- CII 0.,nar"I °"'91 T=l: (C&l*I CERTIFICATE OF INSPECTION I, tht undersigned, holding I v1lid commission issued by the National Board of Boiler and. Prenurw Venel lnspec1ors and the State o, Province of_~Y~A~,..__ _ _ _ _ _ _ , employed bv HSB' I &I CO. of _.._.H....a. .r....,t.._f...,ooL.L.r.wd-a,__,,Culw,.___have inspe,c;ied the V' Pp/qc~ ...,_ 1 IR*pdtjs) o, ~*;,l1taman1fa8 dt1cribed in this Report on

                                                                                                                                                                                              'F-(,'>.,gfl ind nete th;1 10 lht but of my knowlrdQt and belief, this repair or replacement has been connructed in accordance with Section XI of the ASME Code. Br 1ipnin11 this c:'ertific.a1t,.nei1her the Inspector nor his tfmployer m1kr1 any warranty, upreued or implied, concer~

ing tht repair or repl1etmen1 described in this Rtport. Furthermore, neither tht Inspector nor his employer shall be liable in any manner for any ~r1on1I injury or property dt1JY~~}Jofa~i1in11 from or connected with this ln1;p1cti,ny D111 g>-15-<?~ ~ ~ Commiuiona A.)(}J/Joq *!LQ S°l/3

                                                                                             .flnsPN:100, Suppl1m1n1.al ah"n In form of IIID, 1k11ch .. , 01 drawln1,11 mey be u**d provided (II 1111 h II~ In. X 11 In.,
                                                                                                                                                       ~          (S1a11 o, Pn>w*ncl. Na1,c,na1 8o&1GI formnlon In lnrn1 1 through 4 011 thl1 dnt roi:,on 11 Included on **ch 1hNt, and (31 tech ihHt 11 11umber1d
  • number of 1hNtl 11 recorded et the tOP of this farm.
  . :-,.                   ..** :*    -                                                                                                                                        ATTACHMENT 2
                           \

FORM NIS-2 OWNER'S REPORT OF REPAIR OR REPLACEMENT AJ Required bv the Prori1ion1 of ASME Cod, Section XI Ownrr Virginia Power P .0. Box 26666 ShHt-----~--Of~~----~-- IM(lrn&j Un~~~~C)..::*.:..;A}~).;::;;.~~~~~~~~~------~

2. P11nt Surry Power Station ,. ......

3. P,O, Box 315 Surry. VA 23883 Work Performed t,y...,V...A.,_.__ =. . .

                                               '"Same r________

Nl cw-i 38000 b q ). b J

   **5. ldentlficttion of Srnem                             &AO!tall                  R c.Jo
                                                                                             -e_ 9,      ,r        C.(!jo }y +

lat Applic1blt ConstNctlon Code 831-1 19 67 Editlon,..:.l~a:.A.,__ _ _ _ Addendl, Code Cam _ ..... N...A.____ (bl Applic1bla Edition of Section XI Utiliztd for Repairs or Fleplac:tmtntl - 11..80. wan Addenda, Codt ea....... N...A._____

s. lden1ifiu1ion of Coms:>onenu Flepti~d or Replaced. and Repl1ctmen1 Components N1m9 of Comoonent Nam, of Mir.

Mfrs.Ser. No.

                                                                     -N1t'L Bd.

No. CAN No. O,htr ldentl-f"ication

                                                                                                                          ,.,~

Year Repail'ltd, Replactd, 0, ASME Codi Stamped CYftor Nol R1pl1e1rntn1 Jl<511AD.S 1t1~*...w~ S.ot><-11:.ltv J7:rO. tl ;J/A A), A J,j,((-JV-ISSl 8 Jv/Jt {ze}J4cecA

                                                                                                                                             .                         >>o l II s Tv.i).S      ~l~j S-16t-tM             37'f8 l      ~l                             I              *'
                     /rf b J}f Nl.lT5             J:_,..~e,;\.9         O}D3oll 0
~'* STU0.5           He.-J~J~ ecj) 1"1        37StiL/l                    >.J           \
                                                                                                         "                  J                 \J
  ,. Dncription of Work                         C)vif' ~ I U,JJ f;'.

4, I. Tem Conducted: Hydronatic (B-'" Pneumatic O Nominal Operating Pres111rt O Other 0 R,marlts Pressurl! J:-33 s psi Ten Temp.~. F J '3f ' sr1.1 D5 Po 'ii ~rl - J'{5 ~ g

  **               ~iutllt~"UIKIUfet"IDala.-.:ion110tunac"9CI                                               L" Si\.l t).S Po :Ii (5 Y-117 03 0
                  % '* .s 'f\,1-(.S.S Po~cs.i?..: /J.3 t/7J i                                            .JJ/r !VuT Po~ CSY-17'8' .s J t

CERTIFICATE OF COMPLIANCE

 =~~~/.1 nat/knu                              midi ln this report art correct and thls_.......              ,_e_f.,-.--!-l--~"'"~-.1Ma'""qv,._~-f-----=nform1 to Section XI of thl Si11 ftld      ¥i.J: L~AL'
                '      IC)w""  or                  *'0-1 JSJ TIii duG, //
                                                                                                               'iti-1*J
                                                                                                                                                 .,, 85'.

CERTIFICATE OF INSPECTION I. the undersigned. holdi119 1 v1lid commission iu11fd br the National 801rd of Boiler and ,rnsurt Vt11tl lnspec1ora and tht State

 °' Provine, of         VA.                                           *e0ployed bv              usa* 1&1 co.                                                                            of Hartford* CT.                       h1v1      insptc:ttd the     reA Di£ Q..,,\4 T IA'~p1,,f1) o, ~:i11c1menl(1I dmribtd in this          Rtpo,1 on                          £-/s:,          t9n and    11111 1h11 to the bfn of my knowl,diie 1nd btlid, this repair or repl11cem1tnt has been connrvcted In 1cC01d1nce with Section XI of 1ht ASME Codt. Sy sipning this nnificltt, neither the Inspector nor his lmplorer makti any wtrranty, up,,ned or implied. concerfto int tht repair or replaeement described in this Report. F11nhennort, neither tht Inspector nor his employer shall be liable in anr rnanntr for 1ny per1on1I ~jury or propeny d~~ ~,rilin11 from or connected with this lniptct,O?- _

C11t ~ - / ~ - [i' 9 ~ J (ln1po,c1011 . *~ Commiuions IJ(j 7tJ() f f& ,!, 4 ) Nona: Suppl1mantal 1h .. n In form of 11111. *ketch*. or drawings rner be u .. d piovld*CI (ti *In h IM In. X 11 If\., 1S**1t or f'Ti>,,,nc,. N11,on119o&n11 2J lnforrne1lon In 1'9rna t througl\

  • on 1h11 Cine report 11 lncl.,ded on ..,,_ 1hNt. end Ill **ch'""' 11 n .. mt>e**d d 1'\* 11umt,er of 111Mb 11 record*d *t the toP of thl1 forll\o
        . - t'I'                       .... : . -

ATTACHMENT 2

                                       '           FORM N1S*2 OWNER'S REPORT OF REPAIR OR REPLACEMENT AJ Required by the Pro,i1ion1 of ASME Cod, Section XI Owner:   Virginia Pmrec P.O. Box 26666                                                                                                  ShHt--------Of~--------
                                                                      &AOCtftll                                                              J,. J ,:;
2. "'"' Surry Power Station ,.,.,,... un1t _ _ _ _...,C2~::../=V.k ....- - - - - - - - - - - - -

P.O. Box 315 Surry, YA 23883

3. Work Periorm~ br YA I Set! --~s:i...n b'--l_°l_l_1__________
                                                                                                                          ....n....n.__....

CH~ "-pair ~1112.11i0n l'.O No.. JoO Ho~ lie.

                                                       ..Same
        '*5. Identification ofSrnem ,

Ca) Applic1blt ConstNctlon Code 831-1

                                                                    "'°°....,          19 67 R JoeA.G I' ( Oo / Cl/\

Edition, HA t Addenda, Code Cate, ___N"""A_____ (b) Applic1bl1 Edition of Section XI Utilized for Re91i11 or Aeplac1m1nta - 19..BD, WRQ Addenda, Code C.Stt __..N.._.A..____ I. Identification of ComPOnents RtP1ind or Replaced, end Repl1ttment Components N1rnt of Name of Mfrs. Ser. . Net'L CAN Other Year Repaired,, ASME Code Co"'OOnont Mfr. No. Id. No. ldentJ. Burtt Replle9d, Stamped No. rec,tion Of (Yn or Nol Repl1auntnt JYfS)4{Y, l\"-><l "'"'1 5Pl'c~ ll'7 ~?.rt~s, I JJIA ;J))t /-1(..C.~JV-IJSJ<.. JJ/A Realu-ed *;Lio s..J.,., J'"..S,uf\S 5....6~.l J7i1 l l) I

                            /-lo,..lwo.r{
     ~"s ,uD5                     5net:->, \1., 3'J5 t.bq I Jr ' .111 it\\        't{C,,

c~*:\.eui',,. Q). o ~Oil D ~) ~ '\J' . ,:..- ~./

       ,.                                                   Ov~.cJo.~l U°" u e.
q. Er s~ti Description of W0tlr I. Tffll Conduc,l'd: Hydrostatic Pneumatic Operatin11 Prn1u,. 0 Olhtr Q I. AtrNtks
                                                 '".."~ ).::n_ psi Ten Temp. I lr*,rs. r\,\ *"\U 5 [D0 ~s Iv' - I_<.,02.                                    J~"g'1
                    /r.                    ,li\aAUIKluret'I DIIA "ep0n1 10 ti. I I ~                          () ;ti           \;                   "'I         I  'l / J,    J - p "#            d I ~Nos lo"'CSY-1120Jti..... ; t Yy *51'1,d)5 ro CS,-1). 3\./7-5;' 't
                          ~icAl)lf 1

A 1Vll\ 0 (57-1?8'$)-, CERTIFICATE OF COMPLIANCE ASME Code. si11Md

  • n~I-~~

We certify th,t the n1temcnu midi In this report ~re correct and this to-- a, Ow11er1 t>e1

                                                       ~
                                                             ,    I rsr TIii r--eP /o. C ~ ~ i I t*pa,, °' 11p1acemenQ 4Gi a
                                                                                                                     ~111
                                                                                                                                                               ."n conforms to Section XI of the CERTIFICATE OF INSPECTION I, lht undersigned, holding I v11id commission i11ul'd by the National Board of Boiler and Prnsurw Veuel ln19Ktors and lhl S11t1 o,    Provinceof          VA,                                         , employed t,v HS8' I &I CO,                                                                                      of Ha rt ford, CT,                          have inU,Kltd th,         t"'f )"I.e.  'i!.."  el\,--t fA~ a,lfsl o, f;:,11cemcnl(1I ducri~ in this Report on                                        '!-1,r ,t9..8.1 ind n1te 1h11 to 11'11 btn of my knowledge and belief, this rep1ir or replacement h11 been connrvcttd In 1ccord1n~ with Section XI of tht ASME Code. By signing this c:ertific.att, neither the Inspector nor his lmployer m1kr1 any warranty, u:pttned or implied. concern-ing the rep1ir or rrpl,cement describtd in this Report. Funhermore, neither tht Jnipector nor hi1 employer 1h11J ~ li1blt in any manner for 1ny Ptrao~injury or property d ~ ~ f ~ i s i n t from or conne<:ted wonth this fnsp1C1}on.

Datt f-r~ 8 9 ~ ~ Commiuions J){? ZOC) ~ £/4.- 5H 3 (lnsPO<lot)

  • Ilion: 5.,pplem*ntal 1h"t1 In form of Ilia, 1ke1ch*, or dr1wln1,11 nuy be uuc! provided 1111111 h I~ 11'1. X 11 II\.,

jSllle a, Pn,,,,nce. Nahct\119oazGI J lnform1don In 1nm, 1 1hro"fh , on thl1 c!n1 nPor, 11 lncl .. dec! 011 uch '""'* end (31 Heh'""' Is n.,mt,e,ed

           .,.. n11n,t.r of st.Nb 11 ucord*c! 11th* toP of 1h11 form.                                                                            *
                             .... :* -                                                                                                                                               ATTACHMENT 2
                             '           FORM NIS-2 OWNER'S REPORT OF REPAIR OR REPLACEMENT As Required by the Prorisions of ASME Cod, Section XI
*1.       Ownll'. Vi rgi ni a Pawer P.O. Box 26666 IAOO*IINI
2. ,,an, Surry Power Station CH~

P.O. Box 315 Surry, VA 23883

3. Work f'trlormtd by_.V...A.J,. &.,-~"'"'
                                                    ...r________

IN~ 38000 b/q 1 S

                               .            -.Same
 **s. Identification ofSrn*m Cal Applicable ConstNctlon Code B31-1 P-oOrual 19 67 R   e1,e..ia C       CO()

Editlon,_U....

                                                                                                                     }q n      t-A.____ Addcndl, Code Casrs __N__A______

fbl Applicable Edition of Section XI Utilized for Rr;,1in or Replacamanu - Ill.BO. WRQ Addenda, Code Cam_..N....A.._____ I. Identification of ComPOntnts Rrpai~d or Replac.d, and Rci,l1c:ement Components N1mtof Name of Mfn. Ser.

  • N1t'L CAN Other Year Rep1irod. ASME todt Cc"'OOllini Mfr. No. Bd. No. ldcntJ. Bunt RepllCfd. Stamped No. f"ication or fY11 or Nol Repl1ca1111nt
                     *Ho,.,.IWCN.                                                            )-J.1.(-J V-
}}f5Tul)~                5nec.;-.. It., 37if),tl              Jv/A              ;J/A            1ss1A             /VIA                            -R -e/J JCt.u A              ND J;;514D.£                  '1J          375~ l1 J                 I                1             \                    \                             '1                          1
                                                                  ~                \J,                                                                ~
~" ,,J"'-T.S        IM.,l:.

J;.M}11.e~

                                    ~1... OJ.o1 OIi 0                                            \J
7. Description of Work O uer- ~'ii,\ } l1 Jue_

I. Tem Conducted: Hydronatic u;y- rneumatic O Nominal Operatin11 Prn1111'9 0 Other 0 I. Atmarks _ _ _ _,_re_*su_.......,d.,....3-3::-S-ps_l_T_,._,_Te_m_p__:s_'-/_7_*F_...;.J_~-=-'J7.-*"_s_T_u...::;Oc..;s;;.._~P_o_ii-___ (...;;..S_Y_-_N.._S__._1_P'__ IAPPfc.ablt Ma11Utac1ur..-1 Oaui ,-.=-* to toe ~ 3Y 5 Jvt :/)J pO~ CS y - j). J 4 7 J 11 Jl1- ;11w.T Po;jt cs i - J7J7S I 't

                     f;J'2/

CERTIFICATE OF COMPLIANCE

=~~":::."                                       In lhb "Pon'" '°"Kl ood thh_-~..._r_t._f                    fF-.:..1;.;~...;~~,....::~.:.0......,t

____ conforms to Sec:tion XI of Ille Si11Nd ~.~ rT~~ ll)i,,., 11 .,, n CERTIFICATE OF INSPECTION I. lht undersigned, holdiftll I valid commission iuu..:S by the National Board of Boiler and Prt1s11~ Vessel lnspectol'1 end the $1111 or rrovinc1 of VA, , emplor..:S bv HSB" I IH CO. of Hartford, CT. have inu,tmdthe reOlitciiM.?\,t IRts:/a,lfsl o, ~~1,c,rnenl(tl dtsc:ri~in this RtPol'tOft  !?-IS:, ,,fl and llatl 1h11 to tht bHt of my knowlr"9t !nd belief, this repiir or replacement h11 been connructed In 1cc:ordance with Section XI of thl ASME Codt. Br 1i9ni"9 this cenifiatt, neither the Inspector nor his lmployer makes 1ny warranty, uprrned or implied, conctrft-int the repair or repl1eement drscribtd in this Repon. Funhermore, neither the Inspector nor his emplorer shall be liable in 1nr manner for any personal injury or prosanr d ~ ~ * "~ kind arising from or connect..:S whh this lnsp~iOII._....

  • Datt <J--rS-19 ~J.. ~ Commiuions NO ?bo? .s e< '-13 ll"IPl<IOf'I Non: S11ppl*m*ntal ,11 .. n In form of 11111, 1ke1ch*, or drawlnps mar be uo*d provided 1111ln h I!~ In. X 11 lft.,

(Stall Of ~*"Ct,"'""""' llo&nll Information In "'""' 1 througtl , on 1h11 date repor, la lnch,d*d on ..ch ahNt, end 13) uch 1hNt l1 nwmber*d

     .,.. nwmbar of ahMb I* recorded *t th* top of thla forlft.
        *-~                           .*** :* -                                                                                                                            ATTACHMENT 2
                                      '          FORM NIS-2 OWNER'S REPORT OF REPAIR OR REPLACEMENT As Required by the Prori1ion1 of ASME Cod, Section XI
      ...,. Owntr       Vi rgi oia Power                                                                                               <;?/!;)f1 01t1 ______________________________

P.O. Box 26666 Shfft_........._____ of_____.________ jAOOrn&j

2. ,,,11, Surry Power Station ,.~

P.O. Box 315 Surry. VA 23883

3. Work Performed t,y_.V. .A ....."'":"-~--Ul...r---c=---,---------

(N-, 3aaaa 7F' IS 7

                                                      '5ame
4. Identification of Srnem lal Applicabl, Constn,ctlon Codt B31-l IMO~ Rf'.o.19 67*fa " (
                                                                                 ~

e, IOc:, {&v\ t Edition,,~U"'"A.,___ _ _ _ Addenda, Code Cam ___N__ A______ 5. lb) Applic1bl1 Edition of S1e1ion XI Utilized for Re;,1irs or Aeplac,m,nu - 19..80, wan Addenda, Codt Caset ........ H.A._ I. Identification of Compc,nenu Rel)airtd or Replaced, and Repl1t<ement Components Ntmeof N,mt of Mfra. Ser. -Ntt'l CRN Other Veer Rep1i,.d,, ASME Code Co"'OOMl\t Mfr. No. Bd. No. ldentJ. Built Replactd, Stamped No. fic1tion or NnorNol Replacement 1-j<.,(.- FG AIU15 tlt-,l_~ S°""/1" 01. D /Cf 1'! 0 0

                                                                         ;ti/A- /J//r                       )'If')... JJJA          ILep}~c fo1                  J)o 1-1 c,.J:                                                                t~P.c-r~

ST'-lD ~ JJ/A /VIA JJ/A Q;.oJ.u:eA

                                      ""~,t.

5,DfL~">\1,_ 37in--~1 H,-2.. A/D

       ,.    ~ription of Work                           QPD1ctL4>- ~/~;i.; Gcislc\

I. Tms Conduc,ed: H dron11fe ~ Pneum1tic 0 Nomi* I Oi,era1in Prn111'9 0 Other 0 CERTIFICATE OF CO~/LIANCE We c1nify 1ha1 thr n1temr11u mMM In this repor, ar, correct and this llpL&c&~I conform, to Section XI of Ult ASME ~ - dafi t1pa,,or1ap,ac.-nQ Si11ntdSk/ ~~~ to,,""' or ra 0.1,p,_J ISi TIii *l {2 , 11 rf CERTIFICATE OF INSPECTION I. lht undrrsigned, holding a valid commission iuued by 1hc National Board of Boller incl Prruuf9 Vessel lnq,ec1on and tht Stitt Ol Provinceof VA. . empjoyed bv usn* I& I co. of Hartford. CT. havr inu,emd tht r:rflo.t-v....vi t-IRt **'11Jo, ~:,lectff\Cftl{II ducribed in this Repor1 on S'-17 . ,s.:ff and natr that 10 thr btn of my ltnowl,dgt and belief, this rep1ir or rG1placemtnt has bun connn,cttd in 1ccord,nce with Section XI of iht ASME Code. By 1i1,1ning this cenifiutt, neither 1he ln1pector nor his ,mployer makes any w11ranty, ellprened or implied. concerfto d*7';9'!"'?' ing the repair or replacement dHcribed in this Repor,. Funhermore, neither tht Inspector nor hi, 1mployer shall be li,ble in any manner for any per1on1I injury or propcr,y of '"::::i~6A:~in11 from or connected with this Jna,tction. ~ / 0111 $' .. / ] - l( 7 ~~ /. ~~ Commiuionl {)J(JjSlllt 0 1 V g I S:'f 3

                                                                                                                                        ] " l'ti,.o,,cf.

fl"IPKIOI) Non: Supplemeni.l eh"t'I In form of lhu. 1k11ch*. or dr1wln1,11 m*r b<e 1n*d provided CO 1IH h IX In. X 11 In., Cit N11....,.1 aoerdl 12J Information In lftrne 1 1hroui,h , on 1h11 data npo" II Included on Heh ehNt. end 131 uch 1hNI 11 n11mbered nd 1'>* ft11mb<er of 1hNb 11 recorded nth* IOP of 1h11 forlft.

  . -:-,-                                       .....      -                                                                                                                                                    ATTACHMENT 2
                                             \

FORM NIS-2 OWNER'S REPORT OF REPAIR OR REPLACEMENT As Required by the Provisions of ASME Code Section XI

...,.       Owner                Vj rgi Dia Power P.O. Box 26666                                                                                                               Shfft _ _....__ _ _ of_ _ _ _ _ _ __

Surry Power Sta ~"'"' ti on --"'"(')~/Ji:.....,,c~-------~~------------

2. Plant P.O. Box 315..ll'CIOreaal
                                                                               ...   ~

Surry, VA 23883 Unh ____

3. Work Periormtd by_YuA . . . . .-. .a..Pm'..>.UJ,,....e~r_________ 38000 S 6 l '-fl CN11ffl91
                                                                       '5ame
4. ldentlfimionofSynem v-oorwa11 5Hu7c~ LJ~iev
5. fa) Applicable Construction Code 831-1 19 67 Edition, HA Addenda, Code Cam --'""N"-A=-----

(b) Applic1bl1 Edition of Section XI Utilized for Rep1in or Replac:tmanta - 11..80. WBQ

  • Addenda, Codi C.sn _...N.... A._____
s. Identification of Componenu:R"11irTd or Replaced. and Repl1~rnen1 Components N1m1of N1mt of Mfrs.Sar. -Nat'L CAN Other Year Aepai,..d,, ASME Code Comoonant Mfr. No. Id. No. ldentl- Bulh Replaced. Stamped No. fic1tion or (Yes or Nol Replacement

-Xf.'<\St,Ji ,'I\' io,,.r

                                       ~b
                                             .. ,,l.-P,"7 ;,_~)_l:l)..U
                                            ~ ,r                                                          Al/}\- 11//A-            1--5i.,;-Rc""S
                                                                                                                                                     ;(;/A-             rr>f)/~c. ... A                   fa'u Nou I-< f\AO!t!,

51'1.t.l)J {;jl..:.r.:,T* DbD7.01So Al/A- ;V'IA /-s..._,-~"j ;VIA rrp/q,cetl A/i) i , - *.*

  • 7.

I. Oacription of Tm, Conducted: Work-----~-------------------,,."--------------- Hydrostatic O Pneumatic O NomiNI Oper,ting Prnsurw E(. Chhtr 0 A,m.,lu Pressurt,.A!Or psi Ttst Temp. /VdT*F S-f...J.s fo ~ <:..S j _ /?JXI i'? I. (Applallll ManulKhHl"I OalA Ae:,ona 10 be at\lChilQ CERTIFICATE OF CCm1PLIANCE t*. ASME Code.

  • 0 We ctnify that the n1temenu made In this repon art correct and this tf_
                                                                               ~

ISI l't'{)kc.~t.A.. j';pa;,o,,epia~ df,4, z..;.. conforms to Section XI of the Si9Md ~- (O,,nt< crOwnel"a C l e ~ TIii; i[¥111J

                                                                                                                                                                                .11        N CERTIFICATE OF INSPECTION I, tht undersigned, holding I valid commission issued by the National Board of Boller and Pressurw Vessel lnq:>eCtors and tht State o, Province of_                     _.V....A
                                           ......_________ , employed t,,y HSB" I &I CO.                                                                                                                               of
~H...a. .r...t. .f....o. . r...d_,_..c:..&T_,,...__h,ve inspe-clfd the                                     c-eo be~ (At JRrpJ,r(s) o, ~r;,racen,entlsl dncribed in this Repor1 on                             f!-i a.-*        *. ,Jn and nett 1h11 10 1hr t>tn of my knowledge 1n.d belief. this rep,ir or replacement h11 been connrvcted in 1cCD1d1nct with Section XI of tht ASME Code. By 1ipnin9 this certific.a,r, neither the Inspector nor his fmployer mikes any warranty, expressed or implied, concern-int the rrp1ir or rrplacem~nt described in this Report. Funhermo,1, neither thr Inspector nor his employer 1h1II be li1bl~ in any manner for any personal injury or property d f f i ~ o f m d arising from or connected with this'lnii>tct!op..

Dm 2-l,'l-8'j' ~- ~ Commiuions fi){J . 7bO 1 l/Ct Sy3

                                                                                  .*                     (lnsPt<lot) on: $.,ppl1ment.l '""" In f~rm of Iha. 1ketch*, or dr1wlnpe m*w be uHd provided (1J 1IH h I~ In. X 11 Ill..
($1111 Ill P'ri,,,,nc1. Nll,ona_l &oa,GI lnformttlon In 1nm, 1 througtl , on thle data rape" 11 lncl\lded on uch 1hNt, and (31 **ch 1hNl l1 numbered it>* number of 1hNta 1, recorded al th* top-of Ihle form.
       * - :0                   .. ** :*  -                                                                                                                                                                   ATTACHMENT 2
                                   \

FORM NIS-2 OWNER'S REPORT OF REPAIR OR REPLACEME.NT Al Required by the Prorisions of ASME Codt Section XI

      -,.        Owner        Virginia Power P.O. Box 26666
                                                                                                                                                                            ?;3))8'1 Datt----:.-.--------~

Shff1 _ __._ _ _ _ of_ _ _ _ _ _ __

                                            ..                                 C,.OOrna)
2. Plant Surcy Power Station Unh--------------------~

ONE (N~ P.O. Box . 315jAOOraUJ Surry, VA 23883

3. Work Performed by-'V...A ........_._POWe.....,.......r________ 38DDD {?)3£ I
                                                       .                      (NameJ
                                                        --same
4. ldenllficetion of Synem . IAOOIUII _c t:voJ\e,1 C!:>o L\-.y
5. la) Applicable ConstNctlon Code 831-1 19* 67 Edition, HA Addenda, Code Cam --'N...A___

(b). Applicable Edition of Section XI Utilized for Repain or Replac1m1nu - 19..80~ WBQ. Addenda, Code Cases _..N...,A._____

s. Identification of Comp0nenu R~1irtd or Replaced. and A~lacement Components Namtof Name of Mfrs. Ser.
  • Nat1. CAN Other. Year Repai,..d. ASME Code Comoonant Mfr*. No.* Bd. No. Identi- Built RepllCtcf. Stamped No. fication 0, CY11 or Nol Replacement

~M-) :x }JI.\\ .I

     .)i,~s+'"lJ~

7. I. CERTIFICATE OF COMPLIANCE

     =~~~~at t~e nat'11menu m ;thiJ~                                           r1por11r1 ln        correct and this _ _...      /':_~...,.{)-L--'.2-~---e;----."---il.A-
                                                                                                                                                            ....~----\-*_ _ _ conform1 to Section XI of the Si11ned
                                ~....
                                               .,   f;f.,,
                                               ,,.;:.o;~

ISI l=l;

                                                                                                                               /Jc.Ii,
                                                                                                                                ~.,

t.2.. , H f'2 CERTIFICATE OF INSPECTION I. 1he undersigned, holding I valid comminion iuutd by the National Board of Boiler 1nd Pres1ur"1 Vessel Inspectors and tht Sratt Province of YA. *employed by__f.....iS_B...'_I....&_I...__c...o........________________ of 19n 0, Ha rt ford, CT. have inspected the f"?P)q nft\.Vlt j [Rep1.rb) o, Re~t1c1rnentf1I demibffS in this Repon on

                                                                                                                                                                                                 $>""~cl== ,

tnd itate that 10 the ben of my knowlrdpr and belief, this" repair or ,epl:icement h11 been connrvcted in acCOJdance with Section XI of the ASME.Code. By si;nin; thi1 certificate, neither the lnsprctor nor ~i1 lfmployer makes any warranty, expressed or implied, concern-for any personal inju~or property Catt x9,l'J. g11

                                                            !:~~o:':~

ift11 the rrp1ir or repl1eement described in this Report. Furthermore, neitht:r the Inspector nor his employer shall be liable in 1ny manner

                                                            ~-~
                                                                                                          ,rising from or conne,c;ted with thi1 lnsp,~

Comminion1 /JB 70()2 ~fftf3 fln1po,c1cw, . * ** '51111 or Pn,,,,nc:1. Na1.,,,,.1 8oa1III

Suppl1m1ntal 1hN'tl In form of ll1D, 1k11ch*, or drewlngo mey be UHd provided (I) 1111 h IIX In. X 11 In., *.

nformellon In lnrn1 1 through , on tht1 due noon 11 Included on uch 1hNt, ond (3) uch thHt It numbered It>* number of lhNb It recorel*d at th* too of thl1 form.

   . -:-,..                                      .....  -                                                                                                                                          ATTACHMENT 2
                                               \

FORM NIS*2 OWNER'S REPORT OF REPAIR OR REPLACEMENT AJ Required by the Provisions of ASME Code Section XI

 ...,.           own1r Vi rgi ni a Power                                                                                                           D1Tt~_        ?/1/g-                ~-,

_..t:..:.._........._________ ___ P.O. Box 26666 Shfft _ __..,___ _ _ of_ __ _ . ~ - - - -

                                                                                       ~ma)
2. ,11nt Surry Power Station 0/1./b Unh~--~~----------------------

IN~ P,O. Bcix 315.1,4aorea1J Surry, VA 23883

3. Work Performed by_V...A O W....e. r. ________
                                                         . . . . ._._f:'.......
                                                                  .                   IN.,,...

3aaaa S?!? ~ 7'J..

                                                                   --same
4. ldentlfic1tion of Synem. . CAoCIUII Co!"' fol\ V\,i Cool :;:,. . c/
5. la) Applic1blt ConstNctlon Code B31- l 19 67
  • Editlon,....H.....A'--___.Addendt, Codi Casrs ____N.._A______

lb) Applic1bl1 Edition of Section XI Utilized for Rep1in or Replac1m1nt1 - 11..80. WBQ Addenda, Codi Casn_...N"'A..____ I. *

  • Identification of Components Rep1i~d or Replaced. ind R~l1c;,emen1 Components Nam1of N1mt of Mfrs. Ser.
  • N1t'L CAN Oth1r Year Repaired,, ASME Code Comoonent Mfr. No. Bd. No. ldentJ. Built Aepl8'9d, StalnS*S No. ric,tion or (Y11 or No)

Replacement

irfle,../J.~f ~~~-.~

ec.-..11,d l}°;J)..C1Z NIA A)/A /-cc -i:-IC. 10+ ,/< f,(} /q ~//I C _No

  ,.            Description of Work_~L.:a.;c::;:.*t!...;._...~*~:b..:,"':::,'tf~'L,=""'~~..,.:;.~:;..,::.;.:.n=a:1.:::.---==~a.;~:::;-.=0~~=::..;:.i=----~,--.,,....--=-----------

I. Tem Conducted: Hydrostatic O ,neum11ie O Nominal Oper11ing Prnsurt Other 0 Pressurt ,:1,:0,> PII Ten Temp.~F

9. Aemarlu-=-:---::--:-:--:-:-~-::-=-~-:.-~=-::--~-,-~-----~""'.'.:'"~-~---------------
                                       ~icalt Ma11Ulacti,ra!"1 Daia "-:,ot1110 be atlKhlfGI                                       Po~ s5 f         - )_ I J.2??

---.."'." .'-================-:::::.:.:===========================~ CERTIFICATE OF COMPLIANCE

';:,~0'"/tnu made In this repon art correc1 and this _ _~t'--'-~-,t/;~:_,_1.;;.~-::-.-~""',,,lA=a...,..;;.no_T_*__ conforms to Section XI of the Signed , kso<C:Cu,p,-!

(Ow,... er Ow 4,1'/ IS I TIii;

                                                                                                                                      £<a, Z..L 1D&1eJ
                                                                                                                                                                     , ,, YS' CERTIFICATE OF INSPECTION

_I, the undersigned, holding t valid commission luued by the N1tio111I Board of Boiler 1nd PrHsul9 Vessel lnspec1on ind the State or Province of_ _.V~A~,..________ , employed i:,., fiSB" I&I CO. of

   ...H...a...r..Jt...f..,o. . ._r...d_.,__,,C..,Tw,L--hlve irispe<:led the 1Rrp6,,ts)         rep i C eM. eA,-t o, ~~;,t.camar11(18 described in this Repor, on        ------2'-'.--~. . Q.. ___ , 19.3.1 and 11111 1ha1 10 the ben of my knowledpe and belief, this repair or replacement h11 been connructed in acc:o,d1nce with Section XI of the ASME Code. By signing this cenifiau, neither .the lnspe~t~r nor his lmployer mikes any warranty, uprened or implied. concerft-
  • ing the repair or replKemen1 drscribrd in.this Repon. Funherrnort, neither the Inspector nor his employer 1h1II be liable in 1ny manner for any pe110:11 inju,y or property ~o~ !d_o~s ~ny,kind arising from or connected with this ln11>1_ction.

0111 g'- d.J - &j ~- ~ Commiuions A/[J 7tJ O 9 Vt!. S:{ 3

 .                                                                                           (lnspo<10t) n: Suppl1m1nt.l eh"n In form of 11111, 1k11ch*, or drewln1,11 mow be uHCI provided (111111 h ll>l In. X 1*1 In**
                                                                                                                                                 ,          (S111a o, Pn,,,,nca. Na1,ona1 Boa1111.

nformotlon In 1nm, 1 1tirougfl , on thl1 d1t1 upon 11 lncludod on ud\ 1hNt, er)d 131 ucll thNt 11 numbered tf\e number of 1h"b 11 rec:ordeel at tho top of 1h11 form,

       . -:--,,.                         .... :* -                                                                                                                                                            ATTACHMENT 2
                                         \

FORM NIS*2 OWNER'S REPORT OF REPAIR OR REPLACEMENT AJ Required by the Provisions of ASME Code Section XI

     ...,.         Owner:    Virginia Power                                                                                                                    D1t1_____....,~'-'-,~~"--~~t?/~~~~

P.O. Box 26666 Shl'f1~__...___ _ _ ot_ _~ ~ - - - ~

                                              .                                      . i,.oorn&)
2. Plant Surry Power Station
                                                                         ~~-

Unh~~~.... C)"'-';J=!t:"'--~~~---~~~~~~~~ e.o. Box . 315jAdOrall) Surry, VA 23883

3. Work Performed br..cYu8......., ,......t:'

e....r____ OVJ,U.l,,... (Name)

                                                                                                        - ___                             1aoaa9J~ /b
                                                                ....Same
       ...        Identification of Srnem                                               l40C!IUII           (pM,2C)/\       e,r\           C<:>o ),7::t.
5. CaJ Applic1ble Construction Code B31-1 1Sl 6f A._____ Addenda, Code Cam _..:..N,,_A..____

Edition,~H.... Cb) Applicable Edition of Section XI Utilized for Repairs or Replac1m1nt1 - 11..80. wan Addenda, Codt C...s_...N_A____ S. Identification of Comp0nents Repaired or Replaced, tnd Replacement Componen11 N1m1of N1mt of Mfrs. Ser.

  • Nat1. CAN Othtr Year Reptirad, ASME C.odl Comoonent Mfr. No. Bd. No. ldentJ. liullt RepllCfd. Stamped No. f"ic1tion or CYes or: Nol J--cc.-5f Nb l-cc-S8 I J-cc~Jfj 0
7. Description of Work _ __,_,._,,'-"'-..,_c..=""-'---c-*-~-e;:;;ca.:.k___...u_'l.,-.a....lU;..;,..._-'_

I. Tau Conduc,ed: Hydron1tic O Pneumatic O NomiMI Operating Pressu'9 . Other 0 p,.ssurt.AilLpsl Test T e m p . ~

  • F , J) ~ SS v-/1-, 1 J I. Rtmarlu ,1 Lw'°' LO f r:r-0
                      . i,.pplic.ablt r.c....,IKll#ef'I DIU1 Ae:,on1 10 be I I ~                                        t    }, H-e >,- JJ"'l ;,. f O'F" 55 yI) - J ) 3.)                qg
                                                                                                                                      ,f: .5 h,.J.s f O~ 5S r -.2 JO 8:J $ ..

I* ~ . CERTIFl'CATE OF COMPLIANCE

   - Wt cu1ify th1t the rt1t1men                                                                                              ___f'__,e/Jf--'~-Ca..'i!r-\."-"-=0(_.._.,_}_ _ _ _ cc,nform1 to Section XI of the ASME Code.                                                                                                                              r,p&it Ol ltp!ace<naflQ Si11ned---:::---.a:~:......,..i~...;...,.":?1---=-----~---~~~~----, 19                                                                                                               T~

CER Tl FICATE OF INSPECTION I, 1h1 undersigned, holding I v1lid commission iuued by the NatioMI Board of Boiler and Pressur9 Vessel Inspectors ind the State ' or Provi~e of_ _.V. _A....._*- - - - - - - -

  • employed by HSB" I &I CO. of Hartford, CT. hive inspKted the c-e/J/C"t.<.e,.,..,_e,.,J ducri~ in this Flepo,t Oft _ _ _ _ _...p_. . .

IRt p,Jr(1) o, ~t:,t1c1me111(18 _a. .'l.~-. 19.81. ind nett that to 1hr best of my knowle~e and belief, this repair or replacement h11 been connructed in 1cCD1d1nce with Section XI _of the ASME Code. Br sipning this certificate. neither the Inspector *nor his lmployer mikes any w1rr1nty', ea:prened or implied, conccrr.- ing lht repair or repl,ceme~t described in th.is Report. Furthennore, neither the Inspector nor his employer 1hall be li,blt in any ~nner for any personal injury or proper,y d ~ ~ f *~ ki~ arising from or conntoeted with 1hi1 ln1P1ction.. D1tt If- 8<J .~J.- ~ Comminions NB JaoCS****3 i/e.... 5*y,3

       *                                                                                        (ln11>K101)
Suppl*m*nt..l shNta In form of lln1, 1k*1ch*, or drawlnpe rnev be uud provided (ti ,In h IM In. X 1t II\.,

nforrnetlon In ltarna 1 1hrougtl , on thla data upo" II lnclud*d on ..ch ahNt, *na (3) uch thNt 11 numbered o, Pn,.,nc1. Na1..,....1 ~

 *       ,t,1 number of ahNb 11 ttcorded 11th* 100 of thla form.                                                                                                            .
                               .... :*   -                                                                                                                                   ATTACHMENT 2
                . .                                      ,,~ .
                               \

FORM NIS-2 OWNER'S REPORT OF REPAIR OR REPLACEMEN_T As Required by the Prori1ion1 of ASME Code Se~ion XI

    *1. Ownff    Virginia Power P.O. Box 26666                                                                                             S11H1-"""""------ot_ ___._ _ _ __

jAOOrftll

2. rtant Surry Power Station *
                       .                              ,.~                                                             CJAJP Unh--~~~==.,..----------------~

P.O. Box 315 Surry, VA 23883

3. Work Performed by_V...A ....._Se

__._r________ (N-t 3BDDD 7S ~ 3' 5

                                 .                ...same
     **5. Identification of Srn1m                            CAodfNII        Se ,c ( LJO\~ e CV                         V
            ,., Applicabl, ConatNCtlon Code B31-1                                1I    67                            r~...

Editlon,.... A______ ,.ddtnda, Code Case, _ .... NA_,___ __ Cb) Applicable Edition of Section XI Utilized for Aep1irs or Replac1m1nt1 - 11..80. wan Addenda, Codt ea... _N... A..____ I. ldcntifiQtion of Cornpc,ncnu Rt91i"d or Replaced, and Replacement Compon1n11

  • Name of Namtof Mfn. Str. -Nat1. CRN Other Vear Repaired,, ASME Codt Co"'l>ontnt Mfr. No. Id. No. ldentl- lulh Rcplac9CI. Stamped No. f"ication Repla=ment lYn or Nol Uctl vt {,v..)ct, j)*..,~

( Ol"\11&--,.'4,

                                               '1/SJ'/"lo           /JIA             Al/A*        J-51..J-JJ]

Al/A 0pp/~c.<)

                                                                                                                                           .                           ){Jo
7. Otscription of Worll: _ _ _ ____~__e__
                                                          -=:---R__e-F--/q__c.._e"'"='*C       cl<_..........._.lv__e__-=_,...-~~-------
                                                                                                           "l I. Tem Conducied:                Hydronatic          O    Pneumatic O Nominal Opcratin9 Pres11119                                Other       0 Prtssurt        ty,)    psi Ttn T,mp.~*p
t. A1marb _ _ _ _ _ _ _....,,..__,,,_.-----------...... -.---p--------..,..--------

U'l\J{

                     ~iulllt 1,q...,1.c1urlt'1 Da111 lle;10t11 IO Cle 111\KIIIICII                                 J             0 1L- (SY ' }.S / b1 S
                                                                                                                                                 -GI-

.! CERTIFICATE OF COMPLIANCE We cer,ify Ull1 th, n11emenu made in this report ~ra correct and this cep /qc eM &\, + conform* to Section XI of the

                                     ~
                     ~
    <ISMECodo.a                                                                                              ...- * -

Sitntd

                         '°'""".t:_.___..Ak:  . De1'(1WJ                                rsr
                                                                                                           ~a .t.?

eo.111

                                                                                                                                                 .11     n CERTIFICATE OF INSPECTION I, the underaign1d, holdint t valid commission iu11td by the National loard of Boiler and Prcuu" Vessel lnspecton tnd the S11tt or Provine, of         VA,                                         , employed bv HSB" I &I CO;                                                                                    of Hartford t CT*                     ha111 inspec11d the           cee,l°tc e.,..._~+              described in thil Aepon Oft                 .            ~... ~ 1.        , ,,!t
                                                       ..             jAcp ,~11 o, i,t;,11u,..."l(II                                                 .

and 11a11 that 10 1111 best of mv knowledge and belief, this rrp1ir or replacement hes been connrvcted in acco,danC'I with Section .XI of d*~::::: tht ASME Code. By ri9nint 1hi1 certificatt, neither the lnsPtctor nor his lmployer makes any w1irtn1Y, uprened or implied, concern-int lht rrp1ir or repl,etment described in this Report. F11nhermor1, neither the Inspector nor his 1mplorer shall be li1blt in any manntr for any pcr1on1l inj11ry or property a ~ i n t from or connected witll this ln1Ptct.i"" D111 .f-..J.1-. 8'-( ~. ~ Commiuion1 /J/3 J4a f 1/a,.S\t.3 ll"IPKIOl'j Non: $vpplemantal 1hMt1 In form of 11*'11, 1htch*, or dr*wln .. n,ey be ueed p,o .. lCl*d (U 1IH h IX 1ft. X 11 lft.,

                                                                                                                                        !51111 IOI Prc,.,nct. N11,o,,a19ouG1 C2) l11forn,nlon 111 li.rn1 1 1flrou9"1 4 011 thlt due repon 11 Included on .. ch 1hNt, ana 13) uc11*1hNt 11 numbered d lf\e nun,t,er of 1hNtt It recorded a1 th* top of thla form.

I

                          .... :*  -                                                                                                                                                     .ATTACHMENT 2
                          \

FORM NIS-2 OWNER'S REPORT OF REPAIR OR REPLACEME.NT AJ Aequired by the Prori1ioni of ASME Code Section XI

*1.       Owner    Virginia Power                                                                                                                    ?!t~/y~

Oatt-.......~ - - - - - ' - - - - - - ~ ~ - ~ - - P .0. Box 26666 Shtt1~......~--~of~-~-~~~- jAdelrna) Plant Surry Power . Station (H~

                                                                          .                            Unh~~-C2..._'A)..._*=~~~~~~----~~~~~~

P.O. Box 315 Surry. VA 23883

3. Work Performed i,.,._V,..A =.-.....-t~--------
                                                .          (Name)
                                              -..Same
 **5. Identification of Synem                          ~rnlj                 ..fel'v7ce             ~ 4et""

(a) Applicable Constrvctlon Code 831-1 19 67 Edition,_H-A.___ _ _ Addenda, Codi Cases __N.._A____,..__ (bl Applic1bl1 Edition of Section XI Utilized for Rep1in or Replac1m,,,.tl - 11..80. wan Addtllda, Code Cases _N_A____ I .. Identification of Components Repaired or Repl1ced, and Replacement Components

  • Namaof Name of Mfrs. Sar. *N1t'L CRN 0th* Year Repaired,. ASME Codi Comoonent Mfr. No. Bd. No. ldent~ Built Repleced. StafflPN No. rication. cv.. or Nol
                                                                                                                                                         °'

Replacement 1-s1,.1-113 "Viii, I11~ w"'f>~ot..1d\6 cJ /1.J.. loJ o* )l/,4- AJIA- .All.+- r-e//ctcd-

                                                                                                                                                     .                            X/()
7. Description of Work _ _ _.Q~fi-:::.fti-::"Ca..:e"--'U.'-e>i,-t_v_~--:=------------::::,:,--=--------:~---------
1. . T~1 Condue1ed: Hydro1utic O ll'neum1tic O Nominal Operating Prnsu,. Other 0 Pressuretvoe psi Ten Temp.~*, { fl.. * *y J
  • I. Rem1rlu ~ L)"I, Ve. ro~ SJ - I '{ 7"J'f
                   ~c.allll .... rautac:1urer1 Dau A.;,on1 10 be a t l ~

CERTIFICATE C,,- COMPLIANCE We ctrdfy thlt the(Jlt nu mac:lt In this repon are correct and thit _ __.l'__r,_R_)t{_c_~ __:e.:,--,,..._t'_*_,___ confonn1 to Section XI of the ASME Code. * /} ~ . )i,pa;, °' 1ep1a~ signed -G

  • _ (Ow1*orOwr.erarnt.;,
..-r_,,(~
                                                               ~

1s1 T!t= . .. dti1 tDl**J

2. 2...
                                                                                                                                                             ,. n CERTIFICATE OF INSPECTION I, th1 undeni9ned, holding
  • v1lid comm~sion lu~ed by the National Board of Boiler and Pre11urw Vessel ln~tors and the Srata 0

OI' Provine:, of VA , , employed b'f---1IL.Li$.i..Bi. I &1.LLI_C~01,1..a.,- - - - - - - - - ' - - - - - - - - - O f Ha rt . ford, CT. have inspec1ed the rePl<t-Cw._f.A, t (R*W*'1*l o, ~,:,11c1,n1n1(1I

  • demibed in this Repor1 on.

q: ... 1, J... , 19.!'.1 and nate 1h11t to tht but of my lr.nowlr~t ind belief, this rep,ir or replacement h11 been connruc1ed in 1ccord1nc:e with Section XI of the ASME Code. By signing this cenific.att, neither the lnspec1or nor his lmployer mikes any w,.rranty, e~prened or implied, concern-ing the repair or replkrmen1 described in this Repon. F1c1nhermore, nei1her the ln1;>rc1or nor his employer 1h1II be li1blein any manner for any personal injury or property d ~ o f ~:~:arising from or connected with thi1.ln1Ptcti0f\.

  • D1tt S-11.- r ~ . ~ .~ Commiuion1 JJ6 ZP 0 1 kg 6:/3 flns1>1<10f) n: S.,pplemer,ul ,h..,n Jn form of Ilia, *kucl,*, or Cfrewln*po mey be used P*ovlded (11 *ln*h IX In. X 1t In.*
  • l51a1e or P,o,r,nct. Nal,cnal &o.1dl nform.etlon In h*rn1 1 1hrou,tl , on thl1 date upon 11 lncl .. ded on uch 1hNt, end (31 uch ehNI 11 ""mber*d
  • number of 1hNb le recoref*Cf et th* IDP of ml, for"',
                                                ,,~         ...
                            \

FORM NIS-2 OWNER'S REPORT OF REPAIR OR REPLACEME.NT AJ Required by the Provisions of ASME Codi Section XI

2. Unh_~O~-v~-----------------~
3. Work Performed by ..........J~. "-!r~~~~ ,

e£~~-"'v-,:::,::.;CC;;..'.='--;..._--,------- (N-I Rep.air Organization P.O Ho~ Job Ho~ ate.

4. Identification of Synem_..la&l::¥~,c.4~~=--~=~~:;:;._-----------,.,-------------....,..---
5. (1) Applicable Construction Code t3 J/. I 19 G 2 Edition, 4 '?:: Addenda, Code Cases _.:;r/"-"".a::::;.---

(bl Applic11bl1 Edition of Section XI Utilized for Repain or Repl1e1menta - 19.&. Wt: 0 Addenda, Codt Cases~///._.... 4:"""*""*---

6. ldentifiaition of Componenu Rep1irrd or Repla,ced, and Replacement Components Name of N1mt of Mfrs. Ser. -Nat'L CRN Other v,.,. Repaired, ASME Codi Component Mfr. No. Bd. No. ldentl- Buth Replaced, Stamped No. f"ecation or (Yes or No)

Replacemtnt

  -X   4 Sr.,JJr Wt,e,\w.~
                          ,.~A -         .l '?or2,r{,                  ,A,l/,9           µ,h        1-ct::1',/. HN"        Iii~           £_,!,}** -         ~            ~d
7. OeJC:ription of Work_..&.:;;_~"""'"'.:..:....,___~.:..~a...:::L.::;c/,.::,f:-..*_ _ _ _ _ _ _ _ _ _ _ _ _....,...._ _ _ _ _ _ _ _ _ _ _ _ __
8. Tens Conducted: Pneumatic O Nominal Operating Pn:ssurw Othlr D
                                              ...t.;:...!,!.£_ _  psl Ten Temp.~ *F
9. Remarks r. ,, 230 9.3S-IAPPJic@!e ~nulactunlf"1 Da1a ~:,on& o be attachedj CERTIFICATE OF COMPLIANCE We cenify that the n1temenu mllde In this repon art correct and this ~t!:t?c,?-e..,!-N t: conforms to Section XI of the ASME Code (ftp.air or replaeemeftQ CERTIFICATE OF INSPECTION I, the undersigned, holding I valid commission issued by the National Board of Boiler and Pressul"I Vess~I Inspectors and the State or Province of 1/CL . employed by
  • fl£ rJ :£._£- r CO= of tfu.r-ifc 1r-J I et. hav~ inspec1ed the ,e.(;} \ &..C.e f..{ el/J \

IRepairtsl o, f:!t;,lacemenl(II demibed in this Repon on

                                                                                                                                                            .          9-!J *19.n and nnte that to the ben of my knowltdge 11nd belief, this repair or replacement has been constructed in ac001dence with ~tion XI of the ASME Co~. By signing this certifit11te, neither the Inspector nor his t!mployer makes any wsrrenty, expressed or implied. concern-ing the repair or repll,cement describtd in this Report. Furthermore, neither the lnsptctor nor his employer shall be lieble in any m,inner for any pe"onal i:jury or propeny d,:agexr a I~ of any~ind,,,rising from or connected with this lnspe~ion.

Date q :s:- 'i?°( ~(. ~ Commiuions t,/G 700s ilcSlf 3 (lnipe,<:104') on: Suppl1menul 1hoen In form of llns, 1kncha. or drawlnpo may be UHd provld*d (111IH 11 BK In. X 11 In.,

                                                                                                                                      '    C51a1e or Prt,.,nce. National 8o&tdl l lnformnlon In h*m* t throuph 4 on thl1 dna npon 11 Included on ..ch ahHt, and (31 each ,h .. t h numbered and tt>* number of 1hHts 11 record*d at tho top of thl1 form.
                            '               FORM NIS,2 OWNER'S REPORT OF REPAIR OR REPLACEMENT Ai Required by the Provi1ion1 of ASME Cod, Section XI
  *t.      0wn11     Yirgini a Power                                                                                                7/17/g-4 P.O. Box 26666 jMC!rnaj
2. Plant Surry Power Station CN.,.,..

P.O. Box 315 Surry, VA 23883

3. Work ,,rlormtd br...Y ...A_._. _Se
                                                   .....-"'...r_______

CN~ _ 38000 71'( :I q "Same

   '*I. ldentlf"ication of Srnem C1J Applicablt ConrtNctlon Codi 831-1 IAOOfUII 19   67
a. P9 C!°tw ~.Q Edition, ....U
                                                                                                                        /er,,-t A._____ Addendl, Code Carta ___N__A____
   ,.      Cb) Applic1bl1 Edition of Stet ion XI Utilized for Aepain or Rtplac1m1nt1 - 19..80.                                 wan      Addenda, Code Castt _.. .H...A.____

Identification of Companents A~aind or Replaced, and Replacement C.omPontn11 Name of Name of Mfn. Ser.

  • Nat'L CRN Othff v,.,. Repaind,, ASME Codi Co"'Oontnt Mfr. No. Id. No. ldenU* aunt Aepl.:tel, Stamped No. f"c1tion tJi (Y11 o, Nol A1pl1ctmtnt
                       ~    ...... ,.

S-t\,\ DS 5;.,J"\.), *.,... 3:JrfJ-61 n JJIA ;(}/A- 1*-lt-f-1A

                                                                                                    -J:i-,, ~        ;VIA          R,,p/aud Alo "AJu.-r s        Nl)V /\('1k~J;
  • PP,o,')v.ii' o6)l.b1J-D ;JIA. /J/A I-~ -P-1).
                                                                                                    .j::j,_, ~      Al/it         I<. ;J} Jiu .,,,A AJo
  ,.      Description of Work                Qpobr-e +,M<. f' (:vhe t-I.      Ttm Condue1td:               Hydro1l.1c           0""    ,neum11ic 0          Nominal 0Ptratint ,rn1u19               0   Other     0
                                       ,,.uurt!,.F.l.s              psi    Ten Temo.~ *f
  *.      lll1marks-,---,--~-,---,.--=-----,.-,----,.-,,-----=Sr--lA:;.:.D"-'-s_f,_D..__,;;.__5s_r_-_1_1<2_'N__J_ _ _ __
                     ~icAl>lt 1Aa""1Kl..llf"I Caia "-:,ot,* I O ~ _ , . .                                   /V l{ 'l'-5 f O-,;.- J'S 'I - /7 33) q CERTIFICATE OF COMPLIANCE ASME Coda;/'}

Sitflld ~£~~ 6. We c1rtlfr th,t the n11emenu .midi In thil rtpon 111 correct and this ISIEu4; [t' PJe:i c ~en. 1-

                                                                                                             '**pMOI , . ~

J'£it?r-C conforms to Section XI of the p.,... a, I Dea,p-1 TIii tel

                                                                     . CERTIFICAT£0F INSPECTION I. the 11ndtr1i9l'led, holdint I valid commission iuued by the N1tlonal Board of Boller and Prts1urw Vtnel lnspecton and lht S11t1 Ot    Province of       VA,                                           , employed w HSB" T&T CO,                                                                                of Ha rt ford CT*    I                 h1v1 inw,teltd tht               Cf:P.. Jv ~ :0,,t described in this R1por1 Oft IAtP *"laJo, ~~1,c,.,..1u11I q.. 5' , nil and 1111, 1h11 10 tht bfn of my lr.nowl,d!lt and belief. thii repair or replacement has bun connrvcttd in 1ccord1nct with Section XI of tht ASME Coek. Br sipning this crrtificatt, neither tht ln&ptctor nor his ,mplovir nu1kH iflY warranty, uprt11td or implied, conctrfto i"i lhi rrpair or replacement dtscri~d in this Report. Furthermore, neither tht lnt,prctor nor his employer 1h1II be liable in anv maNllf for any c,c11o~al injury or propenv d a ~.B' *~ lr.~d tri1in9 from or connected with this ln1Pt'li0ft.

011, 9--5>~9 ~J.. ~ Commiuion1 µa C51t11 700'1 Va.. ['-f3 P"l,-CIOfl "°Ion: Swpplunental 1h .. n In form of 11111, 1ke1ch*, or dr*wln1,11 rney be UHd prowlded ltJ 1111 It IX II\. X II II\., or l'rDooftCI. N11..,,,.1 9o&rdl 12J lnformetlon In "*"" 1 1hro11"°' 4 on thlt dna ,epor, It lnch,ded on uch 1hNI, and 131 .. ch thNt l11111ff\t>e**d and ... 1111n,t,er of 1hNta It recorded at th* IOP of dll1 for"'"

                            '           FORM NIS*2 OWNER'S REPORT OF REPAIR OR REPLACEMENT AJ Required by the Prori1ion1 of ASME Code Section XI
  ..,. Own.,        Yicgi oi a Power                                                                                                     ?"'!~)~Cf Datt~-------------------~--~

P. 0. Box 26666 Shtt1~----~~-of~---~-----~

2. Plant Surry: Power Statrno -~'"" Unit (?NE C'CANI .

P, O, Box 315 Surry, VA 23883

   ). Work P1rf ormtd bv ...Y    ...A
                                      .......,....Sie.._  r~,--..,..----------
                                                         ...                                              38DQQ o*/J"l c.f (H-,
                                              ..Same
4. ldentlfic1tion of Srn,m ~ ( ~ J)'L-.. ~ t (cc,/.~"-'1 I. ,., ~pliclblt Connrvctlon Codi 831-1 19 67' Edition ......r~....

A,_____ Addtndl, Code Cases ___NA______ fbl Applic1bl1 Edition of Stc:tion XI Utilized for Rt;11in or Replactmtntl - 11..80. waa Addtnc:11, Codt C.111 ~N"'"A"-----

1.
  • Identification of ComPOncnts Aep1irtd or Aepl,~d. and Repl1ctmcnt Components N1rntof N1m1 of Mfn.Str. *N1t'L CAN Other Year Rep1i,.d. ASMECodl Co"IOOntnt Mfr. No. 8d. No. ldlntJ. Dunt Repl~ Sta""*'

No. fc1tion Oi fYn or Nol F11pl1cemen1

,. Uo.J v .e..         c~~

AC ,,,.,(O Lf ()-o'ff-1 Al/A AJ/A /-cc-f/ll) MA {2_r,/ciccJ

                                                                                                                                             ,                     A/o (1 4

(.C*lf "fl

  ,. DftcriptiOft of Work                    /J<fl;/eir_   ,r {Jr       /.,i ~
  **    T1tt1 Conducttd:            Hydros11(ic 9' Pneumatic                   0 Nominal ()per1tin9 l'rns11'9                      0    0,htr     a Prtssurt          U,, ;II- psi     Ten Temp.~ 'F I. R1rnarla _ _ _-------,---,,-------------------------,---------------------
                      ~c.a1111 IM"UfKti,ret'I Oa11 "-=i,o,,* IO tll' ~                              / }  I Vft u c v O j)  /t=- s y 11
                                                                                                                                        - ,)-Q, ~   '"l Q<
                                                                                                                                                         , s CERTIFICATE Of COMPLlf-NCE We c1nlfy Ulat th, nmmcnu midi In this repor, ~re corr1e1 and lhis                                   YY J/q C. e,,i..,..-,\,     t-             conforms 10 Section XI of the ASME ~ - ~ /J                                                                                             fi,pa,10,11~

s;,Md Yv-£~/t~ P.-* 4 Dn,p-1 4<1== 1sr TIit S"&z-c ttl&t*I *" n CERTIFICAT[OF INSPECTION I, 1h1 undlrsi9n1d, holding I v1lid commission iuued br the N11ioMI Board of Boiler and Prt1111re Vessel lnspectcn end lht S1111 or Provinceof VA I

  • employed bv usn* I &I co I of Ha rt ford. CT I h1v1 inU,teltd lhf 'ff.*.,.,0,~ ~

111, ** L

                                                                                ~:,1,c,,,.. ..11,1 dtmibed in \his Repol'I on                                q - 6'" *u.fi and 11111 1h11 10 the btn of my knowlrdgt and belief, this rtpeir or repl,cemtnt h11 been connrvcted in accordence with Section XI of lht ASME Code. Br sipning this unifiutt, ntither the lnsp,ctor nor his fmplover mokt1 any warranty, u:p,,ned or implied, concerfto ing the l!lp~ir or replKtmenl dtscribtd in this Repon. Funhennore, neither tht Inspector nor his employer 1h1II be li1bl1 in 1nr inanntr for ,n.,. personal iniul'f' or property           da~1        ~ ? ' ? : : : : i s i n g from or connected wi1h thi1 ln1Ptl:ii0ft.~

D111 c=, ... s:- 8~ ~¢. .* ~ Commission, /J(3 cs,,

                                                                                                                                        - 76a     r Nat0'\11
                                                                                                                                            .. l'R,.,nc,.  ()., CS'fi!;
                                                                   ""IPKIOl'I "ilon: Svpplemer,i.l ,h ..-n Jn form of 11111. 1ke1ch*. or drawlr1111 "'*" t,e IIHCI provided (111ln II IX In. X 11 In.,

0, CZI lf'lfo,"'*llon In lnm1 1 tt1ro11fh , on thh Cine upor, It lftcluel*d on uch 1hN1. er1d 13) uch 1hHI 11 ftumb9**d end 1'>* f'lllff\b9r of 1PINll l1 recorded ** lh* IOP of fl'III form.

ATTACHMENT 2

                                \

FORM NIS,2 OWNER'S REPORT OF REPAIR OR REPLACEMENT A.J Required by the Prowi1ion1 of ASME Cod* Section XI 2. 0wn11 Plant Yirgini a Power P.O. Box 26666 Surry Power Station e.o. Box 315 Surry, YA IN...., jAGOrnaj 23883

3. Wo,k P'1rformtd 1,y_V...A c.....,,._..,...
                                           .......,.....Sie_....."'

CN-S _____ -:i~nnn YI '11 0

                                                  ,same
      **I. ldent1ric11ion of Srn1m                                  IAOC!iall            Co"'      pOA-<Ai                 Coo /~   "",?

laJ ~plicablt Constn,ctlon Coclt 831-1 19 67 Edition,.:.H::..A,__ _ _ Addtndl, Code Caln _,.aN..,,A___ lb) Applic1bl1 Edition of Section XI Utilized for R,;,1in or Replae1m1nta - 11.BD. wao Addlnd1, Code C.sn-N....A ____ I. Identification of Coml>OntnU Arp1ind or Replactd, and RrplaC"tmtnt Componenta N1rnt of Name of Mfn.Ser.

  • Nat'L CRN Other Ytar Repaired. ASMECodt Co"'OOlllnt Mfr. No. Id. No. ld1ntJ. &vlh R1plec:t4 Starnpad No. r,cauon Of (Yn or Nol Replactment H.,,..{_'--J"'i' 1-c,.rv-1108
  /ff .!J 1/JJ.s             s,~c .... /1', Db Is~, L/                      AJIA- !VIA                                               ))/A                     12. f p}ti,L ~    I             11/0 Y.r "Sf1ti. f)S               0               J7 1-S !LS' (                 A)/A /1//A                    1-<<.-rvJuol!,

Al/A /)._ ;/)Jlii.c -erA <,4/f) - I

1. Dtsc:ription of Work Reoq,,,- U&\,lve.

I. Tan Conducted: Hydro1u1ic 0 P'nevmatic 0 Nominal Operatine Prnsv,. ~ Other 0

    =~~~*

SitNcS ~~

                             -;:;,;;                                           CERTIFICATE OF COMPLIANCE
                                                """'1ft thd "*"" ** '""",.. "'"---"

IT~l e'c1,1

                                                                                                                         'f+f--i-:..-c...eor""'~-.~-'-11..-f-:
                                                                                                                                ~fj.e.c .r

____ conforms to Section XI of u..

                                                                                                                                                                        .,,         R:S'.

CERTIFICATE OF INSPECTION I. lht undersigned, holding I valid commission lssved by the N1tlonal Board of Boner end Pr111ul9 V1111I lnspec1on ind tht St1t1 OI' Provinc,of VA* , 1mpl,yed t,v usa* 1& J co e of Ha ct ford I CT I h1v1 inw,tetld tht te p/'t.C- "f!.J'°\. ~ -t dtscribed in this Repon on IRtp,,l'f,Jo, ~;lllct .... 1'1(11 1'-!) . ,,J:'.i and natt that 10 tht but of my knowlrdgt and belief, this r1p1ir or r1pl1ccment h11 been connructtd in 1cC1C11d1nct with Section XI of tht ASM£ Code. By 1ignir19 this ceriifiutt, ntither the ln1p,c10, nor his dmploytr m1kr11ny warranty, ea:prrned or lmplitd, concar~ ing tht rrp1ir or rrplactment described in this Report. Furthermore, neither the lnsp,ctor nor his 1mploy11 shall be liable in 1ny manner for tny per1on1l .injury ~r property d ~ 0 2 J O ~ n y11kind ari1in9 from or connected with thi1 ln1P1cti: D11t q-S- 8'f ~ J . .pr,1pe,c100,  : C:udL-.. Commiuion1 /J{? 7llO q _IL4.. &"t../J

 "'on: Svpplomoni.l          1h"n In        form of         11111, 1ko1ch*. or drewlnp, mew t,.e und provided
                                                                                                                                                                !51111 o, '"'°,r,ce. N11..,,,.1 ao,na (ti 1IH II IX 1ft. X 11 In.,

12J lnformellon In ltanu 1 1hro11gh 4 on thh date noor, h lncl11d*d on Heh 1hN1. and (31 uch thNI I* nwmberad end 9'* n11mt,.er of '""" la recorded 11 the toP of 1h11 forlll'I.

                            \

FORM N1S*2 OWNER'S REPORT OF REPAIR OR REPLACEMENT As Rtquired by the Prorision, of ASME Cod* $ec1ion XI

    ...,. Ownff   Virginia Power P .0. Box 26666 IMO*ftll
2. ,1.n, Surcy Power Station (H......

P,O. Box 315 Surry, VA 23883

                                             ~

111

3. Work P'erformtd bv....aY...A~,...... r________
                                                .............                                            38DQO 7 g,3g-q
                                                              <H-i
                                           ..same 4,

I. ldent1ric1tion of Srnem la) As>Plicablt Co1111Nctlon Code B31-1 v--aa 11 67 e<>~uf.u- Loo /M, "T Edition,.:.;IJ.._A.___ _ _ Addtndl, Code Cases _ .... N::...:A._..__ Cb) Applic1bl1 Edition of Section XI Utilized for Re;,1ir1 or Replac:1m1nt1 - 11.BO. waa Addenda, Codt C.m_..H....A._____ I. Identification of ComPOnenu Rep1irtd or Replec.d, end Repl1ttmen1 Components Name of Name of. Mfn. Ser. -N1t'L CAN Other Ytar Rep1i,.d, ASME Code Co"'OOlllnt Mfr. No. Id. RtpllCtd. No. No. ldentJ. f'c1tion '"'" Of Replacemtnl SteffiPCd (YnorNol

    ) ,A/4,T5 rt...J-e SJ>eL:..fh      o)o/1'110                NIA- .AJ/11-               1-£.t-.~NG A,t/A-        I< t11Ace!                     ;,,,,uo STl,\,i>S              J;          Jn-K').b I                   }              i       /-\Lt-~/11(,

JUI~ ,/l_ <J)hJctl I _,,(.,JO I. Description of Wo,k Tem Conducted: H dro1u1ic 0' Rf!J/1(.,-e_ f:Jc,,-p

                                                                 ,neumatic        0 Gaol-ef-5 Nomin,1 Oper11i           ,,n111,w   0    Olher      0 CERTIFICATE OF COMPLIANCE We certify lh*t 1h1 n1ttmenu medt In this repon art correct and this                          ttfl/cic t:/"\.q +-                         conforms 10 Section XI of \ht ASME~ * ~                                                                                          '  **PM***~

Sitntd JU,..~ p.;;.;o:;::;;;&;,0-1 IS I TIii

                                                                                           ¢...-6;              £°&-,k r. C
                                                                                                          !De**I I
                                                                                                                                         .,, n CERTIFICATE Of INSPECTION I, lht undersigned. holding a valid commission luued by tht N1tlonal loard of Boller and "'",. Vessel Inspectors tnd lht State 0,   Provincuf        VA,                                        *employed w           usa* I&I co,                                                                              of Hartford. CT.                  h1v1 insptelfd tht                ~lttl~fA,,+ describnl in this Report fA1p1    slo, ~~lacemeftl(SI Oft                         'i-S- .11f.l and 111111 !hat 10 the btn of my knowltdgt ind beli1f, this repair or replacement h11 been connrvcted in 1cCC1td1ne1 with Section XI of the ASME Codt. Ir signing this nrtificltt, neither tht lniPfctor nor hi1 lmployer mokrs ;ny .vimlflty, up,es~d or implied, concer,..

int lhw r,peir or replacement drscribtd in this Report. Furthermore, neither tht Inspector nor his employer 1h1II be liable in 1ny manner for tny personal inju,rr or propcny ~ o n of 1ny kind *ri1i111 from or connected with 1hi1 lnt01ctifft- .... 0111 1-S-R'l l~-~ Commiuion1 /013 7<3° J l/e11... ~ r1 flftlP<'CIO')

  • 151111 c,, '""'"'Cl. Nll,or,al 1oA'111
                                                                                                                                                                                       *e lllon: Swpi,lemant..l 1hNt11 l11 form of lln1. 1k11ch*, or dr1wln111 mar be 111ed provided 111 elH le IX In. X 11 lft..
12) lftform1tlo11 111 lt.rn1 t 11\rovut,
  • 011 thh dna ,epor, 11 lftclwd*d Oft ,.ch '""'* *"er 13) HCh *hNt le 1111mber*d
 *"d    1"* """"be'  ot lflNte le recorded at th* tOP of 1h11 form.
                             '            FORM NfS*2 OWNER'S REPORT OF REPAIR OR REPLACEMENT AJ Required by the Prowi1ion1 of ASME Cod* Sec1io11 XI
  ...,. 0wner     Yi rgi oi a Pro'!er                                                                                                    ?/3v/rcr Datt~----------~~--~~

P.0. Box 26666 Shtt1~----~-of_ _.....,._ _ _ __ jAOClrftlj

2. ,1,111 Surcy Power Statjnn C)/1.JE' Unh~--~_,;;;.-~---~~-----~---

(fl...... P.O. Box 315 Surry, YA 23883

3. ~ r-=-------

Work P1rformed t,y..;Y...A.u..,.................."'

                                                            ... ,..,.,.                                         38QQQ          7 ?-3 ;- (
                                            ""same 4,     ldentmc,tion of Srn1m                                ~                      /2.. e1>.01-iv--   Coo    fc..,._ L.

I. Cal Applicablt ~,,rwctlon Code B31-1 19 b7 Edition,-"'H...,_/\_ _ _ _ Adderidl, Code Cam _ _,N_.A___ lb) Applic1bl1 Edition of Section XI Utilized for Rr;i1ir1 or Fltpl.c1m1nt1 - 11..80. wan Addenda, Code Cam ......Nig..A_ __ I. lderitification of CornPOn1n111 Aep1ind or Replaced, and Replacement Compon1n11 Name of Name of Mfra. Ser.

  • Nat'l. CRN Other Ytar Rep1i,.d. ASME Codi Co"'Oontnt Mfr. No. Id. No. ldlntl- lulh R1pl1Ctd, Su~

No. i'"ication or (Y11 or Not Replacamtnl

                                                                                                                           ;(I/It- R.d) fctc-e cJ.

14,-J~ 5ivtO.S 5.oeL:O.,fi-, J )ff.HJ N/lt })/Ir 1-tc..--FAl6

                                                                                                                                                                           'A.lo JV1,1:,s                ~             O;l-e111't?O                    J            J.,             .J__,                 J       R(;/<tve(A
                                                                                                                                          .                                 /i/n
   ,.      DtscriptioftOf Work                RtO lu..c. e.          Pl:'j e          6CtJ ke t 5
   **     Tem Conducted:               Hydro1J1ic            aj?'   PnNmetic: 0              Nominal C)per11int Prnsuf9 0                 Other Q                 .l 'f )J.J" n,maru                       ,,.11ure Z~,iC               pal Ten Temp.~ 'F v7fA _       , o . , A-:_,._.
                                                                                                                         <: QS ./J -z+/-...(S y              - i,#,fp-J
   **                "'"'C&IIII IM"Ulacturat'I Olla 1lepone IO           lie_,,.                                       Ali-t,'IJ . to  IS=- C. s f      - :)_ } q  "J' I CERTIFICATE OF COMPllANCE We cenify that 1h11 n1tt1Mnu mw In this rtpon ~r11 correct and this ASME Codi.

r--q "{c.gM-b\. t-

                                                                                                                   **s,e,torrt~

conforms to Section XI of lhe s.ntet ()eo-,,..t:~ _ 11r De,,o_J . rs 1 .6.-tS: T1111

                                                                                                                        ~er:: s::::::

ll)e1111 ' *" rz CERTIFICATE OF INSPECTION I. lht 11ndersi9ned, holdir19 1 valid commission h1utd by tht National loard of Boiler and Prt1111" Vtntl lnspecton end tht S11te OI Province of YA e

  • employed b-, usn* I&I co e .,

Ha rt ford, CT, hive insptClld the t!J:l,c--..-(/\.T jRep *'111111 ~:,tecomenl(al ducribed in 1his Repotl on f . . J , 11..fl and 11111 that 10 tha btn of mv kno ....1,cjgt and belief, 1hia repair or replacement h11 bun connructed in 1cCC1d1nn with Section XI of the ASME Code. Br 1i9riin; thi1 unifiutt, neither the lri'9'ctor nor his lmploy11r makts ;ny w;rr;nty, u:prt11td or implied, coricer,,. in, tht rrr:,~ir or repl;ument dtscribtd in thi1 Repor,. Funhermore, neither the Inspector nor his tmplower shall be lieblt in any manner for any pe11on1I injury or propcr,y d~'l' of~1risin9 from or conne<ted with this ln1Ptcti°?' / Datt q_ S'- s,'9 ~-~ ~ Commiuion1 JU{] 7oD'f VCC S-'( 3 ll"IPKIO') CSIIII o, rn,.,i,c:1. NfloOt\111 8oenll l\loN: Supplem*M*I ehNTI In form of 111-a, 1ke1eh.. , or drewlnpi "" t.. uoed provided UJ 1IH II l:K In. X 11 II\,, 12J lnformellon In ,,.,.., 1 11\rovgfl

  • on Ihle dne repor, 11 lnch,d*d on ..ch 1hNt, *nG Cl) ucll 1hMt l1 nwmbe**d end Ill'>*"""'~' of 1hNta l1 recorded el Iha toP of tflla form.
                               \

FORM NIS*2 OWNER'S REPORT OF REPAIR qR REPLACEMENT AJ Required by the Prori1ion1 of A~ME C¢* Section XI

  • 2.

0wntr Plant Virginia Pro'iet P.0. Box 26666 Surcy Pawer Station P.O. Box 315 Surry, VA 23883

                                                          ~ ......
                                                                       ~,....,

D11e _ o/3D/Ft _..?f..!_._____' - -tYf Shffl~--'-----~Of~--------- Unh~~....a:('.)__;J~t;:~~~~~~~~~~~~

                                                                                                                                                                                      -------~~
3. Work P1rformtd t,y_,VuA........... r&wew.M r~-------
                                                              ...aai
                                                                 ..                                                          38000 ;! / ; '-/ (j
                                                    .                 CH..._
                                                     ...same 4.

S. ld1ntJric1tionofSrn1m CaJ ~plicabl, ConnNctlon Codi

                                                                     ~e"'J 831-1
                                                                                         \,J,d-.v 1967                        Edition,,_._U.._A,..__ _ _ Addendl, Code Cases _ _.N'-'A___

lb) Applic1bl1 Edition of S1ction XI Utiliz*d for Rc;,ai11 or Replac1m1nta - 11..BO. WBQ Addlnda, Code Casn _..N.._A,_____ I.. ldtntific.ation of ComPOn1n11 Rrpaind or Repl1cad, ind Replactrnent Compon1nt1 Name of Name of Mfrs. Ser. -N111. C:RN Other Year Repaired, ASME Codi Co"'<<>Ontnt Mfr. No. Id. No. ldlntl- 8111h' R1pltetd, SurrlC*I No. r,ution or CY11 or Nol Replacement

      .S1'vo s            ,Nou<<t,_~lin*
                                  ,,.J...,.t. 37rf).(Jo                 Mjt ));A                       1-A..1-/'f).
                                                                                                                                        }II.A         lr'fl fttc 'l:"c4                    PO
7. Description of Work UlfJ),~.., Ug/v e. * .

I. Tem Conduc,td: Hydro1i.tic ~Pneumatic O Nominal Ooer11ins Prn1uf9 a Other 0 Prwuun /J7J psi Ten Temp. A,f,r *,

     *. "ernaru                                                                                                               SJ::l.i JDS fo:,,. C 5 Y - )- 'I IS I 1
                        ~CAM IA&"VIKtllfllf"I Olla                 "-:ion* IO I:. _ , . .

CERTIFICATE OF COMPLIANCE We ce,iify th*11hr nateme,,u m~ In this r,por, ~re corrK11nd thil f ,ef )4. l tr-'\.~ t- conforms to Section XI of Ille C-./'7 . / ' ~ . **-~- ASME Sit"M ~eo,.,,.._.

                             - / ,I
                                     ~

ISI tf:u4 TIii 51 r.r:i.**f k ,11 M' CERTIFICATE OF INSPECTION G, ihe 1,ndtnigned, holding I v1lid commission luutd by the National Board of Boner and Prnsurt V1111I lnspactOfl and lht Srate OI Provine, of VA I

  • 1mploytd ~_.t... o. . .__

iS....B.._*_1....&...I.__.C... . _______________ ., Hartford, CT. h1v1in1Pt<lld1ht ceol,cey.,.._fJ~T 111,Ta,,,a)o, ~;11,c,,,,."11*1 ducri~in1hisRepo,10ft 1-le .,,n and 11111 th1t 10 1h, brn of mv knowl,~e ind btlid, this repair o, r1pl1ccm1nt h11 been connrucltd in acco,d1nce with Section XI of the ASME Code. Br 1ipning this cenifiu11, neither the ln1pecto, nor his lmployer meba onv w;rranw, upr,ued or implied, conctrft-i"9 the repair or rrplecemrnt dr.>11cribed in this Aepo,i. Funh1nnor1, neither tht ln1Ptcto, nor his employer shall be liable in 1ny manner for eny per10,,al _inj11ry or property d ~ o u of J.fV)ind ari1in9 from or coi,niKted wi1h this lnc>tction. D111 1- b. . i?T ~""IPl'CI.., f. ~ Commiuions /JB CSttll 7dCJ CJ l/o.. S<{:3 11101W: Svpplemant..1 ~hNn In form of 11111, , . . tc:h*, or e1,.wln5a mer t.. 11nd provided 111 tlH le 1>, 1ft. X II II\., DI """"*ftCf. 11111,c,nal ~ 121 lnfo,m,IJon In ,,...,, 1 1hro11gPI , Oft lhh dna npo" 11 lnc:l11d*d on uch ehNt, and (31 HC:h thNI 11 nwmt..r*d end " ' ' ,..,,.,to., of ehMta 11 ncord*d n lht IOP of 1h11 form.

     .  -:-,..                                                                                                                                                               ATTACHMENT 2
                                     \

FORM NIS*2 OWNER'S REPORT OF REPAIR OR REPLACEME.NT AJ Requirtd by the Provision* of ASME Code Section XI

   ...,.         Owner     Virginia Power                                                                                        D1tt    V?;-- /t?: /~82' P.O. Box 26666                                                                                        Sh NI                          of_ ___._ _ _ __
                                                                    ~*naJ
2. P11nt Surry Power Station CN""91 e.o. Box 315.{ACIOr9111 Surry. YA 23883
3. '
e. r--,.

Work Perlormtd by...;Yu8..LL,,_._PO>,£.Llw... . ~.,,,., ________ 38000 ? 2. 3'.3 I

                                                  -..same
4. Identification of Synem 5:f.,e...?r~.rEce:._r-,..,,:,.,..v
5. (a) Applicablt Construction Code B31-1 11 67 Editlon.....r~"'-A,_____ .Addenda, Code Cases _ _.N.... A___

(b) Applic:1bl1 Edition of S1e1ion XI Utilized for Repain or Repl1e1m1nu :_ 11..BO. wan '~nda, Codt Casn ...... N'""A._____ I. Identification of Comp0nenu Aepairtd or Replaced, end Aepl1ctment C.Omponentl Namtof N1mt of Mfrs. Ser. -N1t'I. CRN Other Ytar Repaired. ASME Codi Component Mfr. No. Bd. No. ldentJ. Buth Repltctd, ~tamped No. f"ic1tion or ;as or No) Replac:emtnl r.c,9,c/tf,1,vu,-S

  ,.-,.j,);, A/.1 l-/~)ie,4U;-

6,Ee,,..,.,~.,u ,...,/,? 1(/4 ,vfe- ,-.a--/e-/9d,: >>47 b;,,',* ,I .,f-,v,- ,,/~

7. Dneription of Work R£~..: - A Z:..1/ ;;:---

I. Tms Conducted: Hydrosutic D Pneumatic 0 Nominal Oper11in Prnsurt Et" Othtr 0 CERTIFICATE OF COMPLIANCE We cenify that th* n1t1menu made In this report art correct and this _ _ _ _ _ _ _ _ _ _ _ _ conforms to Section XI of the

    **ME,.,.._,,,,_ / )                                     *
   ;::ned ---* 0 ;(7,/ - -

t11pa,ror111>1a~ IS r y tow-*~ A ,' Tn11

                                                                                                              ~),7; /

it{.111

                                                                                                                                               .,, 0/

CERTIFICATE OF INSPECTION I. the undersigned, holding I valid commission issu~ by the Nttlonal Board of Boiler tnd Pressurt Vessel ln~1ors and tht S11tt OI Province of_ _.V....A

                                   ........________ , employ~ by                                  usn* I &I co          I                                                             of

_H_a_r_t_f~o_r_d__._c.T. . . __ h,ve insptcltd the Beo ('l.c;.eM.e,,rb* IR~P~'1SJ o, ~~:,11c1rne111(1I dtmi~ in 1his Repon on 9,-/[ . ,t.41 ind 1u111 1h11 to tht best of my ltnowlrdge and belief, this repair or replacement h11 been connructed in 1cc:o,d1n" with Section XI of the ASME Code. By signing this cenificau, neither the Inspector nor his lmployer maltts any warranry, upreued or implied, concer* i"III the repair or replacement describttd in this Rttpor,. F unhermore, neither the lnspttctor nor his employer 1h1II be liable in any manner for tny pe:onal :jury or propeny d 1 m : ' = ! ? ¥ i k}'\d arising from or connected with this ln1P1cti0ft. _.. D11t q 18 8<{ ~u~ Comminions /tJB~or v(i... jt.{3

                                                        ,.                Cl"SPK1Df)                                                   1$1111 or Piv,,,nc1. N1ho*11* llo&ldl on: S11ppl1m1n1Al 1hNt1 In form of ll1a,*1ketc:h*, or drawing. may be u11d provided C1l 1IH h IX In. X 11 lft,,                                                                         *.

lnform11lon In harn, I 1hro11eh

  • on 1h11 dale repor, 11 lnc:lud*d on ..c:h 1hNI, and 131 .. ell 1hHt 11 n11mber*d ii 1'>* n11mber of 1hNII h re:ord*d 111h1 1op of thl1 form.
    . -~f'                          .... :* .                                                                                                                                                   ATTACHMENT 2
                                                              ,,~ .
                                    \

FORM NIS-2 OWNER'S REPORT OF REPAIR OR REPLACEME.NT As Required by the Provisions of ASME Code Sec1ion XI

  ...,.         Ownet         Virginia Power                                                                                                                            /....,!,,.._,...,/'.:.::a~_.._~-------._.

D1tt_--:.__5:;-~_,;)....._,;;-....,.,__ P.0. Box 26666 ShHt ____..._______ of______....._________ j,t.OdresaJ

2. ,,an, Surcy Power Sta ti an (Nafflll P.O. Box 315~CIOl'IUI Surry. VA 23883 Work Performed by VA I t'Ower . 38DQQ 2t f /a
                                                                     ~-i
                                      .                ...Same       ~                        /
    ...         Identification of Synem C././e-~~c &~ 14e.J Vo.e.v,y.?

fa) Applic1blt Constrvctlon Code *B31-1 19 67

                                                                                                            <iJvr'2t:??

Editlon,.,.,H"-A,___ _ _ Addendl, Code Cases __.....N._A_____ 5. Cbl Applic1ble Edition of Section XI Utilized for Repain or Replac1mant1 - 11...BD, WBQ Addenda, Code CaSH _N_A..._____ I. Identification of ComPOnenu Repeind or Replaced, and Replactment Components Name of N1mtof Mfn.Ser. -N1t'L CRN Other Year Repeirtd, ASME Code Component Mfr. No. Bd. No. No. ldentJ. f'ic1tion riulh Aeplacad, or ~'*""*'

                                                                                                                                                                                        ; as or Nol Aeplacemant
     !!~.-? ,vi} ,5-           #~ul#,M                                                             /
   -,r,:,, )..c  .I, *./M-r':   'S>k *""' ...:,,!.s-       A/k-                R#;J-         ,,v//1    I-C//-/.t/3          u.4              ,/J,t!,b....~ / )
                                                                                                                                                  ,                                  A/M
7. DescriptionofWork ;2E)>.::.,?c:.!-'µ ,,e~,;9veft:! do.:::.77.,v,("
   **         Tem Conduc,ed:                    Hydronatic O Pneumttic O                          Nominal Opeming Prnsurw           W' Other 0
                                   ./           P,,uurt 102? s,sl Ten Temp.~eF
9. A,marb /V()Q4
                             ~al>lt Ma"UIKhHf'I Oli. lw:K)l'll 10 be IIIKJWdl CERTIFICATE OF COMPLIANCE Wt ctnify that the n1t1menu midi In this repon trl corrtcl and this                                       h).e:.,4-e.&&b'/                                  conforms to Section XI of the
: Code. QJ(.~4<

io--oro-.ra D e ~ ISI T1111 CERTIFICATE OF INSPECTION I, tht undersigned, holding I valid commission issufd by the N1tlonal Board of Boiler and Pressurt Vusel lnSl)Ktors tnd tht Statt or Province of VA , , employfd by HS B* I&I CO

  • of Hartford. CT, h1vein1Ptcttdthe repla.,ewievl IRti,a1111) o, ~t:,l*cemanl(II dmribedinthisReporton q:--;g ,19~

and 111111! that to tht ben of my knowl,~t and belief, this repair or replacement hes been connructed in ecc:ordance with Section XI of tht ASME Code. By signing this certifiutt, neither the Inspector nor his lmployer makes any warranty, tlltpreued or implied. concer~ for any personal injury or propeny ~!' ing the repair or repl1etment describeiin this Repon. Furthermore, neither the Inspector nor his employer ahell be liable in any 1T11nritr any kind arising from or connected with this ln1Ptction. D1tt q ~ '1 ~~ . Commiuions N(j 74C$111t 0 q Lia t;l/:3> pn1i,e<:IOfl n: $11pplamani.l 1h"t1 In form of 11111. ,~etch*, or drewlnga may be uuel provided '11 elu h IX 111, X 11 111., f/l """"'ftCt. lllaho<,al Boatll) Information In lnr,11 1 through

  • on thl1 Cina report 11 lncl11d1d on itech 1hNt, and 131 .. ch'""' I, n11mber*d 1'\I n11mber of 1hNtl 11 recorded It Iha too of thl* form.

ATTACHMENT 2

                                                                  ,,~ .
                                \

FORM NIS-2 OWNER'S REPORT OF REPAIR OR REPLACEME°NT A.J Required by the Provisions of ASME Code Section XI

      -,.      Owner      Virginia Power                                                                                                                            D1tt~~9       ..... J"",~~----7~~~~~
                                                                                                                                                                                    * ~_./___

P .0. Box 26666 ShNl.~~-----Of~---------~ jAOClreNJ

2. Plant Surcy Power IN.,.... Station p,o. Box 315 Surry. YA 23883 .{AOOtHI)

Work Performed by_V...A. . . . . .l:'0-k

                                                        . . ...l-e...r________                                                            38DDD ttO'il26
                                                                              ~-i
                                                    --Same
4. Identification of Synem C.1)0..v~ Cc.,,.;,,~
5. le) Applic1bli Construction Code 831-1 19 67 Editlon,, ....H_A____ Addende, Code Cases --'N_,A___

lb) Applic1bl1 Edition of S1e1ion XI Utilized for RepaiB or Replac1m1nt1 - II.BO, WBQ Addenda, Code Ca111 _..N_A..____ I. Identification of Componenu Aepai~d or Replaced, and Replac-ement Components Namtof Name of Mfrs. Str.

  • Nat'L CAN Other Ytar RepaiBd, ASME Code Component Mfr. No. Bd. No. ldenti- Bulh RepllCtd, ~tamped No. f"ic1tion or ;as or No)

Replacement

 ..T,v~~,. C,y,,_,b.
   #~,-,t>--,v.oJA,/        Vr.,(rs4              ?'1-rt- ?.],.r                              ,1//p                     _j /,~

1-cr-L-/A /'f"b ,t).£,,i)c4,(!_.,d ,V/J

7. Description of Worlc _~/<_J.__ ,,__t:)._c_.4'__...""e?."",...)__..C7

__4-..........

                                                                                                         ;</             ~y'-------------------------
                                                                                                             .....w.;;.;;*

I. Tffll Conducted: Hydrosutic O Pneumatic O Nominal Operating Pressuf9 9-" Other 0 Pressure /',lo)} psi Test Temp.~*, I. Atmarb _ _ _ _ _ _ _ __ , , - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -

                          ~<.ablt ~11UIK1uret"1 D11a Ae:,on110 bl attKl'IMII CERTIFICATE OF COMPLIANCE We cenify that the nat1menu made In this repor, art correct and this__._Af:_......                                                ~-~...4. c...,t:._'___
                                                                                                                                              ........      -.4t' e.=,<./----~----COnform1 to Section XI of the ASME Code.~'                       ~                                                                                                  trtpa,ror 1 1 p 1 a ~

Signed vJy(~,e:L,4-; io,.- or Ownet" ,,o,...I ISI TIiie

                                                                                                                                          ~p;- /r' (Da(1J
                                                                                                                                                                                    .,, gy*

CERTIFICATE OF INSPECTION I, the undtrai;ned, holding a valid commission issued by the National Board of Boller and Pressuf9 Vessel ln~tora ind the State or Province of VA, , employed by HSB' I &I CO, of Hartford, CT I have inspected the er, (a.c e M et-.Jl C!Arp *'1*1 ~r:,tacement(II o, dmribed in this Report on Cf-(8'. *,99Cf and nate lhet to tht ben of my kno .... ltdge and belief, this repair or replacement hts been connructed in 1ccordanct with Section XI of the ASME Code. By signing this cenifiate, neither the Inspector nor his lmployer makes any warranty, uprened or implied, concern-

'°':9' int the repair or repl1eement described in this Repor,. Funhermort, neither the Inspector nor his employer shall be liable in any manner
                                                                                                       ~ ki~ arising from or connected with this Inspection.

for any personal i:jury or property d ~ D1tt q-ci ~'f ~~ p111oec1~

                                                                                                      ~                            Commiuions                       µ8 7t>cCf           v~    5l/'3 (S1111 or ~nc,. Nahon11 8olldl
    . ": S11pplamani.l '"""Inform of lln:a, 1k11ch*, or drawlnpa mav be uHCI provld*CI CU 1111 h IX 1ft. X 11 In.,

lnform,tlon In ITem1 1 1hrough , on thl1 Cina 11por, la Included on ..ch ahNt, anCI (31 each'""' 11111,mber*d 11'1* n11mbar of U1Nt1 l1 racord*CI at 1ha 1op of thl* form.

      . -~                              ......     -                                                                                                                                                            ATTACHMENT 2
                       ....                                              ,,~    "'
  • .,. Owntt:

Vi rgi ni a Pawer P.0. Box 26666 FORM N1S*2 OWNER'S REPORT OF REPAIR OR REPLACEME.NT AJ Required by the Provisions of ASME Cod, Section XI 7/tJ-/n

                                                                                                                                                              ~ff---"--'------------

Shttt_......._~--0'---------

2. Plant Surry Power Statibnrnai Unh ____....CJ..........,/1/,.___~----------------------

(H~ . PO , , Box 315 Surry, VA 23883

a. Work Performed t,y ...V ...A......_
                                                          .........Powe.>UJu.wt'_ _ _ _ _ _ _ __                                                                                                                        fyu.1 4"atnel                                     "'pait Or;anwilioft ,.o No.. Jo<ol1~,                     C~lhPI. I
                                                                                                           #A-         Rc.~sv~/$SIA                 #,A j;.,.J,..s i..ta.1       3Jfy,2 lt           O        ;tiA-                                                                            R... ditte,e.d              Alo
7. Description of Work _ _ )J.

___ -Pi__ _ _ r._......,.,.._..e_

                                                                       <.._...J                     _.t-=--*,..,o..;../t:..;111\......;;,,~---------------------

I. Ttm Conduc,ed: Hydrosutic &' Pneumatic O No~nal Operating Prn111ra D Other 0

     ,.                                            Prusure21 l.S: pal                           Ten Temp.~*F R1marks _ _ _ _ _ _ _. , . . - - : : - - - - - - - - - -........- - - - - - - - - - - - - - - - - - - - - -

l,\pplal)lf M&"UfllC1 ........ Data ~:,ol'IIIO be att.te~ A, Ifo-, f o ,p.-, ss 'I J..-1 7 'fs 1 CERTIFICATE OF COMPLIANCE

~~':;.~~{attmelnum ~ Mrrpon In thil S Iare rt: .f)IHr.m,, e.-. T ,
                                                                                              ~correct and thls_----.,,..apal,'-l-ar.;....;..,e;:..p1a""'ca,.::.m'"'.,i='.~~--con orms to Section XI o thl t

signed ~<Lei~- P.,net 01 Mf"I 199 rs1 TIii

                                                                                                                                ,kv   (Dl14'
                                                                                                                                                           /9r                     .,, ?J CERTIFICATE OF INSPECTION I, the undersigned, holding I valid commission lss11ed by tht National Board of Boller and Pressul9 Vessel lnspec1ora and tht Statt or l'rovince of_              _.VCLA,*. ._________ , employed by HS B' I&I CO.                                                                                                                                        of
   ....,H_a~r-t....f_o-r_d._.,.__.C~T_.*..__have inspKltd tht IAtpe,,<11                     c:r./J /eiLu....e,,.,t demi~ in this Rtpott on                                                          7:...:/'( *;gf!.

o, '!e:;,1,cen,e111(1I and n111 that 10 tht ben of my knowltdgt and belief, this repair or replacement has been connl'llcttd In acc:ordanc:t with Section XI of tht ASME Code. By signing this cenificatt, neither the Inspector nor his lmployer makes any warranty, u:prened or implied, concern-ing the repair or replacement described in this Repon. F11nhermort, neither the Inspector nor his employer shall be litblt in any manner for any pe11onal lnj11ry or propeny d~~ ,9r.a~!f any kind arising from or connKted with this ln~1e1ion. ,,- Date 7-(9- ~J //~~ L ~ Commiuions µ(3 7tJD f t},:,._ 5Lf3 V ""IPKIOI) (Sltll Of Pro,,,~ ** Nahon1l 9o&r111 Non: Supplemen'l.el 1hMn In form of Ilsa, 1ke1ch*, or dr*wlnpo m*v t.. ueed p1ovld*d CU 1111 h IIM In. X 11111,. 121 lnfo,mnlon In ltarn1 1 through , on thle dna nPort 11 Included on uch shNt, *nd 131 uch 1hNt l1 numbered

 *nd 1">* number of eh .. tl la recorded 11 the top of 1h11 form.
    . . :-,.                      .**a***

ATTACHMENT 2

                   . ....                                   ,,~ .
                                  \

FORM N1S*2 OWNER'S REPORT OF REPAIR OR REPLACEMENT Al Required by the Prowi1ion1 of ASME Code Section XI

   -,.       Ownlf        Vi rgi ni a Power                                                                                           D1tt~_::z               ~/')_-----~f?~CJ~~~

P .0. Box 26666 Shfft_.__....__._ _ of......_..~...- - ~

                                                                  * &MOrflll
2. ,1,n1urryowerS P Statrno Unh ....__;;:C)~;J_..:;:~;..._........~................~....~ . . - ~

e.o, Box JlS(NSutry, YA 23883

3. Work P1rf ormtd br-Y~A
                                                       ,lAOOra&II
                                             ........-1:'0~W_e-r_________                                             3aooo 73 f 7-=t hvg ?r-'f1Jo 4Narnll
                                                      ,same
                                                                  &,lOO.....,        (\

Identification of Synem V<...e.5,.c..,-f..,. Coo lee, f r,J Applicablt Construction Code B31-l 19 67 H"'-A...____ .Addenda, Code Casra ___N_A____ Edition, .... lb) Applicable Edition of Section XI Utilized for Repail"I or Repl1C1menta - 19..80, wan Addenda, Code C.m ..... A____ t.J... I. Identification of Components Rrpairtd or Replaced, rind Replactment Components Name of Namt of Mfrs. Sar. -Ntt"I. CAN Other v,.,. Repaired, ASME Codi Component Mfr. No. Bd. No. ldentJ. Buth Replectd. Ste~ No. rication Of (Yn or No) Aeplacement (....d.~\ 1,..,-s..i-Bo Hi'A / A 'J AJ....> "-,. I 31?%'.:i..Ltti tt!A .AJA ISS/f, ~A-

  • f< e :o /.,_c:e tA I
,,,</D
  • 7.

I. I. Description of Work Tem Conducted: Hydrostatic

                                                           )J~ ff°;-9 Er' Prtssure2.J,l..,..--psi Pneumatic
e.
  • O Bo /--J,:}:7 Ten Temp . .J-,y7 *F Nominal Operating Prnsu'9 A1m1rlu _ _ _ _ _ _ _ _...,_._ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __._ __

D Other 0 jA.pplabll~nulKIUlet'I0.111~:,o,'IIIObUt\K,.. & /1,7 /Jo.:tJ.... S5 f ;;l..) 7 'f51 CERTIFICATE Of COMPLIANCE

~~~~11?-rt*~~~ this
                                                                 ~repon ceplq_c._fM_,e.,t l n art correct and thls _ __.__t,-p&lf+,-o,--"'-,e""p1a-=-cemena~"'"'"...__ _ conform1 to Section XI o the f

Signed 'pd~ io,.;oiOwnet'ifu~ Z~ ' / ISI TNII

                                                                                                                         ,kt!.)!

(DIii) tf * ,, r;S' CERTIFICATE OF INSPECTION I. 1h1 under1igned, holding I valid commission issued by the N1tlonal Board of Boller and Preuurt Ve~stl Inspectors and lht S11t1 or Provinc,of VA. *employed bv us o* I&I co e . of Hartford. CT. heve inspected the ce1Jlac~Mt4 +- ducribed in thb Repon Oft 2-11 . ;9~ IRtpl,,{11 o, Re;,11ceme111(1I ind n1t1 that 10 the bell of my knowledge and belief. 1hi1° repair or replacement h11 been connructed In 1ccord1nce with Section XI of the ASME Codr. By 1ignin9 this cenificatt, neither the Inspector nor hi1 lmployer makes any warranty, expressed or implied, concerft-ing lht repair or repltcement described in this Repon. Funhermort, neither the Inspector nor hi1 employer ahall be li1ble in 1ny manner for 1ny pe11onal Injury or propeny d1ffi'p~ ? n ~ d ,rising from or conne<:ted with this lnip1cti~ ,,: D1t1 7-(1-li'9 ~L~ Commiuionl /U(37oo? t<.o <f3

                                                             .            (ln&PKIClfl                                                          ($1111 Of f'ro,,111CI. Naf,o,,al 9oal11t Non: Suppl*manul 1h"ts In form of 11111, 1ka1ch*, or d1awlnpe "1*Y be UHd provided CO 1ln h I>' In. X 11111.,

(2) lnforma1lon In lnrn1 1 1hrougl'I

  • on 1h11 dna raoon 11 lr,clud*d on uch 1hNI, and (3) *ecll 1hHI 11 numbered and It>* number of 111Mb 11 recorded at th* 100 of thl1 form,

ATTACHMENT II

  * -:-"1*
                            '             FORM NIS-2 OWNER'S REPORT OF REPAIR OR REPLACEME.NT As Required by the Provisions of ASME Code Section XI 2.
!iAddrt!U)
3. Work Performed bv---i~=c.1*-'-/-h_..,..,,,,;,..........fs""'!t,'"""'-.,-------

(Name) Repair OrgAniution P.O No~ Job No~ etc. 5"'4-Y & (AOd-.1

4. ~=W,,.=~~r....."1-=~=-----------------------------,----

Identification of Synem~""S.-=*c:..,e,(...._,t.",t;,£"".

5. (al Applicable Construction Code dJ/. I 19 G 2 Edition, b/..12: Addenda, Code Cases /V~

(bl Applicable Edition of Section XI Utilized for Repain or Replacements - 19~, W J"CJ Addenda, Code Cases ek

6. Identification of Componenu Repaired or Replaced, and Replacement Componenu Name of Name of Mfrs. Ser. . Nan'I. CRN Other Year Repaired, ASME Code Component Mfr. No. Bd. No. ldenti- Built Replaced, Stamped No. fication or (Yes or Nol Replacement
'llJiU     VA,,,/,!-

FoU,usoi</

                      .f1<17,1,t;,,t,;,fS       --                       --- -                     I-S1,,J_  ~                   /),!;~~;,,L~,.-                      /~

7.

8. Other 0 9.

CERTIFICATE OF COMPLIANCE We certify that the natements made in this report are correct and this_-<.;,.2_=.,,:-'-)""",:-'-~-=-=='-":.£.""w"'""'r::~----COnforms to Section XI of the ASME Cod.Yl - 1

                                      ,,,f~                                                                    (repairo,replacementl Signed          ~.rh~A:::::::

(Owner ot Owne Desipnee) J:J'.£ C,(/(f. TIiie 2.40 (Date) CERTIFICATE OF INSPECTION I. the undersigned, holding a valid commission issued by the National Board of Boiler and Pressura Vessel Inspectors and the State or Province of i/a., , employed by

  • f/ J 13 t: f:_I" {!) 0 of Ha.rtFor-J ct hsveinspectedthe (ep~O.(M,ea.,'T
                      .J                                                IRepair(sl or Re;,lacement(s)J describedinthisReporton                               9-* 1-D      ,19.Ri.

11nd state that to the best of my knowledge 11nd belief, this* repair or replacement has been constructed in accordance with Section XI of the ASME Code. By 1igning thi1 certificate, neither the Inspector nor hi1 employer make1 any warranty, expressed or implied. concern-ing the repair or replacement described in this Report. Furthermore, neither the lns.pector nor his employer shall be liable in any manner for any personal injury or property dnage,,or3-n of any kind arising from or connect~ with this inspection. Date 1-io - R'\ ~t. ~ ComminionsA102bb'/ tic..... 543 (lnspe<:tot) Note: Supplemenul 1heet1 In form of ll*n. 1ketchm. or drewln111 m*Y btl uaed provided (1111n 11 8% In. X 11 In., (St~I* o, Prowonce, Nalional 6o&"'l (21 Information In INm1 1 through 4 on this data repon II Included on each 1hMt, and (31 uch 1hHt 11 numbtlred and in* number of 1hH~ Is recordBd at the top of thl1 form.

ATTACHMENT 2

                        \

FORM NIS-2 OWNER'S REPORT OF REPAIR OR REPLACEME.NT As Required by the Provisions of ASME Code Section XI

  -1. Owner    Virginia Power                                                                                                          03- !0 ~<;?~

D1tt~---~------------- P.O. Box 26666 ShHt _ _ _ _ _ _ of_ _ _ _ _ _ _ __ CAOOrna)

2. P11nt Surry Power Sta p,,-,

ti on P.O. Box 315 Surry, VA 23883

                                           .(AOOraUI
3. Work Performed by-'V....A......._,_1-'0..,IJ,..l..,e....r_________ 380QQb6f/J (Namel. Repair 0"11*nizalion P.0 No~ Jot, _ND~ ate.
                          .             --Same
4. Identification of Synem ,&'.1C~~Ol,f"'-'.7" ~ ~..adtb~) dJJ /
5. (al Applicable Construction Code B31-1 19 67 Editlon.~H::..A,___ _ _ Addenda, Code Cases -~N-A______

(b) Applicable Edition of Section XI Utilized for Repairs or Replacements - 19..BO, wan Addtnda, Code Cam ....... N....A._____

6. Identification of Componenu Repaired or Replaced, and Replacement Components Name of Name of Mfrs. Ser.
  • N1t'I. CAN Other Y11r Repaired, ASME Code
  • Component Mfr. No. Bd. No. ldentl- riullt Replaced, Stamped No. fic1tion or (Y11 or No)
                                                                                                               .                      Replacement o n""-'f.

5vr1h"1:e Wd;;,,,.Au,c., 14 ~I) 1-t OJ-

                                                                                                    ~y':"'-

PIii(*

                                                                                                                      ',fl)          /

fl.A., . ;A.."t) rl l"'/'t I

7. Description of Work flew t'J cJ.. /bL!J II SC/4/$'.E '(/Vi}/C'@d"'J .C),-v §c r/e.n.d ~ep-d ro Ir c,;.,,_r sd,rv,f/oc <

B. Tens Conducted: Hydrosutic D Pneumatic O Nominal Operatin11 Pressur"I O Other Jit /'7,r-// PressureZ31J' psi Ten Temp.~ *F

9. Remarks ""IA,-ppl-=-ic.lt>le----:~:-:-n-u""°1ac'"'1,-ur-er-:-1-:0.::--1*-=~=--:,oc,---1..,.10-:be-*-t1*-c-:-hed)-::-----------------------------

CERTIFICATE OF COMPLIANCE

~~~~t ~he natem~enu~made
                                                                                                             ?@//"

ln_this repon ire correct 1nd this _ _ __.i7..,.~e-i;.;,---Cll'-re_p1a_cemenQ _ _ _ _ _ _ conform1 to Section XI of the Si11ned u_ .

           --,,..J              'M~
                                             .                                          ISI Tnlt                  l[Mtel 3 /; 0
                                                                                                                              /
                                                                                                                                              , 19    P7' CERTIFICATE OF INSPECTION I, the undersi11ned. holdin11    1   valid commission issued by the National Board of Boller and Pressur1 Vessel Inspectors ind the Stall or Province of     VA ,                                                , emgloyed by HS 8* I &I CO ,                                                                                 of Hartford. CT.               have inspected the                           ?~.4/A.                  described in this Report on                                   3 /;(} *. ,sf-5
                             *                                           [Rep*, Io, ~e;,l1cementf1D                                                                  /

ind state that to the best of my knowledge ind belief, this repair or replacement hes been connructed in accordance with Section XI of the ASME Code. By signing this certificatt. neither the Inspector nor his l!mployer makes any w1rranty, expressed or implied, concern-for 1ny personal injury or.propeny d11:::'~o~ny Dm 3 / /(3 I/ ~ 1 ~~- e~ ki::r:g ing the rep1ir or replecement described in this Report. Funhermore, neither the Inspector nor his employer 1h1II be li1ble in 1ny manner from or connected with this Inspection. Commissions ~JG Zoo(Stilt q [)a, !i"'i .J (lns~tCII') on: Supplamanul ahMt'I In form Df ll1t1, tka1cha Dr drawlnpa m*Y b4I uud provided (1) 1IH 11 B~ In. X 11 In;, 0 o, Pn,,,,ncc, Nat&O'\AI Boa,,!) 121 lnformnlon In h.,n, 1 throuvh 4 on 1h11 dat* rapon 11 lnclud*d on .. ch 1hHt and 13) uch 1hHt 11 numb41red 0 end it,1 numb41r of lhNb h record*d nth* top of thla form.}}