ML20127J570
| ML20127J570 | |
| Person / Time | |
|---|---|
| Site: | Arkansas Nuclear  |
| Issue date: | 01/18/1993 |
| From: | Elliott J, Lomax D ENTERGY OPERATIONS, INC. |
| To: | |
| Shared Package | |
| ML20127J567 | List: |
| References | |
| NUDOCS 9301250179 | |
| Download: ML20127J570 (200) | |
Text
1 4
ATTACHMENT 1 FORM NIS-1 OWNER'S REPORT FOR INSERVICE INSPECTIONS 6
f i
k 9301250179 930118 DR ADOCK 05000368 PDR
lNSERVICE INSPECTION
SUMMARY
REPORT ARKANSAS NUCLEAR ONE, UNIT 2
- OUTAGE NUMBER: 2R9 OUTAGE COMPLETION DATE: 10/20/92 OWNER:
Arkar sas Power'& Light Company Capital and Broadway Little Rock, Arkansas 72203 OWNER / OPERATOR:
1 Entergy Operations, Inc.
Subsidiary of Entergy Corporation GENERATING PLANT:
Arkansas Nuclear One Route 3, Box 137G Russellville, AR 72801 Commercial Operating Date: March 26,1980 Submittal Date: January 18,1993 a--
i.
m
Page 1 of 15 FORM NiS 1 OWNER'S REPORT FOR INSERVICE INSPECTIONS As required by the Provisions of the ASME Code Rules Arkansas Power & Light Company /Entergy Operations, Inc.
1.
Owner P. O. Box 551, Capitol Tower Building, Little Rock, AR 72203 (Name and Address of Owner) 2.
Plant Arkansas Nuclear One, Rt 3 Box 137G, Russellville, AR 72801 (Name and Address of Plant) 3.
Plant Unit 2
4.
Owner and Certificate of Authorization (if required)
N/A 5.
Commercial Service Date 03/26/80 6.
National Board Number for Unit 22009 7.
Components Inspected ASME Code Class 1 (IWB), Class 2 (IWC), and Class 3 (LWD)
Components and Their Supports (IWF)
Manufacturer Component or Manufacturer or Installer State or National Appurtenance or Installer Serial No.
Province Board No.
(Manufacturer)
Reactor Vessel Combustion Engr 206-1 ARK 2204 22009 (Manufacturer)
Pressurizer Combustion Engr 2T-001 ARK 2201 21497 Steam (Manufacturer)
Generator 2E24 A Combustion Engr 2E24A ARK 2203 21083 Steam (Manufacturer)
Generator 2E24B Combustion Engr 2E24B ARK 2202 21084 Reactor Coolant (Manufacturer)
Pump 2P32C Byron Jackson N/A N/A N/A Shutdown Cooling (Installer)
Hx 2E35A Bechtel N/A N/A N/A (Installer)
LPSI Pump 2P60A Bechtel N/A N/A N/A (Installer)
HPSI Pump 2P89C Bechtel N/A N/A N/A (Installer)
Class 1 Piping Bechtel N/A N/A N/A (Installer)
Class 2 Piping Bechtel N/A N/A N/A (Installer)
Class 3 Piping Bechtel N/A N/A N/A Cfass 1 (Installer)
Component Supports Bechtel N/A N/A N/A Class 2 (Installer)
Component Supports Bechtel N/A N/A N/A Class 3 (Installer)
Component Supports Bechtel N/A N/A N/A AP&UEntergy by [D. B. Lom'ax o Date f,6/A Factory Mutual by Q. M [/Dr-Date //7/'73 g J. O. Elliott. ANil EPG92034
l Page 2 of 15 FORM NIS 1 (Back) 8.
Examination Dates: 04/20/91 to 10/20/92 9.
Inspection Interval from: 03/26/90 to 03,/2QlqQ
- 10. Applicable Editions of Section XI 1986 Addenda N/A
- 11. Abstract of Examinations, include a list of examinations and a statement concerning status of work required for current interval.
A listing of all ISI examinations performed during refueling outage 2R9 are located on supplemental pages 3 of 15 through 15 of 15 of this report. This was the second refueling outage of the 1st inspection Period of the 2nd inspection Interval.
- 12. Abstract of Conditions Noted.
See the attached ISI Component Examination Summary tables for a detailed description of all conditions noted during the course of the examination effort.
- 13. Abstract of Corrective Measures Recommended and Taken.
See the attached ISI Component Examination Summary tables for a detailed discussion of corrective measures recommended and taken.
We certify that the statements made in this report are correct and the examinations and corrective measures taken conform to the rules of ASME Code,Section XI.
Certificate of Authorization No. (if applicable)
N/A Expiration Date N/A Date k.6 10 93 Signed AP&UEntergy Operations. Inc. By M J
(/
Owner
/
D. B. f.om6x CERTIF!CATE OF INSERVICE INSPECTION 1, the undersigned, holding a valid commission issued by the National Board of Boller and Pressure Vesselinspectors and the State or Province of Arkansas and employed by Arkwdaht MutualInsurance QA of Norwood. Mass have inspected the components described in this Owners Report during the period V/Ao/9 / to lo/A c/9 A. and state that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owners 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, express or implied, conceming the examinations and corrective measures described in this Owners Repen.
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.
Factory Mutual Engineering Association
. O. b/
Commissions NB-9947. ARK-1133 'N' "l* "A" Inspectors Signature National Board, State Province, and Endorsements J. O. Elliott Date hn. 7 1993 8
EPG92034
Pcoe 3 of 15 SUPPLEMENT TO FORM NIS 1 OWNER'S REPORT FOR INSERVICE INSPECTIONS FOR ASME Code Class 1 (lWB), Class 2 (IWC), and Class 3 (IWD) Components and Their Supports (IWF)
Arkansas Power & Ught Company /Entergy Operations, InC-1.
Owner P. O. Box 551, Capit0! Tower Building, Little Rock, AR 72203 (Name and Address of Owner) 2.
Plant Arkansas Nuclear One, Rt 3 B0x 137G Russellville, AR 72801 (Name and Address of Plant) 3.
Plant Unit 2
4.
Owner and Certificate of Authorization (if required)
N/A 5.
Commercial Service Date 03/26/80 6.
National Board Number for Unit 22009 ASME AsME Exam GattoorY lldlb2, (omDonent Cr SYsiem Exem No.
Method Ducciotbn B-A B 1.30 Reactor Vessel 01 020 UT Upper Shes to Fiange CircumferenbalWeid B-A B 1.40 Reactor Closure Head 02401 UT,MT Fiange to Peel Segment Tonas B-B B 2.31 Steam Gererator 2E24A 03 008 UT Lower Head to Lower Extenskan Ring B-B B 2 32 Steam Generator 2E24A 03405 UT Peel Segment to Peel segment @ 210' B-D B 3130 Steam Generator 2E24A 03410*
UT 42" Hot leg Nonie to Head B-D B 3130 Steam Generator 2E24A 03411' UT 30" Cold Leg Nonie to Head @ 45' BD B 3130 Steam Generator 2E24A 03412*
UT 30" Cold Leg Nonle to Head @ 315' B-D B 3140 Steam Generator 2E24A 03419 UT 42" Hot Leg Nonle inner Radius Secta BD B 3140 Steam Generator 2E24A 03420 UT 30" Cold Leg Neube Inner Radius @ 45' B-D 83140 Steam Generator 2E24A 03421 UT 30" Cold Leg Nonie inner Radius @ 315' B-F B 5130 Reacts Coolant (Cold Leg)08-014' UT Ppng Ossimilar Metal Butt Weed B-F B 5.130 Reactor Coolant (Co63 Leg) 09400*
UT,PT Piping Drssimitar Metal Butt Weld B.F B $130 Reactor Coolant (Cold Leg) t o414*
UT Ppng Dissimdar Metal Butt Weld B-F B 5130 Reactor Coolant (Cold Leg) 11 008*
UT,PT Piping Dissimnar Metal Bytt Weld B-F B5140 Reacter Cooiant 3S-001 PT Piping Dissimilar Metal Butt Wold B-F B 5.140 Reactor Celant 41 o40 UT PT Piping D*similar Metal Butt Wold B-F B540 Pressurtzer 42401*
UT,PT Pressurizer Dissir Sar Metal Butt Weld B-G 1 8 6.10 Reacter Vessel 01 N 001 MT Closure Head Nut B41 8 6.10 Reactor Vessel 01-N-002 MT Closure Head Nut B41 8610 Reactor Vessel 01-N-003 MT Closure Head Nut B-G-1 B 6.10 Reactor vessei 01-N-004 MT Closure Head Nut B41 B610 Reactor Vessel 01-N405 MT Closure Head Nd B41 B 6.10 Reactor Vessel 01-N 406 MT Closure Head Nut 841 0610 Reactor Vessel 01-N 007 MT Closure Head Nut B41 B 610 Reactor Vessei 01 N 006 MT Closure Head Nd Bei B 610 Reactor Vessel 01-N409 MT Closure Head Nut Bei 86.10 Reactor Vessel 01-N410 MT Closure Head Nut B-G 1 B 610 Reactor Vessel 01-N 011 MT Closure Head Nut Bei B 6.10 Reactor Vessel 01-N-012 MT Closure Head Nut B-G-1 B 6.10 Reactor Vessel 01-N413 MT Closure Head Nut
' Code required coverage in excess of 90% was not achieved due to examination imitation. A Relief Request will be sutwn,'tted for NRC review and approvat, as required by 10CFR50, for failing to fumit this Code requirement.
AP&UEntergy by,k
,A Date i/q/r3 Factory Mutual by.ddM Date f /7/'f3 D.B.L max J. O, Elliott, ANil EPG92034
i Page 4 of 15 SUPPLEMENT TO FORM NIS 1 OWNER'S REPORT FOR INSERVICE INSPECTIONS FOR ASME Code Class 1 (IWB), Class 2 (IWC), and Class 3 (IWD) Components and Their Supports (IWF)
Arkansas Power & Light Company /Entergy Operaticns, Inc.
)
1.
Owner P O. 80x 551, Cap!101 Tower Building, Little Rock, AR 72203 l
(Name and Address of Chvner) 2.
Plant Arkansas Nuclear One, Rt 3 B0x 137G, Russellville, AR 72801 (Name and Address of Plant) 3.
Plant Unit 2
4.
Owner and Certificate of Authorization (if required)
N/A 5.
Commercial Service Date 03/26/80 6.
National Board Number for Unit 22009 ASME AsME Exarn C.tlt293 ftem No, Comoonent or System Exam No, Method Description B-G-1 8 6.10 Reactor Vessef 01 N 014 MT Closure Heed Nut B41 8 6.10 Reacter Vessel 01 N 015 MT Cbsure Head Nut B41 B 6.10 Reactor Vessei 01 N 016 MT Cicsure Head Nut 841 B 6.10 Reactor Vessel 01-N417 MT Closure Head Nut S41 B 6.10 Reactor Vessel 01-N 018 MT Cbsure Head Nut Bei B 6 30 Reactor Vessel 01 S 001 UT.MT Cbsure Head Stud B41 B 6 30 Reactor Vessel 01 S-002 UT,MT Cbsure Head Stud B41 8630 Reactor Vessel 01 S-003 UT,MT Cbsure Head Stud Bei B 6.30 Reactor Vessel 01 S-004 UT.MT Cbsure Head Stud B41 B 6.30 Reactor Vessel 01-S405 UT,MT Cbsure Head Stud B-G 1 B 6 30 Reactor Vessel 01-S-006 UT,MT Cbsure Head Stud Bei 8 6.30 Reactor Vesset 01-S-007 UT,MT Closure Head Stud B-G-1 B 6.30 Reactor Vessei 01 S-008 UT,MT Closure Head Stud B41 B 6.30 Reactor Vessel 01-S 009 UT.MT Closure Head Stud l
B-G-1 8 6.30 Reactor Vessel 01-S 010 UT,MT Cbsure Head Stud B-G-1 B 6.30 Reactor Vessel 01 S-011 UT,MT Cbsure Head Stud Bei B 6.30 Reactor Vessel 01 5-012 UT,MT Closure Head Stud Bei B 6.30 Reactor Vessel 01-S 013 UT,MT Cbsure Head Stud B41 B 6 30 Reactor Vessel 01 5-014 UT,MT Cbsure Head Stud B-G-1 B 6.30 Reactor Vessei 01-S-015
B41 B 6 30 Reactor Vessei 01-S-016 UT,MT Cbsure Head Stud t
841 8 6.30 Reactor Vessel 01 S-017 UT,MT Cbsure Head Stud B41 8 6.30 Reactor Vesset 01-S-018 UT,MT Cbsure Head Stud B41 8640 Reactor Vess.1 01 4-001 UT Vessef FlangeThreads B-G-1 0640 Reacbr Vessel 01 4-002 UT Vessel Flange Throeds l
Bei B 6 40 Reactor Vessei 01 4-003 UT Vesset Flange Threads B41 B 6 40 Reactor Vessel 014 0o4 UT Vessel Flange Threads Bei B 6 40 Reactor Vessei 014-005 UT Vessel Flange Threads B41 B 6.40 Reactor Vessel 01 4-006 UT Vessel Flange Threads B-G-1 8640 Reactor Vessel 01 L 007 UT Vessel Flange Threads B-G-1 B 6.40 Reactor Vessel 01-L 006 UT Vessel Flange Threads B41 B 6 40 Reactor Vessel 01-L-000 UT Vessel Flange Threads B41 B 6.40 Reactor Vessel 01 L-010 UT Vessei Flange Threads
.B41 B 6.40 Reactor Vessei 01 4-011 UT Vessel Flange Thrands B41 B 6 40 Reactor Vessei 01 4 012 UT Vessel Flange Throede B41 B 6.40 Reactor Vessel 01-L 013 UT Vessel Flange Throede Bei B 6 40 Reactor Vessel 01 4 014 UT Vessel Flange Throede B41 B 6.40 Reactor vessel 01 4-015 UT Vessel Flange Threads
' Code required coverage in excess of 90% was not acNeved due to examination imitation. A Reraf Request wi!! be autrnitted for NRC review and approval, as required by 10CFR50, for fa; ting to futral this Code requirement AP&L/Entergy by v"
Date A/93 Factory Mutual by Q. O /l~ d Date //7/93 D. B. Lomax f J. O. Elliott, ANil EPG92034
Page 5 of 15 SUPPLEMENT TO FORM NIS 1 OWNER'S REPORT Fort INSERVICE INSPECTIONS FOR ASME Code Class 1 (IWB), Class 2 (IWC), and Class 3 (IWD) Components and Their Supports (IWF)
Arkansas Powar & Light Company /Entergy operations, Inc.
1.
Owner P. O. Box 551, Capitol Tower Building, Little Rock, AR 72203 (Name and Address of Owner) 2.
Plant Arkansas Nuclear One, Rt 3 Box 137G, Russellville, AR 72801 (Name and Address of Plant) 3.
Plant Unit 2
4.
Owner and Certificate of Authorization (if required)
N/A 6.
Commercial Service Date 03/26/80 6.
National Board Number for Unit 22009 ASME ASME Exarn Gilt 22Df item No. Cornoonent or System Es am No.
Method Description B41 B 6 40 Reactor Vessel 01-L 016 UT Vessel Flange Threads B-G 1 B 6 40 Reactor Vessel 01t 017 UT Vessel Flange Threads Bei B640 Reactor Vessei 01-L 016 UT Vessel Flange lhroeds Bei B 6.50 Reactor Vessel 01 W-001 VT 1 Cbsure Head Washer B41 8 6.50 Reactor Vessel 01-W 002 Vr 1 Closure Head Washer B-G-1 8 6.50 Reactor Vessel 01-W-003 VT 1 Closure Head Washer Bei B 6.50 Reactor Vessel 01 W Co4 VT 1 Cbsure Head Washer B41 B 6.50 Reactor Vsssel 01-W 005 VT 1 Cbsure Head Washer B-G-1 8 6.50 Reactor Vessel 01-W 006 VT1 Closure Head Washer B-G 1 8650 Reactor Vessel 01-W 007 VT1 Cbsure Head Washer B-G 1 B 6 50 Reactor Vessel 01-W 006 VT 1 Closure Head Washer B41 B 6 50 Reactor Vessei 01 W 009 VT 1 Closure Head Washer B41 B 6 50 Reactor Vessel 01-W-010 VT 1 Cbsure Head Washer B-G-1 8 6.50 Reactor Vessel 01-W 011 VT 1 Cbsure Head Waster B41 8 6.50 Reactor Vesset 01-W-012 VT 1 Closure Head Washer B-G-1 B 6.50 Reactor Vessel 01 W 013 VT 1 Closure Head Washer Bei B 6 50 Reactor Vessel 01 W 014 VT 1 Closure Head Washer-B41 B 6 50 Reactor Vessel 01 W 015 VT 1 Closure Head Washer B41 8650 Reactor Vessef 01 W-016 VT 1 Closure Head Washer B41 8650 Reactor Vessel 01-W 017 VT 1 Closure Head Wastwr 841 B 6 50 Reactor Vessef 01-W 016 VT 1 Closure Head Washer B.G.1 B 6.180 Reactor Coolant Pump 2P32C 33-S-001 UT Reactor Coolant Pump Stud B41 B 6.180 Reactor Coolant Pump 2P32C 33-S-002 UT Reactor Coolant Pump Stud B-G 1 0 6.180 Reactor Coc4 ant Pump 2P32C 33-5-004 UT Reactor Coolant Pump Stud B41 B 6.180 Reactor Coolant Pump 2P32C 33-S-006 UT Reactor Coctant Pump Stud Bei B 6160 Reactor Coolant Pump 2P32C 33 S-007 UT Reactor Coolant Pump Stud B41 B 6 200 Reactor Coolant Pump 2P32C 33-N-001 VT 1 Reactor Coolant Pump Nut B-G 1 B 6 200 Reactor Coolant Pump 2P32C 33-N-002 VT-1 Reactor Coolant Pump Nut B41 B 6.200 Reactor Coolant Pump 2P32C 33-N-003 VT 1 Reactor Coolant Pump Nut B41 8 6.200 Reactor Coolant Pump 2P32C 33-N-004 VT-1 Reactor Coolant Pump Nut 841 B 6 200 Reactor Coolant Pump 2P32C 33-N-005 VT 1 Reactor Coolant Pump Nut B-G-2 8 7.10 Reacter Closure Head 02-B-068 VT-1 ICI Flange Bolbng B-G-2 B 7.10 Reactor Closure Head 02-B-089 VF1 Ici Flance Bolt;ng B42 8 7.50 Pressurner 42-010 VT-1 Flange Bolting l
l
' Code required coverage in excess of 90% was not schieved due to examination limitabon. A Relief Request will be submitted for NRC review and approval as required by 10CFR50. for failing to ruirJI this Code requirement.
AP&L/Entergy by M Date f/p/f3 Factory Mutual by Q. C / fcD Date l/7/93 D B. Lomax f J. O. Elliott. ANil EPG32034 i
Page 6 of 15 SUPPLEMENT TO FORM NIS.1 OWNER'S REPORT FOR INSERVICE INSPECTIONS FCR ASME Code Class 1 (IWB), Class 2 (IWC), and Class 3 (LWD) Components and Their Supports (IWF)
Aftansas Power & Light Company /Entergy Operations, inC.
1.
Owner P. O. Box 551, Capitol Tower Building, Little Rock, AR 72203 (Name and Address of Owner) 2.
Plant Arkansas Nuclear One, Rt 3 Box 137G, RuSSellvile, AR 72801 (Name and Address of Plant) 3.
Plant Unit 2
4.
Owner and Certificate of Authorization (if required)
N/A 6.
Commercial Service Date 03/26/80 6.
National Board Number for Unit 22009 ASME ASME Exam Catecoff item No. Component or system Exam No.
Method Deseriotion B42 B 7.70 Safety inpcbon 21 080 VT 1 17 Gate VaNo 2CV-50231 (Bolbng)
B42 B 7.70 Safety inrecten 21461 VT 1 17 Check VsNe 2SL158 (Bolbng)
B42 B 7.70 Safety inpeton 22 073 VT-1 17 Check Vane 2SI-15A (Bolbng)
B42 B 7.70 Safety Iryecbon 22474 VT-1 17 Check Vane 2SL16A (Bofbng) 842 8 7.70 Safety inpcbon 22476 VT1 6* Check Vane 2SLitA (Bolung)
B42 8 7.70 Safety infecbon 23482 VT 1 17 Check VaNo 2SL16C (Bolung)
B42 B 7.70 Safety in eebon 23496 VT 1 6 Check Vane 2SL14C (Bolbng) s B-G-2 B 7.70 Safety injecten 24489 VT 1 12" Check Vane 2SL160 (Bolung)
B-G-2 B 7.70 S.afety tr ec*aon 24-090 VT1 17 Gate Vane 2CV 5063-2 (Bolung)
B-H BS.30 Steam Generator 2E24A 03401 MT Support Skirt to Lomt Head Wold B4 B 911 Reactor Ccolant (Hot Leg) 06 009 UT,MT Ppng Circumferental Butt Wold 64 8911 Reactor Coolant (Cold Leg) 08-001*
UT,MT Piping Circumferenta! Butt Wald B4 8911 Reactor Coolant (Cold Leg) 06-015*
UT Poing Circumferental Butt Waid B4 8911 Reactor Coolant (Cold Leg)
O M 09*
UT,PT Ppng Circumferental Butt Wold B4 8911 Reactor Coolant (Cold Leg) 10 001*
UT,MT Pping Circumferental Butt Weid B4 8 9.11 Reactor Coolant (Cold Leg) 10 015*
UT Piping Circumferental Butt Weid B4 8911 Reactor Contant (Cold Leg)11-009' UT,PT Pping Circumferential Butt Wold N
B 911 Reactor Coolant 28 023 UT Piping Circumferental Butt Weld 84 8911 Reactor Coolant 43-022 UT,PT Peing Circumferental Butt Waid B4 B 911 Reactor Coolant 43-026' UT,PT Ppng Crcumferental Butt Wekt B4 8 9.11 Reactor Coolant 43 027' UT,PT Ppng Circumferenbal Butt Weld B4 B9.12 Reactor Coolant (Cold Leg)
OM06 UT,MT Piping Longitudinal Weid B4 8912 Reactor Coolant (Cold Leg) oM07 UT,MT Pping Longiudinal Weld B4 8 9.12 Reactor Coolant (Cold Leg) 11 006 UT.MT Piping LongitudinalWev.!
B4 B 9.12 Reactor Coolant (Cold Leg) 11 007 UT,MT Ppng LongitudinalWeid B4 8 9.31 Reactor Coolant (Hot Leg)
OH10' UT,PT Ptping Branch Connect >on 84 B'9 40 Reactor Coolant 2SCO2 PT Piping Socket Weid ELJ B 9.40 Reactor Coolant 29403 PT Pping Socket Weid B4 8940 Reactor Coolant 29-004 PT Piping Socket Weid Eh!
B 9 40 Reactor Coolant 24005 PT Ppng Socket Wold B4 8 9.40 Reactor Coolant 35404 PT Pipin9 Socket Wold B4 8940 Reactor Coolant 35407 PT Piping Socket Weld B4 8940 Reactor Cociant 35 008 PT Ppng Socket Wold l
B-K-1 B 10.10 Safety trjecbon 23469W PT Integra!!y Welded Attachment 2CCA 24 H22
- Code required coverage in excess of 90% was not acNeved due to examinaten limitatort A Relief Request wCI be submitted for NRC review and approval, as required by 10CFR50, for fail.ng to fulfill tNs Code requirement.
AP&UEntergy by [
Date s/v/43 Factory Mutual by $. C. [E&D Dats _ //7/9,3 D. B. L0r6ax (7 J. O. Elliott, ANil EPG92034
Page 7 of 15 -
- SUPPLEMENT TO FORM NIS.1 OWNER'S REPORT FOR INSERVICE INSPECTIONS FOR-ASME Code Class 1 (IWB), Class 2 (IWC), and Class 3 (IWD) Components and Their Suppofts (IWF)
Afkansas Power & Light Company /Entergy Operations, Inc.
1.
Owner P. O. Box 551, Capitol Tower Building, Little Rock, AR 72203 (Name and Address of Owner) 2.
Plant AfkanSas Nuclear One, Rt 3 B0x 137G, RuSSellville, AR 72801 (Name and Addre$s of Plant) 3.
Plant Unit 2
4.
Owner and Certificate of Authorization (if required)
N/A 5.
Commercial Service Date 03/26/80 6.
National Board Number for Unit 22009 ASME ASME Exam Cateogty flem No. Component or Svstem Exam No.
Method Descriotion B-K-1 B 10 20 Reactor Coolant Pump 2P32C 33403 PT Integrally Weeded Attachment #1 B42 B 12.50 Safety trgection 21 076 VT4 17 Check Valve 2Sh158 (Inside Surfsoe)
B42 B 12 50 Safety tryocton 22 045 VT4 1T Check Vaw 2S)-15A (Inside Surface)
C4.12 B 12 50 Safety Irsecten 22 046 VT4 12* Check Valve 2SI-16A (Inskie Surface)
B42 B 12.50 Safety tryocton 23453 VT4 17 Check Vatve 2SI-16C (Inside Surface) 842 B 12 50 Safety infecten 23-057 VT-3
- 6* Check Vatve 2SI-14C (Inside surface) 842 8 12.50 Safety injection 24461 VT 3 12" Check Vatve 231-160 (Inside Surface)
B42 B 12.50 Safety tryoction 24-062 VT 3 IT Gate VaNo 2CV-5063-2 (Inside Surface)
B-N-1 B 13.10 Reactor Vessei 01 069 VT3 VesselInterior Surface C-A C 1.10 Steam Generator 2E24A 03-030 UT Intermedate Shee to Conical Shea C-A C 1.10 Shutdown Cochng HX 2E35A 4&401*
UT Flange to Chrinet Cyhnder Wold C-A C 120 Steam Generator 2E24A 03 032' UT Upper Shel to Top Head Torus CB C 221 Steam Generator 2E24A 03 035' UT Feedwater Nc221e to Upper Shoe C-8 C 2.21 Steam Generator 2E248 04 034' UT Main Steam Nozzie to Top hem Dome C-8 C 2.22 Steam Generator 2E24 03-043 UT Feedwater No:zie Inner Radius Secten C-C C 320 Feedwater 17-026W MT Integrally Weided Attachment 2DBB 1-H1 CC C 320 feedwater 17 029W" MT Integrah Weided Attachment 20BB 1-H4 C-C C 320 Feedwater 17-041W MT Integrany Welded Attachment 2DBB 1-H16 CC C 3 20 Main Steam 18-023W MT Integrah Welded Attachmerd 2 EBB-1 A-H7 C-C C 3 20 Main Steam 18-024W MT Integrah Weided Attachment 2 EBB-1 A-H6 C-C C 3 20 Safety Iryecten 53 025W PT IntegranyWelded Attachment 2GCB4 H23 C-C C 3 20 Feedwater 62409W MT-IntegshWelded Attachment 20BB-1-H5 -
C-C C 320 Feedwater 62 010W MT Integrany Welded Attachment 20BB-1-H19 C-C C 3 20 Main Steam 63-039W MT IntegraltyWelded Attachment 2 EBB-1-H2 i
C.F 1 Shutdown Coonng 30406 UT,PT Piping Circumferential Butt Weid Shutdown Cochng 30-007 UT,PT Piping Circumferential Butt Wold C-F 1 C-F-1 Safety tryecten 55019 UT,PT Piping Circumferental Butt Wold 1
C-F 1 Safety injection 55422 UT.PT Piping Circumferential Butt Weld C-F 1 Safety triecuen 55-030 UT,PT Piping Circumferential Butt Weid C-F 1 Containment Spray 76401 UT,PT Piping Circumferential Butt Wold C-F-1 Containment Spray 76 003-UT,PT Piping Circumferential Butt Weid C-F-1 Containtnent Spray 76-008 UT,PT Piping Circumferential Butt Weid
- Code required coverage in excess of 90% was not achieved due to examination limitation. A Relief Request will be submitted for NRC review and approval, as required by 10CFR50, for faasng to fuir.!! this Code requirement.
AP&L/Entergy by _,Id A Date //g/v3 Factory Mutual by Q. 6(L[M Date //7/93
'D. B. L0mhx f J.O. Elliott, ANil EPG92034
Page 8 of 15 SUPG.EMENT TO FORM NIS 1 OWNER'S RE? ORT FOR INSERVICE INSPECTIONS FOR ASME Code Class 1 (IWB), Class 2 (IWC), and Class 3 (IWD) Components and Their Supports (IWF)
- Arkansas Power & Light Company /Entergy Operations, Inc.
1.
Owner P. O. Box 551. Capitol Tower Building, Little Rock., AR 72203 (Name and Address of Owner) 2.
Plant AftanSas Nuclear One, Rt 3 Box 137G, Russellville, AR 72801 (Name and Address of Plant) 3.
Plant Unit 2
4.
Owner and Certificate of Authorization (if required)
N/A 6.
Commercial Service Date 03/26/80 6.
National Board Number for Unit 22009 ASME AsME Exam Catecory llem No. Component or System Eram No.
Ptib.2d Description C F-1 Safe *y Irvection 91445 UT,PT Pipiry Circumferential Butt Weid C-F-1 Safety injection 91463 UT,PT Piping Circumferential Butt Wed C-F 1 Shutdown Cookng 3040GA UT,PT Ppng Longitudinal WeM C-F-1 Shutdown Cooling 30 0068 UT,PT Peng LengtudinalWold C-F 1 Safety injection 55-020AB UT,PT Peng Longitudinal Weid C-F 1 Safety insecten 55-030AB UT,P T Peng Longitudnal WeM C-F 1 C 5.21 Hgh Pressure Safety Intecten 81470 UT.PT Piping Circumferential Butt Wald C-F 1 C 5.21 Hgh Pressure Safety triecton 83-033 UT,PT Peng Creumferential But! Wold C-F 2 C 551 feedwater 17 001 UT,MT Piping Circumferential Butt WeM C-F-2 C 5 51 Feedrater 17402 UT,MT Ppng Circumferential Butt WeM C F-2 C 5 51 Main Steam 6%01 A UT Piping Circumferential Butt WeM C-F-2 C 5 51 Main Steam 6M01B UT Ppng Circumferentr Butt Weld C-F 2 C 5 51 Main Steam 6X02 UT,MT Ppng Circumferential Butt Weld C-F 2 C 5.52 Main Steam 63402AB UT,MT Ppng Longitudnal WeM C-F 2 C 5.81 Main Steam 63-003 MT Peng Branch Connection D-B D 2 20 Semce Water 72427W VT-3 integrah Welded Attachment 2HBC-33-H21 D-B D 2 20 Service Water 72 035W VT-3 Integrah Welded Attachment 2HBC-35-H4 DB D 2.20 Semce Water 72438W VT 3 Integra!!y Welded Attachment 2HBC-33-H1 DB D 220 Service Water 72 05M VT 3 Integrah Weided Attachment 2HBC-S9-H4 D-B D 2.20 Service Water 72-054W VT-3 Integrah Welded Attachtnent 2HBC-SS-H6 D-B D 2 20 Service Water 72 056W VT 3 integrah Weided Attachment 2HBC 59-HS D-B D 2.20 Service Water 72-057W VT-3 Integ ah Welded Attachment 2HBC 53-H10 D-B D 2 20 Service Water 72-056W VT-3 Integralty Welded Attachment 2HBC-59-H11 D-B D 2.20 Service Water 72-086W VT 3 integrah Welded Attachment 2HBC-33-H14 D-B D 2,20 Service Water 72495W VT-3 Integrafty Welded Attachment 2HBC-85 H1 D-B D 2.20 Semco Water 72-099W VT-3 Integrah Welded Attachment 2HBC-85-H5 DB D 2.20 Semce Water 72-166W VT-3 Integrah Welded Attachment 2HBC-85-H7 DB D 2.20 Service Watw 72168W VT-3 Integrah Wekled Attachment 2HBC-85H10 D-B D 2.20 Service Water 72175W VT-3 Integra!?y Welded Attachment 2HBC-35-H2 D-B D220 Semce Water 72-178W VT-3 Integ affy Welded Attachment 2HBC-54H9 D-B D 2.20 Semce Water 7M4tN VT3 Integra!!y Welded Attachment 2HBC-64-H9 D-8 D 2.20 Service Water 7MG3W VT-3 Integra!!y Welded Attachment 2HBC-34-H14 D-B D 2.20 Service Water 73-075W VT 3 Integrah Welded Attachment 2HBC-60 H3 DB D 2 20 Service Water 73-077W VT-3 Integrah Weided Attachment 2HBC-60-HS D-B D 2.20 Semce Water 73-10SW VT3 Integerity Weided Attachment 2HBC-64 H1
- Cede required coverags in excess of 90% was not schieved due to examination limitat:crL A Relief Request will be sutxrutted for NRC review and approva!, as required by 10CFR50, for faihng to fulfill this Code requirement l
[
_ Date f[$3. Factory Mutual bypJ. O. Elliott, ANll]M9 Date 1 AP&UEntergy by D. B. Lomax y
1 E PG92034
Page 9 of 15 SUPPLEMENT TO FORM NIS 1 OWNER'S REPORT FOR INSERVICE INSPECTIONS FOR ASME Code Class 1 (IWB), Class 2 (IWC), and Class 3 (IWD) Components and Their Supports (IWF)
Arkansas Power & Light Company /Entergy Operations, Inc, 1.
Owner P. O B0x 551, Capitol Tower Building, Little ROCK, AR 72203 (Name and Address of Owner) 2.
Plant Arkansas Nuclear One, Rt 3 Box 137G, RusSellville, AR 72801 (Name and Address of Plant) 3.
Plant Unit 2
4.
Owner and Certificate of Authorization (if required)
N/A 5.
Commercial Service Date 03/26/80 6.
National Board Number for Unit 22009 AsME AsME Etam Gate 9MY ltem No, comoonent or Svt1C Elam No.
M.tt.El Description h
D-B D 2.20 SeMee Water 73-106W VT4 Integrah Welded Attac.vnent 2HBC 84-H10 D-B D 2.20 Semce Water 73-108W VT4 Wegra#y Weided Attachment 2HBC-34-H1 D-B D 2.20 Emergency Feedwater 85104W VT-3 Wegrally Welded Anachment 20BC 144 D-B D 2.20 Emergency Feeduter 85-105W VT-3 IntegraHy Welded Attachmerd 2DBC-1 H5 D-B D 2 20 Emergency Feedwater BS 127W VT-3 Wegralty Welded Attachment 2DBC 1 H27 D-B D 2.20 Emergency Feedwater 85136W VT-3 Wegralty Welded Attachmerd 2DBC-1-H36 DB D 2 40 Semce Water 7%g1AW VT-3 Wegrafty Welded Attachmerd 2HBC-104-H2 0-8 D 2 40 Emergency Feedwater 85-120W VT-3 Integralty Welded Attachment 2DBC-1-H2O D-B D 2.50 Service Water 7%B8W VT 3 Integrally Welded Attachment 2HBC-104-H7 F-A F1.10A Safety intecton 2 % 62 VT 3 One-Way Restraint 2CCA 24 H18 F-A F 1.10A Safety intecten 2 % 65 VT 3 One-Way Restraint 2CCA 24-H3 F-A F1.10A Sa ety hrecten 2 % 68 VT 3 One-Way Restrad 2CCA-24 H21 r
FA F 1.10A Reactor Coolant 35 018 VT-3 One-Way Restraint 2CCA-32-H1 F4 F 1.10A Reactor Coolant 37-047 VT-3 One Way Restraint 2CCA 12-H9 FA F 1.10A Chemcal & Volume controi 4M55 VT-3 One-Way Restrart 2CCA-27 3-H4 F-A F 1.10A Chemical & Volume Contrd 40 056 VT 3 One-Way Restrard 2CC A-274-H3 F4 F 1.10A Chemcal & Volume Control 4o-058 VT4 One-Way Restraint 2CCA 27 Mi1 F-A F1.10A Chemical & Volume Control 40-059 VT-3 One-Way Restraint 2CCA-27-4 H1 F4 F1.10A Reactor Codart 43-0M VT 3 One-Way Restraint 2BCA 14-H2 F-A F 1.100 Satety injecton 24 068 VT 3 Mutti directional Restraint 2CCA-23 H12 F4 F 1.10B Reactor Codant 37 o42 VT 3 Muttierectonal Restraint 2CCA-12M3 F4 F 1.100 Chemical & Volume Controt 4M52 VT-3 Multi 4rectonal Restraint 2CCA 27 2-H6 F-A F1.10B Chemcal & Volume Contrd 4 H57 VT-3 Multi 4rectonal Restraint 2CCA-27-3-H2 F-A F 1.10C Safety injecten 2 % 64 VT-3 Variable Spnng 2CCA-24-H2 F-A F 1.10C Safety injection 2 % 67 VT-3 Variable Spring 2CCA 24 H2O F-A F1.10C Safety injecten 2 % 81 VT-3 Vanable Spring 2CCA 24-H12 FA F 1.10C Reactor Cootant 37439 VT4 Variable Spdng 2CCA 12-H1 FA F1.10C Reactor Coolant 37 o41 VT-3 Variable Spring 2CCA 12 H6 F4 F1.10C Reactor Coolant 43 052 VT-3 Variable Spring 2BCA 14-H4 F.A F 1.10E Safety Intecten 23 069 VT-3 Anchor 2CCA-24-H22 FA F 1.10F Reactor Cedant 13017 VT-3 Snubber 2BCA 1 H2 F-A F i.10F Reactor Coolant 16-018 VT 3 Snubber 2BCA-1 H3 F-A F 1.10F Safety injecten 21 057 VT4 Snubber 2CCA-21-H12
- Cale required coverage in excess of 90% was not achieved due to examination firnitaten. A Refief Request will be submitted for NRC review and appmval, as requwed by 10CFR50, for failing to futfill this Code requirement.
AP&L/Entergy by jd Date 44/e Factory Mutual by)/ J. O. Elliott, ANil. & d./lM D. B'. Lothax t
E PG92034
Pcoe 10 of 15 SUPPLEMENT TO FORM NIS 1 OWNER'S REPORT FOR INSERVICE INSPECTIONS FOR ASME Code Class 1 (lWB), Class 2 (IWC), and Class 3 (IWD) Components and Their Supports (IWF) m Arkansas Power & Light Company /Entergy Operations, Inc.
1, Owner P. O. B0x 551, Capitol Tower Building, Little Rot.n, AR 72203 (Narne and Address of Owner) 2.
Plant Arkansas Nuclear One, Rt 3 Box 137G, RuSSellville, AR 72801 (Name and Address of Plant) 3.
Plant Unit 2
4.
Owner and Certificate of Authorization (if required)
N/A 5.
Commercial Service Date 03/26/80 6.
National Board Number for Unit 22009
~
ASME ASME Exam CA].t29.(X grmEg, Component or System Enam No-M11h2d falgiotion F-A F1.10F Safety intacten 21 058 VT 3 Snubber 2CCA-21-H18 FA F1,10F Safety irjeebon 21 oS1 VT-3 Snubbar 20CA 21 H10 FA F 1.10F Safety inpcton 21 063 VT 3 Saubber 2CCA-21-H17 FA F110F Safety Irvecten 21 067 VT-3 Ser rbber 2CCA 21 H15 FA F1.10F Safety insecta 21 068 VT-3 Snubter 2CCA 21-H19 FA F 1.10F Safety insecbon 21 C72 VT 3 Snubber 2CCA-21 H16 r
F-A F1.*0F Safety infecton 22450 VT-3
$nubber 2CCA-22 H22 F-A F 1/20F Safety injecten 22 052 VT 3 Snubber 2CCA 22-H21 F-A F 1.10F Safety injectm 22 055 VT-3 Snubber 2CCA-22-H19 F-A F 1.10F Safety trjecten 22456 VT-3 Snubber 2CCA-22-H18 F-A F1.10F Sa'ety insectm 22457 VT 3 Snubber 2CCA 22 H17 FA F 1.13F Safety inpcten 22-060 VT 3 Snubber 2CCA 22 H15 F-A F 1,10F Safety in#ectm 22-062 VT 3 Snubber 2CCA-22-H14 FA F 1.10F Safety injection 224G4 VT4 Snubber 2CCA 22 H13 FA F1.10F Gafety injection 23459 VT4 Snubber 2CCA-24-H15 F-A F 1.10F Safety infection 2 M 61 VT-3 Snubber 2CCA-2&Hl7 F-A F 1.10#
Safety inacton 2M63 VT 3 Snubber 2CCA 24-H19 F-A F 1.10r Safety inpction 23475 VT-3 Snubber 2CCA-24 H27 F-A F 1.10F Safety ineection 23-076 VT4 F.nubber 2CCA 24-H24 F-A F 1.10F Safety injection 24-067 VT 3 Snubber 2CCA-2SH11 F.A F 1.10F Safety insecton 24 074 VT 3 Snubtw 2CCA-23 H2O FA F 1.10F Safety injecten 2447ti VT4 Snubtw 2CCA 23-H27 F-A F1.10F S fetyingcbon 24477 VT 3 Snubber 2CCA 2SH18 F-A F1.10F-Safety intecton 24-079 VT4 Snubber 2CCA.4H28 F-A F 1.10F Safety inpction 24400 VT-3 Snutber 2CCA 23-H21 FA F 1.10F Safety Inpction 24484 VT 3 Snubber 2CCA-23-H23 l
FA F 1.10F Shutdown Coohng 25474 VT4 Snubber 2CCA-25 H3 F-A F1.10F Shutdown Cochng 25-075 VT-3 Snuboer 2CCA 2SH4 FA F1.10F Shutdown Coohng 25-077 VT-3 Snutter 2CCA 2SH5 FA F 1.10F Shutdown Coohng 25479 VT 3 Snuther 2CC arm 6 F-A F 1.10F Shutdown Cooling 25-082 VT-3 Snubber 22CA *dS-H10 F-A F 1.10F Shutdown Coohng 25-084 VT4 Snubber 2CC A-25-H14 F-A F 1.10F Shutdown Cookng 25-088 VT-3 Snubber 2CCo 2SH13 F-A F 1.10F Reactor Loolart 26-024 VT-3 Snubber 2CCA-14.H2 FA F1.10F Reactor Coolard 26-028 VT-3 Snubber 2CCA-1Sh.9 FA F1.10F Reactor Cootart 26 C30 VT4 Snubber 2CCA 15-H27
(
F-A F 1.10F Reactor Cootart 26-031 VT 3 Snubber 2CCA 15 H26 F-A F1.10F Reactor Coolard 26 053 VT-3 Snubber 2CCA-14+tS F-A F1.10F Reactor Coc4 art 2$054 VT-3 Snubber 2CCA 15-H45
~
FA F1.10F Reactor Cootort 26035 VT-3 Srmbber 2CCA-15-H44
- Code requred coverage in excess of 90% was not achieved due to ewninaten ritnitaten. A Renef Request will be subrn!tted for NRC review and approval, as requved by 10CFR50, for faihng to fu!rdi this Code requirement.
l AP&L/Entergy by /d[
Date,t/4/43 Factory Mutual 12y #9. C. UdDate y'7]fj D B Lom'ax
// J O. Elliott ANil EoG92034
POce 11 of 15 SUPPLEMENT TO FORM Nis.1 OWNER'S REPORT FOR INSERVICE INSPECTIONS FOR ASME Code Class 1 (IWB), Class 2 (IWC), and Class 3 (IWD) Components and Their Supports (lWF)
Arkansas Power & Ught Company /Entergy Operations, inC-1.
Owner, P. O. B0x 551. Capitol Tower Building. Uttle Rock, AR 72203 (Name and Address of Owner) 2.
Plant Arkansas Nuclear One. Rt 3 Box 137G, Russellville, AR 72801 (Name and Address of Plant) 3.
Plant Unit 2
4.
Owner and Certificate of Authorization (if requifid)
N/A 5.
Commercial Service Date _ _03/26/80 6.
National Board Number for Unit 22009 A5ME ASME Ezam GMt290 lltm32. Cpmoonent etlygtnL.,,
f Xam Ng, Method Dtictiotion F4 F1.10F Reactor Coolant 26-060 VT-3 Snubber 2CCA-15H41 FA F1.10F Reactor Coolart 20062 VT-3 Snubber 2CCA 15-H39 FA F 1.10F Reactor Coolant 27 030 VT 3 Snubber 2CCA 13M4 FA F1.10F Reactor Coolant 27 034 VT 3 Snubber 2CCA-15 H24 F-A F1.10F Reactor Coolant 27 067 VT 3 Snubber 2CCA 15 H60 F-A F 1.10F Reactor Coolant 27-074 VT 3 Snubber 2CCA 15-H56 FA F 1.10F Reactor Coolant 27 076 VT4 Snubber 2CCA-15-HS3 F-A F 1.10F Reactor Coolard 27-076 VT-3 Snubber 2CCA 15-HSO F-A F 1.10F Reactor Coolant 27 081 VT4 Snubber 2CCA 15H48 F4 F 1.10F Reactor Codard 28436 VT 3 anubber 2CCA 15-H29 F-A F 1,10F Reactor Codant 28-037 VT 3 Snubber 2CCA-15-H30 F-A F1.10F Reactar Cootant 28-054 VT 3 Snubber 2CCA 15-H31 FA F 1.10F Reactor Coolant 28456 VT 3 Snubber 2CCA 15-H34 FA F 1,10F Reactor Coolant 28458 VT-3 Snubber 2CCA-15-H36 F-A F1.10F Cherrucal & Volume Contrd
'h029 VT 3 Snubber 2CCA 10 H10 FA F 1.10F Chemica! & Volume Control 29-036 VT-3 Snubber 2CCA 16-H3 F-A F 1.10F Chemical & Volume Control 29 038 VT-3 Snubber 2CCA 16-H4 F.A F 1,10F Chemcal & Volume Cordrd 29462 VT-3 Snubber 2CCA-1&H21 FA F 1.10F Chemca! & Volume Control 29064 VT-3 Snubber 2CCA 16 H16 FA F 1.10F Chenical & Vdume Contrd 29468 VT 3 Snubber 2CCA 16-H12 F4 F1.10F Reactor Coolant 35 019 VT3 Snubber 2CCA-32-H2 FA F 1.10F Chemical & Volume C:antrol 41 045 VT 3 Snubber 2CCA-26-H2 FA F 1.10F Reactor Cociant 43441 VT 3 Snubber 2BCA-14 H7 F-A F 1.10F Reactor Coolant 43-044 VT 3 Snubber 2BCA-11 "14 F4 F1.10F Reactor Coolant 43446 VT 3 Snubber 2BCA-1.d3 FA F 1.10F Reactor Coolant 43-047 VT-3 Snubber 2BCA 14-H5 FA F 1.10F Reactor Coulant 43-049 VT4 Snubber 2BCA 14-H13 F4 F 1.10F Reactor Coo 4 ant 43-050 VT-3 Snubber 2BCA 14 H12 FA F 1.10F Reactor Coolant 43451 VT 3 Snubber 2BCA 14-H15 F4 F 1.10F Reactor Coolard 43-054 VT-3 Snubber 2BCA-14-H1 F4 F1.20A Feedwater 17 041 VT 3 One-Way Restraint 208B-1 H16 FA F1.20A Shutdowri Cooling 30 023 VT 3 One-Way Restraint 2GCB-$-H19 FA F 1.20A Safety injectson 55-102 VT4 One-Way Restraint 2GCB-7-H10 FA F1.20A Safety injecten
$$-106 VT4 One-Way Restraint 2GCB-7-H22 -
FA F1.20A Feedwater 62410 VT 3 One-Way Restraint 2DBE 1-H?9 F-A F 1.20A Main Steam 63 039 VT 3 One Way Restraint 2 EBB-1 H2 F-A F1.20A High Pressure Safety triecten e0-S96 VT-3 One Way Restraint 20CB4-H33 F4 F1.20A Hgh Pressure Safety Irpecton 80 642 VT-3 One-Wa3Mestraint 2DCS 3-H24 FA F 1.20A High Pressure Safety Inston 82 022 VT 3 One-Way Restraint 2CCB-7-H5
- Code required coverage in excess of 90% was not achieved due to examination Smitatert A Refief Request will be submitted for NRC review and approval, as required by 10CFR$o. for fa*ng to futrill this Code requirement.
AP&UEntergy by _h s///f3 Factory Mutual by Q.C [fk@ Date 1/7/93 Date D. B. Lomax f J. O. Elliott, ANil EPG92034
PC0e 13 of 15 SUPPLEMENT TO FORM Nis.1 OWNER'S REPORT FOR INSERVICE INSPECTIONS FOR ASME Code Class 1 (IWB), Class 2 (IWC), and Class 3 (IWD) Components and Their Supports (IWF)
Arkansas Power & Light Company /Entergy Operations, Inc.
1.
Owner P. O. Box 551, Capitol Tower Building, Uttle Rock, AR 72203 (Name and Address of Owner) 2.
Plant Arkansas Nuclear One, Rt 3 B0x 137G, RuSSellville, AR 72801 (Name and Address of Plant) 3.
Plant Unit 2
4.
Owner and Certificate of Authoritation (if required)
N/A' 6.
Commercial Service Date 03/26/80 6.
National Board Number for Unit 22009 ASME ASME Exam Galt22Dr item No. Component or syriem ham No.
Mtlhgd Descriotton FA F 128 Shutdown Cookn0 50 024 VT4 Multidirectional RestraN 2GCB-5-H6 F-A F1.20B Safety injechon 55-104 VT-3 Multsiirectma! Restrad 2GCB-7-H18 F-A F12B Hgh Pressure Safety injection 80 564 VT 3 MutS4:rectonal Restrad 2DCB-511 H13 F-A F1.208 Hgh Pressure Safety injecten 80 573 VT 3 Mutu-directonal RestreW 2DCB-5114414 F-A F12C Feedwata 17 026 VT 3 Vanable Spnng 2DBB-1 H1 FA F 1.20C Shutdown Coohrig 3M22 VT 3 Vadable Spring 2GCB-5-H2O F-A F1.20C Shutdown Cochng S M 25 VT 3 Variable Spring 2GCB 5-H7 F-A F 1.20C Safety tryecten 53 025 VT 3 Variable Spring 2GCB-3 H23 FA F 1.20C Safety intecton 55-103 VT-3 Variable Spring 2GCB-7-H1 F-A F1.20C Safety infecten 55 105 VT 3 Vanable Spring 2GCB-7.H6 FA F12E Shutdown Coohng 51 021 VT 3 Anchor 2GCB-S-H30 F-A F12E Hgh Pressure Safety injeebon 80-565 VT 3 Anchor 2DCB-511-H12 FA F12F Feedwa'er 17-027 VT 3 Snubber 2DBB-1443 F-A F 12F Feedwster 17 023 VT 3 Snubber 2DBB-1412 FA F 1.20F Feeduate 17 029 VT-3 Snubber 2DBB 1 H4 F.A F12F Feedwiter 17 030 VT 3 Snubber 20BB-1-H6 FA F 12F Feedwater 17 031 VT-3 Snubber 2DBB-1 H17 FA F12F Feed *3ter 17 033 VT-3 Snubber 2DBB-1-H9 FA F12F Feedwater 17-034 VT 3 Snubber 20BB-1 H8 FA F12F Feedwater 17 035 VT 3 Snubber 2088-1-H10 FA F 12F Feedwater 17 037 VT-3 Snubber 208B-14i13 FA F12F Feodwater 17 03S VT 3 Snubber 20BB-1-H12 F-A F120F Feedwater 17-039 Vr-3 Snubber 2DBB-1-H14 F-A F12F Main Steam 18-020 VT 3 Snubber 2 EBB-1 A-HS FA F12F Main Steam 1 M 21 VT-3 Snubber 2 EBB-1 A-H4 F-A F 12F Main Steam 1M23 VT 3 Snubber 2 EBB 1 A-H7 FA F12F Main Steam 18-024 VT-3 Snubber 2 EBB 1 A-H6 FA F1.20F Feedwater 1M28 VT-3 Snubber 20BB-2 H2 F-A F12F Feedwater -
1 M 29 VT 3 Snubber 2DBB-2 H16 F-A F12F Feedwater 1M32 VT 3 Snubber 20BB-24119 FA F12F Feedwater 1 M 33 VT 3 Snubber 200B-2448 i
FA F12F Feedwatw 19-034 VT 3 Snubber 2DBB 2-H17 F-A F 12F Feedwater 1M37 VT-3 Snubbc 2DBB-2-H11 FA F 12F Feedwater 19 039 VT-3 Snubber 200B-2-H13 l
FA F 12F Feedwatw 19 041 VT 3 Snubber 20BB-2-H15 F-A F 12F Main Steam 2M18 VT-3 Snubter 2 EBB-2A-H4
' Code required coverage in excess of 90% was not achieved due to examinaten limitation. A Reisf Request will be submitted for NRC renew and approvar, as required by 10CFR50, for faAng to fulfill this Code requirement.
l AP&UEntergy by M Date th/13 Factory Mutualby k C UL Date I/7/93 D. B. Lomax f J. O. Elliott, ANil EPG92034
Pcge 13 of 15 SUPPLEMENT TO FORM NIS.1 OWNER'S REPORT FOR INSERVICE INSPECTIONS FOR ASME Code Class 1 (IWB), Class 2 (lWC), and Class 3 (LWD) Components and Their Supports (lWF)
Arkansas Power & Light Company /Entergy Operations, inC-1.
Owner P O. B0x 551, Capitol Tower Building, Little ROCK, AR 72203 (Name and Address of Owner) 2-Plant Arkansas Nuclear one, Rt 3 Box 137G, RuSSellville, AR 72801 (Name and Address of Plant) 3.
Plant Unit 2
4.
Owner and Certificate of Authoritation (if required)
N/A 6.
Commercial Service Date 03/26/80 6.
National Board Number for Unit 22009 ASME ASME Eram Cateoorv ltem No. Component or System glam No.
Method Ductiotion F-A F 120F Main Steam 24019 VT4 Snubber 2 EBB-2A HS F-A F 120F Main Steam 20021 VT-3 Snubber 2 EBB 2A-H6 F-A F 120F Men Steam 20422 VT 3 Snubber 2 EBB-2A-H7 FA F 1.20F Shutdowm Cooling 30418 VT 3 Snubber 2GCB-5-H21 F-A F 120F Shutdowm Coohng 50 022 VT 3 Snubber 2GCB6tC3 F-A F 120F Safety injecte 52440 VT 3 Snubber 2GCB4H31 Sa ety injecten 52442 VT 3 Snubber 2GCB-2 H3 F-A F 120F r
F-A F 120F Safety infecte 57425 VT-3 Snubber 2GCB 3-H22 F-A F 120F Safety insecbon SS-028A VT4 Snubber 2GCB4H24 F.A F 120F Safety Irvecten 61 045 VT4 Snubber 2CCB4H2 F-A F 120F Main Steam 63438 VT 3 Snubber 2 EBB-1-H4 FA F 120F Main Steam 63441 VT 3 Snubber 2 EBB 4H2 F-A F 120F Main Steam 65-035 VT 3 Snubber 2 EBB-2 H4 FA F 120F Main Steam 65-037 VT4 Snubber 2 EBB-2-H6 F.A F120F Main Steam 65 038 VT4 Snubber 2 EBB-2-H5 F-A F120F Containment Spray 75441 VT-3 Snubber 2GCB-10-H5 F-A F120F Containment Spray 75446 VT 3 Snubber 2GCB 11 H5 F-A F 1.20F Containment Spray 78-061 VT4 Snubber 2HCB-15 H15 F.A F 120F Containment Spray 79 071 VT-3 Snubber 2HCB-27417 F-A F 120F Safety trjecten 91 124 VT4 Snubber 2GCB-9-H24 FA F1.30A Sendee Water 72452 VT 3 One Way Restraint 2HBC-59-H4 F-A F1.30A Service Water 72456 VT 3 One-Way Restraint 2HBC-50-H8 FA F1.30A Service Water 72 058 VT4 One-Way Restraint 2HBC-59-H11 FA F1xA Serv 6ce Water 73-044 VT-3 One-Way Restraint 2HBC44-H9 FA F1XA Service Water 73-045 VT-3 One-Way Restraint 2HBC44 H11 F-A F1SA Ernergency Feedster 85 126 VT 3 One Way Restraint 2DBC-1 H26 F-A F1XB Service Water 72 099 VT-3 Mufti-directional Restraint 2HBC-85-H5 F-A F1XB Service Water 72 166 VT-3 Multsl.rectenal Restraint 2HBC-85-H7 F-A F1XB Sensce Water 73-075 VT 3
- Murti-directonal Restraint 2HBC-60-H3 FA F128 Emergency Feedwater 85 124 VT-3 Multi-directional Restraint 20BC-1-H24 F-A F1XB Ernergency Feedwater -
B5125 VT-3 Multi directonal Restraint 2DCB 1 H25 F-A F130C Service Water 72449 VT4 Variable Spnng 2HBC-SS H1 F-A F GOC Service Water 73-091A VT 3 Vartable Spring 2HBC-10+H2 F-A F15E Service Water 72-057 VT-3 Anchor 2HBC-5S-H10 F-A F12E Emergency Feedwater 85-127 VT4 Anchor 2CSC 1 H27
- Code required coverage In excess of 90% was not achieved due to examination bmitaten. A Relier Request wiX be submttted for NRC review and approvat, as required by 10CFR50, for failing to fulfdl this Code tNuirerrent.
AP&L/Entergy by Date gg Factory Mutualby 9.d. 6/SQDate //7/93 D. B Lomax f J. O. Elliott, ANil E FG92034
J Po0e 14 of 15 SUPPLEMENT TO FORM NIS 1 OWNER'S REPORT FOR INSERVICE INSPECTIONS j
FOR ASME Code Class 1 (IWB), Class 2 (lWC), and Class 3 (IWD) Components and Their Supports (IWF)
Arkansas Power & Light Company /Entergy Operations, Inc.
1.
Owner P. O. Box $51, Capitol Tower Building. Uttle Rock. AR 72203 (Name and Addre$s of Owner) 2.
Plant Arkansas Nuclear One, Rt 3 Box 137G, Russellville, AR 72801 (Name and Addre$s of Plant) 3.
Plant Unit 2
4.
Owner and Certificate of Authorizaticn (if required)
N/A 5.
Commercial Service Date 03/26/80 6.
National Botrd Number for Unit 22009 ASME ASME Ezam Galt22!2 ltem No, Comnonenf or Syrtwn fJLam No.
M11b2d Discriotton FA F1.30F Semce Water 72 134 VT-3 Snubber 2HBC 103 M22 FA F1/OF Service Water 72 136 VT 3 Srwbber 2HBC-103-H16 M
F 1.30F Semco Water 72-137 VT 3 Snubber 2HBC 103-H2O FA F1.30F Semce Water 72-138 VT-3 Snubber 2HBC 103-H17 F-A F 1.30F Semce Water 72 153 VT-3 Snubber 2HBC 105-H4 FA F 1.30F Sen, ice Water 721$9 VT-3 Snubber 2HBC 105-H14 FA F 1.30F Servce Water 72 161 VT 3 Snubber 2HBC-105 Hf 7 FA F1.30F Service Water 72-162 VT-3 Snubber 2HBC-105-H16 F-A F 1.30F Semco Water 72 163 VT-3 5 Jbber 2HBC-105-H18 FA F 1 A0 Steam Generator 2E24A 03 001S VT 3 Support Sidtt FA F1.40 Reactor CMant Pump 2P32C 33010 VT-3 Pump Support #1 FA F 1.40 LPSI Pump 2P60A 46403 VT 3 Pump Support (s)
FA F140 Shutdom Coohng HX 2E35A 48410 VT 3 Shea Supports-Class 3 FA F 140 HPSI Pump 2P89C 90001 Vr-3 Pump Support (s)
- Code required coverage in excess of 90% was rd achieved due to examinaten limitaten. A Rerief Request will be sutxtetted fo. NRC review and approval, as required by 10CFR50, for famng to fu! fill this Code requirement.
Date f/g Factory Mutualbyh' J O Elliott ANilo,[RM Date l/7/7 AP&L/Entergy by M
C. B. Lomax O
EPG92034
Page 15 of 15
$UPPLEMENT TO FORM NIS.1 OWNER'S REPORT FOR INSERVICE INSPECTIONS FOR ASME Code Class 1 (IWB), Class 2 (IWC), and Class 3 (IWD) Components and Their Supports (IWF)
Arkansas Power & Light Company /Entergy Operations, Inc.
1.
Owner P. O. Box 551, Capitol Tower Building, Little Rock, AR 72203 (Nume and Address of Owner) 2.
Plant Artansas Nuclear One, Rt 3 Box 137G Russellville, AR 72801 (Name and Address of Plant) 3.
Plant Unit 2
4.
Owner and Certificate of Authorization (if required)
N/A 6.
Commercial Service Date 03/26/80 6.
National Board Number for Unit 22009
~
ISI Pressure Tests:
The following ISI nressure tests were completed this cycle of operation:
- 1. ASME Class 1 components (Category B-P) system leak test during 2R9.
2.
10-Year Program hydrostatic tests on;
- a. Fuel Poc! Cooling Cystem
- b. Service Waterit Fuel Pool Cooling Heat Exchanger
- c. Class 2 Containment Penetrations 2P 39 and 2P 58 2
- 3. Inservice leak tests (per ASME Code Case N-498) in lieu of hydrostatic tests on containment penetrations 2P-1, 2P-2, 2P 3, 2P-4, 2P-14, 2P 32, 2P 34, 2P 51, 2P-52, 2P 59, 2P-60, 2P-64, 2P-15,2P 27,2P 29,2P-46 and 2P 31 4.
Period pressure tests, as required, for the 2nd interval,1st Period.
AP&t)Entergy by j[
k Date 1/Af3 Factory Mutual by 1. 6. f _.14& Date
/7/'AT D. B. Lom'ax (7 J. O. Elliott, ANil l
EPG92o38
ATTACHMENT 2
SUMMARY
OF TIIE ISI COMPONENT EXAMINATION d
_~
ARKANSAS NUCLEAR ONE UNIT 2 REFUELING OUTAGE NO. 9 (2R9) 2ND INSPECTION INTERVAL /15T INSPECTION PERIOD
'ISI COMPONENT EXAMINATION
SUMMARY
N O
Exam No.
ASME O G T
Component Description Code Exam Method R
E H
Remarks Line #/ Component Type Category E
O E
lte m N o.
C M
R 01 020 B-A UTO'
/
Examined entire circumference from j
Upper She's to Flange Circ Weld B 1.30 UT6.5'
/
the seal surface.
Reactor Vessel UT13'
/
02 00f B-A MT
/
Examined 1/3 of the circumference Fl:nDe to Peel Segment Torus B 1.40 UTO' LAM Scan
/
from stud h)le #1 to stud hole #18.
Reactor Closure Head UTO' DAC Scan i
UT45' Shear Axial
/
UT45' Shear Circ
/
UT60* Shear Axial
/
UT60' Shear Cire
/
03 008 B-B UTO' DAC Scan
/
Lower Head to Lower Extension Ring B 2.31 UT35' Shear Axial
/
Steam Generator 2E24A UT45' Shear-Axial
/
UT45' Shear Circ
/
UT60' Shear Axial
/
UT60* Shear Cire 7
03 005 BB UTO' DAC Scan
/
One Code acceptable indication re-Peel Segment to Peel Segment @ 210' B 2.32 UT35' Shear Axial
/
corded with the UT60' Shear-Axial Steam Generator 2E24 A UT45' Shear-Axial
/
scan. The Indication is a weld !n-UT45' Shaar Circ
/
clusion with no measurable through-UT60' Shear-Axial
/
wall dimension.
UT60' Shear-Cire
/
03 O f 0 -
B-D UTO' DAC Scan
/
42' Hot Leg Nonle to Head B 3.130 UT35' Shear-Axial
/
Steam Generator 2E24A UT45' Shear Axial
/
UT45' Shear-Circ
/
UT60' Shear-Axial
/
UT60* Shear-Circ
/
UT70' Shear Axial
/
03-01f BD UTO' DAC Scan
/
One Code-acceptable indication re-30" Cold Leg Nonle to Head @ 45' B 3.130 UT35' Shear-Axial
/
corded with the UT70* Shear-Axial Steam Generator 2E24A UT45* Shear Axial V
scan. The indication, which is sus-UT45' Shear-Circ
/
pected to be lack of fusion,is of an UT60' Shear Axial
/
acceptable size per Table UT60' Shear-Circ
/
UT70* Shear-Axial
/
/
03 0f2 B-D UTO' DAC Scan
/
30" Cold Leg Nonle to Head @ 315' B 3.130 -
UT45' Shear-Axla!
/
Steam Generator 2E24A UT45' Shear Circ
/
UT60' Shear-Axial
/
UT60' Shear-Circ
/
UT70* Shear-Axial
/
03 0f 9 B-D UT45' Shear
/
42" Hot Leg Nonle inner Radius Section B 3.140 UT60' Shear
/
Steam Generator 2E24A EPG92033 Page 1 i
j ARKANSAS NUCLEAR ONE - UNIT 2 I
REFUELING OUTAGE NO. 9 (2R9) 2ND INSPECTION INTERVAL / iST INSPECTION PERIOD ISI COMPONENT EXAMINATION
SUMMARY
N O
Exam No.
ASME O
G T
Component Description Code Exam Method R
E H
Remuks Line #/ Component Type Category E
O E
ltem No.
C M
R 0J 020 B-D UT45' Shear
/
30' Cold Leg Nonle Inner Radius @ 45' B 3.140 UT60* Shear
/
Steam Generator 2E24A 03 02f B-D UT45' Shear
/
30' Cold Leg Nonle Inner Radius @ 315' B 3.1 0 UT60' Shear
/
Steam Generator 2E24 A 08-014 B-F UT45' Shear-Axial
/
Elbow to Safe End Cire Weld B 5.130 UT45' Shear Cire
/
2CCA-5-30" UT45' RLong-Axial
/
UT45' RLong-Circ
/
09 008 BF PT(Initial)
/
One Code-acceptable linear surface Safe End to Pipe Circ Weld B 5.130 PT(Reinspection)
/
Indication (5/8") initially recorded.
2CCA-6-30' UT45' Shear-Axial
/
After additional surface preparation, 3*
UT45' Shear-Circ
/
the area was reexamined and two UT45* RLoag Axial
/
Code-acceptable linear surface in-UT45' RLong-Circ
/
dications (5/32* & 5/16*) were recorded.
10-O f 4 BF UT45' Shear-Axial
/
Elbow to Safe End Circ Weld B 5.130 UT45' Shear-Circ
/
2CCA-3-30" UT45* RLong-Axial
/
UT45' RLong-Cire
/
f1-008 B-F PT
/
[
Safe End to Pipe Circ Weld B 5.130 UT45' Shear-Axial
/
2CCA-4-30" UT45' Shear-Circ
/
UT45' RLong-Axial
/
UT45* RLong-Cire
/
35-00 f B-F PT(initial)
/
One rounded surface indication Noule to Safe End Circ Weld B 5.140 PT(Reinspection)
/
(1/4") was initially recorded. The 2CCA-32-2*
indication was the result of a therm 0 couple that had been at-tached to the piping and removed.
This non-service induced indication was removed by surface preparation.
4f 040 B-F PT
/
Safe End to Nonle Circ Weld B 5.140 UT45' RLong-Axial
/
UT45' RLong-Circ
/
42-00f B-F PT
/
One Code-acceptable indication Nonle to Flange Circ Weld B 5.40 UT45' RLong-Axial
/
/
recorded with the UT45' RLong-Axial Pressurizer UT45' RLong-Circ
/
scan. The indication is a spot re-flector with no measurable through-wall dimension.
i 1
l EPG92033 Page 2
ARKANSAS NUCLEAR ONE - UNIT 2 REFUELING OUTAGE NO. 9 (2R9) 2ND INSPECTION INTERVAL / iST INSPECTION PERIOD ISI COMPONENT EXAMINATION
SUMMARY
N O
Exam No.
ASME O
O T
Component Description Code Exam Method R
E H
Remarks Line #/ Component Type Category E
O E
lte m N o.
C M
R Of N-00f B-G 1 MT
/-
Closure Head Nut B 6.10 Reactor Vessel Of N 002 B-G 1 MT
/l l
Closure Head Nut B 6.10 Reactor Vessel Closure Head Nut B 6.10
_ _ _ l Of N 003 B-G-1 MT
/l Reccior Vessel
~
Of N 004 B-G-1 PET
/l Closure Head Nut B 6.10 Reactor Vessel Of N-005 E -G-1 MT
/l l
~
Closure Head Nut B 6.10 Reactor Vessel
~
01-N 006 B-G-1 MT
/l l
Closure Head Nut B 6.10 f
Reactor Vessel Of N-007 B-G 1 MT
/l l
Closure Head Nut B 6.10 Reactor Vessel Of N 008 B-G-1 MT
/l l
Closure Head Nut B 6.10 Reactor Vessel Of N 009 B-G 1 MT
/l l
Closure Head.. Nut B 6.10 Reactor Vessel Of-N 010 B-G-1 MT
/l l
i Closure Head Nut B 6 'O 1
Reactor Vessel Of N Of f B G-1 MT
/l l
Closure Head Nut B 6.10 Reactor Vessel i.
Of N 012 B-G-1 MT
/l l
l-Closure Head Nut B 6.1C Reactor Vessel Of N Of3 B-G 1 MT
/l l
Closure Head Nut P 6.10 Reactor Vessel Of-N-Of4 B-G-1 MT
/l l
Closure Head Nut B 6.10 Reactor Vessel Of N Of5 B-G-1 MT
/l l
Closure Head Nut B 6.10 Reactor Vessel EPG92033 Page 3
_ ~. _. _.....
ARKANSAS NUCLEAR ONE - UNIT 2 REFUELING OUTAGE NO. 9 (2R9) 2ND INSPECTION INTERVAL / iST INSPECTION PERIOD ISI COMPONENT EXA MINA TION S UN4MA R Y '
N O
Exam No.
ASME O G T
Component Description Code Exam Method R
E H
Remarks Line #/ Component Type Category E
O E
ltem No.
C M
R Of N4f 6 B-G 1 MT
/
Closure Head Nut B 6.10 Reactor Vessel Of N Of7 B-G 1 MT
/l l
Closure Head Nut B 6.10 Reactor Vessel 0f N-018 B-G-1 MT
/l l
Closure Head Nut B 6.10 Reactor Vessel Of-S-007 B-G 1 MT
/
Closure Heat Stud B 6.30 UT45' Shear Fwd
/
Reactor Vessel UT45' Shear-Rev
/
ID Creeper
/
Of S-002 B-G 1 MT
/
Closure Head Ciud B 6.30 UT45' Shear-Fwd
/
Reactor Vessel UT45' Shear-Rev
/
ID Creeper
/
Of S 003 8-G-1 MT
/
C:osure Head Stud B 6.30 UT45' Shear-Fwd
/
Reactor Vessel UT45' Shear Rev
/
ID Creeper
/
01 S-004 B-G 1 MT
/
Closure Head Stud B 6.30 UT45' Shear-Fwd
/
Reactor Vessel UT45* Shear-Rev
/
ID Creeper
/
Of-S 005 B-G-1 MT
/
Closure Head Stud B 6.30 UT45' Shear-Fwd
/
Reactor Vessel UT45' Shear Rev
/
ID Creeper
/
Of-S 006 B-G-1 MT
/
Closure Head Stud B 6.30 UT45' Shear-Fwd
/
Reactor Vessel UT45' Shear-Rev
/
ID Creeper
/
Of S-007 B-G-1 MT
/
Closure Head Stud B 6.30 UT45' Shear-Fwd
/
Rosctor Vessel UT45' Shear Rev
/
ID Creeper
/
Of S 008 B-G-1 MT
/
Closure Head Stud B 6.30 UT45' Shear-Fwd
/
Reactor Vessel UT45* Shear-Rev
/
ID Creeper
/
Of-S 009 -
B-G-1 MT
/
Closure Head Stud B 6.30 UT45' Shear-Fwd
/
Reactor Vessel UT45' Shear-Rev
/
ID Creeper
/
EPG92033 Page 4 i
ARKANSAS NUCLEAR ONE - UNIT 2 REFUELING OUTAGE NO. 9 (2R9) 2ND INSPECTION INTERVAL / iST INSPECTION PERIOD ISI COMPONENT EXAMINATION
SUMMARY
N O
Exam No.
ASME O O T
Component Description Code Exam Method R
E H
Remarks Line #/ Component Type Category E
O E
ltem No.
C M
R Of-S-Of0 B-G 1 MT
/
Closure Head Stud B 6.30 UT45' Shear-Fwd
/
Reactor Vessel UT45' Shear-Rev
/
ID Creeper
/
Of S-Of f B-G 1 MT Closure Head Stud B 6.30 UT45' Shear Fwd
/
Re: dor Vessel UT 45' Shear-Rev
/
ID Creeper
/
Of S-Of 2 B-G-1 MT
/
Closure Head Stud B 6.30 UT45' Shear-Fwd
/
Reador Vessel UT45' Shear-Rev
/
ID Creeper
/
Of S-Of 3 B-G 1 MT
/
Closure Head Stud B 6.30 UT45'ShearFwd
/
Re ctorVessel UT45' Shear-Rev
/
ID Creeper
/
Of S-Of4 B-G-1 MT
/
Closure Head Stud B 6,30 UT45* Shear-Fwd
/
Recctor Vessel UT45* Shear Rev
/
ID Creeper
/
Of S-Of 5 B-G-1 MT
/
Closure Head Stud B 6.30 UT45* Shear Fwd Reactor Vessel UT45' Shear Rev
/
ID Creeper
/_
Of-S-Of6 B-G-1 MT-
/
Closure Head Stud B 6.30 UT45' Shear-Fwd
/
Reactor Vessel UT45' Shear-Rev
/
ID Creeper
/
Of S Of 7 B-G-1 MT
/
Closure Head Stud B 6.30 UT45' Shear-Fwd
/
Reactor Vessel UT45' Shear-Rev
/
lD Creeper
/
Of S-Of 8 B-G-1 MT
/
Closure Head Stud B 6.30 UT45' Shear-Fwd
/
Rzactor Vessel UT45' Shear-Rev
/
ID Creeper
/
Of L-00f B-G-1 UTO' DAC Scan
/
Vessel Flange Threads B 6.40 Reactor Vessel Of t-002 B-G-1 UTO' DAC Scan
/l l
Vessel Flange Threads B 6.40 Reactor Vessel
~
/l j
Vessel Flance Threads B 6.40 Reactor Vessel EPG92033 Page 5
ARKANSAS NUCLEAR ONE UNIT 2 REFUELING OUTAGE NO. 9 (2R9) 2ND INSPECTION INTERVAL /1ST INSPECTION PERIOD LSI COMPONENT EXAMINATION
SUMMARY
N O
Exam No.
ASME O
G T
Component Description Code Exam Method R
E H
Remarks Line #/ Component Type Category E
O E
item No.
C M
R Oft 004 B-G-1 UTO' DAC Scan
/
Vessel Flange Threads B 6.40 Reactor Vessel Of t-005 B-G-1 UTO' DAC Scan
/l l
V:ssel Flange Threads B 6.40 Reactor Vessel Of L-006 B-G-1 UT0* DAC Scan
/l l
V;ssel Flange Threads B 6.40 R actorVessel Of L-007 B-G-1 UTO' DAC Scan
/l l
V;ssel Flange Threads B 6.40 Reactor Vessel OfL-003 B-G-1 UTO' DAC Scan
/l l
Vessel Flange Threads B 6.40 Reactor Vessel Of t-009 B-G 1 UTO' DAC.ican
/j l
Vessel Flange Threads B 6.40 Reactor Vessel 01 L-Of 0 B-G-1 UT0* DAC Scan
/l l
Vcssel Flange Threads B 6.40 Reactor Vessel OfL-Off B-G-1 UTO' DAC Scan
/l l
Vessel Flange Threads B 6.40 Reactor Vessel Of L-Of 2 B-G-1 UTO' DAC Scan
/l l
Vessel Flange Threads B 6.40 Reactor Vessel Of t-Of 3 B-G-1 UTO' DAC Scan
/l l
Vessel Flange Threads B 6.40 Reactor Vessel 01 L-014 B-G-1 UTO' DAC Scan
/l l
V:ssel Flange Threads B 6.40 Reactor Vessel Of-L-Of5 B-G-1 UT0* DAC Scan
/l l
Vessel Flange Threads B 6.40 Reactor Vessel 01-L 016 B-G-1 UT0' DAC Scan
/l l
Vessel Flange Threads B6A0 Reactor Vessel Of L Of 7 B-G-1 UTO' DAC Scan
/l l
Vessel Flange Threads B 6.40 Reactor Vessel Of L-Of 8 B-G-1 UTO' DAC Scan
/l l
Vessel Flange Threads B 6.40 Reactor Vessel EPG92033 Page 6
ARKANS AS NUCLEAR ONE - UNIT 2 -
REFUELING OUTAGE NO. 9 (2R9) 2ND INSPECTION INTERVAL / iST INCPECTION PERIOD
- ISI COMPONENT EXA MINA TION SUMMAR Y; N
O Exam No.
ASME O
G T
Componeet Description Code Exam Method R
E H
Remarks Line #/ Component Type Category E
O E
Item No.-
C M
R Of W40f -
B-G-1 VT 1
/
Closure Head Washer B 6.50 Reactor Vessel OfoW-002 B-G 1 VT 1
/l l
Closure Head Washer B 6.50 Reactor Vessel 0f W-003 B-G-1 VT-1
/l l
Closure Head Washer B 6.50 Reactor Vessel Of0W 004 B-G-1 VT-1
/l l
Closure Head Washer B 6.50 Reactor Vessel of W405 B-G-1 VT-1
/l l
Closure Head Washer -
B 6.50 Reactor Vessel 01 W-006 B-G-1 VT-1
- l l
Closure Head Washer B 6.50 Reacter Vessel l
01 W 007 B-G-1 VT 1
/I l
Closure Head Washer 8 6.50 Reacior Vessel 01 W-008 B-G-1 VT-1
<l I
Closure Head Washer B 6.50 Reactor Vessei Of W 009 B-G 1 VT 1
/l l
Closure Head Washer B 6.50 Reactor Vessel 07 W Of0 B-G 1 VT-1
/l l
Closure Head Washer B 6.50 Reactor Vessel Of W-Off B-G-1 VT 1
/l l
Closure Head Washer B 6.50 Remetor Vessel OfcW Of 2 B-G 1 VT-1
<l l
Closure Head Washer B 6.50 Reactor Vessel of W-Of3 B-G-1 VT-1
/l l
Closure Head Washer B 6.50 Reactor Vessel Of W-Of4 B-G-1 VT-1
<l l
r Closure Head Washer B 6.50 l
Reactor Vessel -
l Of W-015 B-G-1 VT 1
<l l
l Closure Head Washer B 6.50 Reactor Vessel i
EPG92033 Page 7 l
ARKANSAS NUCLEAR ONE - UNIT 2 REFUELING OUTAGE NO. 9 (2R9) 2ND INSPECTION INTERVAL / iST INSPECTION PERIOD
- ISI COMPONENT EXA MINA TION SUMMA R YI Exam No.
ASME O
G T
Component Description Code Exam Method R
E H
Remarks Line #/Ccmponent Type Category E
O E
ttem No.
C M
R OfcW 018 B-G-1 VT-1
/
Closure Head Washer B 6.50 Reactor Vessel Of W-017 B-G-1 VT-1
/l l
Closure Head Washer B 6.50 Reactor Vessel Of-W-Of8
~
B-G-1 VT-1
/l l
Closure Head Was'.er B 6.50 Reactor Vessel JJ-S-00f -
B-G-1 UT70* Shear-Fwd
/
Pump Stud #1 B 6.180 UT70' Shear-Rev
/
Reactor Coolant Pump 2P32C ID Creeper
/
33 S-002 B-G-1 UT70' Shear-Fwd
/
Pump Stud #2 B 6.180 UT70' Shear-Rev
/
Reactor Coolant Pump 2P32C ID Creeper
/
33-S 004 B-G-1 UT70' Shear Fwd
/
Pump Stud #4 8 6.180 UT70' Shear-Rev
/
Reactor Coolant Pump 2P32C ID Creeper
/
33 S 006 B-G-1 UT70' Shear-Fwd
/
Pump Stud #6 B 6.180 UT70* Shear-Rev
/
Reactor Coolant Pump 2D32C ID Creeper
/
33 S-007 B-G-1 UT70* Shear-Fwd
/
Pump Stud #7 B 6.180 UT70' Shear-Rev
/
Reactor Coolant Pump 2P32C ID Creeper
/
33-N 001 B-G-1 VT-1
/
Pump Nut #1 B 6.200 Reactor Coolant Pump 2P32C 33 N 002 B-G-1 VT-1
/l l
Pump Nut #2 B 6.200 Reactor Coolant Pump 2P32C 33 N 003 B-G 1-VT-1
/l l Pump Nut #3 B 6.200 Reactor Coolant Pump 2P32C 33 N-004
' B-G-1 VT-1
/l l Pump Nut #4 B 6.200 Reactor Coolant Pump 2P32C 33-N-005 B-G-1 VT-1
/l l
Pump Nut #5 B 6.200 Reactor Coolant Pump 2P32C EPG92033 Page 8 j
ARKANSAS NUCLEAR ONE UNIT 2 l
REFUELIN3 OUTA2E NO. 9 (2R9) 2ND INSPECTION INTERVAL / iST INSPECTION PERIOD lFI COMPONENT EXAMINATION
SUMMARY
N O
Exam No.
ASME O
G T
Component Description Code Exam Method R
E H
Remarks Line #/ Component Type Category E
O E
Item No.
C M
R 02 D-088 B-G 2 VT 1 l/ All eight nuts and three studs have ICI Flange Botting B 7.10 some form of damage as a result of R: actor Closure Head the installation / disassembly process.
An engineering evaluation was per.
formed per IRF 6566. The evaluation concluded that the damage is not significant and the botting will still perform its intended design function.
02 0 089 BG2 VT 1 l
l<
All eight nuts and two studs have ICI Flange Botting B 7.10 some form of damage as a result of R: actor Closure Head the installation / disassembly process.
An engineering evaluation was per-formed per IRF 6560. The evaluation concluded that the damage is not significant and the botting will still perform its intended desl0n function.
42 Of 0 B-G 2 VT-1 l
l/
Minor tool marks observed on some Fl:nge Bolting B 7.50 of the nuts from installation. The de-Pr:ssurizer gradation is not significant. Use "as is".
2 f.080 BG2 VT 1 VI l
12" Gate Valve 2CV 50231 B 7.70 2CCA 2112" 2f 081 B-G 2
'/T-1
/l l
12" Check Valve 2SI 15B B 7.70 2CCA 2112" 22 07J B-G-2 VT-1
/l l
12" Check Valve 2St 15A B 7.70 2CCA-2212" 22 074 6-G-2 VT-1
/l l
12" Check Valve 2SI 16 A B 7.70 2CCA-2212" 22 076 B-G 2 VT 1 VI l
6' Check Valve 2SI-14 A B 7.70 2CCA 2212" 23 082 B-G 2 VT 1 l
l/
Four nuts replaced due to wear.
12' Check Valve 25110C B 7.70 2CCA 2412"23-086 B G-2 VT 1 l
l/
Oorroded studs replaced.
6' Check Valve 2SI-14C B 7.70 2CCA 24-6" 24 089 B-G 2 VT-1 (l
l 12" Check Valve 2SI-160 B 7.70 2CCA 2312" EPG92033 Page0
ARKANSAS NUCLEAR ONE - UNIT 2 REFUELING OUTAGE NO. 9 (2R9) 2ND INSPECTION INTERVAL /1ST INSPECTION PERIOD jft COMPONENT EXAMINATION
SUMMARY
N O
Exam No.
ASME O
G T
Component Description Code Exam Method R
E H
Remarks Line #/ Component Type Category E
O E
ltem No.
C M
R 24-090 B-G 2 VT 1
/
12' Gate Valve 2CV 5063 2 B 7.70 2CCA 23-12' 03 00f BH MT
/l l
Support Skirt to Lower Head Weld B 8.30 Steam Generator 2E24 A 04-009 B-J MT
/
Transition Piece to SG Hot Leg Nonle B 9.11 UTO' LAM Scan 2CCA 142' UT45' Shear Axlal
/
UT45' Shear Circ
/
08 00f B-J MT
/
SG Cold Leg Nonle to Transition Piece 8 9.11 UT35' Shear Axial
/
2CCA 5-30" UT45' Shear Axial
/
UT45' Shear-Circ
/
08 015 B-J UT45' RLong Axial
/
Safe End to Pump Circ Weld B 9,11 UT45' RLong-Circ
/
2CCA 5 3G' 09 009 BJ PT
/
Pump 1 A to Safe End Circ Weld B 9.11 UT45' RLong Axlal
/
2CCA-6-30' UT45' RLong Cire
/
10-00f B-J MT
/
SG Cold Leg Nonle to Transition Piece B 9.11 UT35' Shear-Axial
/
2CCA 3 30' UT45' Shear Circ
/
10-Of5 B-J UT45' RLong Axial
/
Safe End to Pump 18 Circ Weld B 9.11 UT45' RLong Circ
/
2CCA 3 30' ff009 B-J PT
/
Pump 18 to Safe End Cire Weld B 9.11 UT45' RLong-Axial
/
2CCA 4 30" UT45' RLong-Circ
/
78 02J B-J UT52' Shear-Axlal
/
P;pe to Safe End Circ Weld B 9.11 UT52' Shear Circ
/
2CCA 16-4' UT45' RLong-Axial
/
UT45' RLong Cire
/
43-022 B-J PT
/
Tee to Pipe Circ Weld B 9.11 UT60' Shear-Axial
/
2BCA 14 6*
UT60' Shear Cire
/
43-026 B-J PT
/
Valve to Pipe Circ Weld B 9.11 UT60' Shear Axial
/
2BCA 14-4*
UT60* Shear Cire
/
43 027 B-J PT
/
Pipe to Valve Circ Weld B 9.11 UT60' Shear Axlal
/
2BCA 14-4' UT60' Shear-Cire
/
EPG92033 Page 10
ARKANSAS NUCLEAR ONE. UNIT 2 REFUELING OUTAGE NO. 9 (2R9) 2ND INSPECTION INTERVAL /1ST INSPECTION PERIOD ISI COMPONENT EXAMINATION
SUMMARY
N O
Exam No.
ASME O
O T
Component Description Code Exam Method R
E H
Remarks Line 9/ Component Type Category E
O E
ttem No.
C M
R 09 006 B-J MT f.
Pipe Long Seam-Right Side B 9.12 UT45' Shear Axial
/
2CCA-6-30' UT45' Shear Circ
/
09 007 B-J MT
/
Pipe Long Seam Left Side B 9.12 UT45' Shear Axial
/
2CCA-6 30' UT45' Shear-Cire
/
f f 006 B-J MT
/
Pipe Long Seam Right Side B 9.12 UT45' Shear Axial
/
2CCA-4 30' UT45' Shear-Cite
/
f f 007 B-J MT
/
Pipe Long Seam-Left Side B 9.12 UT45' Shear Axial
/
2CCA 4 30' UT45' Shear Cite
/
06-Of0 B-J PT
/
12' Branch Connedion B 9.31 UT45' Shear Axial
/
2CCA 1-42' UT45* Shear Clrc
/
29-002 B-J PT
/
Elbow to Pipe Socket Weld B 9.40 2CCA 16-2*
29 003 B-J PT
/I l
Pipe to Elbow Socket Weld B 9.40 2CCA 16-2*
29-004 BJ PT dl r
Elbow to Pipe Socket Weld B 9.40 2CCA 16-2*
29 005 B-J PT
/l l
Pipe to Elbow Socket Weld B 9.40 2CCA 16 2*
35-004 B-J PT
/l l
Pipe to Elbow Socket Weld B 9.40 2CCA 32 2*
35-007 B-J PT
/l l
Elbow to Pipe Socket Weld B 9.40 2CCA 32 2*
B-J PT
/l l
35-004 Pipe to Elbow Socket Weld B 9.40 2CCA-32-2*
23-069W B-K 1 PT
/l l
Integrally Welded Attmnt 2CCA 24-H22 8 10.10 2CCA 24-8*
33 003 B-K 1 PT
/l l
Support Lug #1 8 10.20 Reactor Coolant Pump 2P32C 2f 076 6M2 VT 3
'7}
l 12" Check Valve 2SI 15B B 12.50 2CC A 21 12" EPG92033 Page 11
ARKANSAS NUCLEAR ONE. UNIT 2 REFUELIND OUTA0E NO 9 (2R9) 2ND INSPECTION INTERVAL / iST !NSPECTION PERIOD ISI COMPONENTEXAMINATION
SUMMARY
N O
Exam No.
ASME O
O T
Component Description Code Exam Method R
E H
Remarks Line #/ Component Type Category E
O E
ttem No.
C M
R 22 045 BM2 VT 3
/
12' Check Valve 2SI 15A B 12.50 2CCA 2212' 22 046 BM2 VT 3
/l l
12' Check Valve 2SI-16A B 12.50 2CCA 2212' 23 053 B-M 2 VT 3
/l l
12" Check Valve 2SI 16C B 12.50 2CCA 2412' 23 057 BM2 VT 3
/l l
6" Check Valve 2SI 14C B 12.50 2CCA 24-6*
24-06 f BM2 VT 3
/l l
12* Check Valve 2SI 16D B 12.50 2CCA 2312' 24 062 B-M-2 VT 3 l
l/
Very small gouges detected in valve 12' Gate Valve 2CV 5063-2 B 12.50 body outside of the effective sealing 2CCA 2312" area. Accepted "as is' per evaluation by MER OC-92-09-0014 M.
Of 069 BN1 VT 3
/l l
VasselInterior Surface B 13.10 Reactor Vessel 03 030 CA UT60' Shear-Circ
/l l
Intermediate Shell to Conical Shell C 1.10 Steam Generator 2E24A 48 00f CA UT60' Shear Axial
/
One ID clad interface signal recorded Flange to Channel Cylinder C 1.10 UT60' Shear Circ
/
with the UT60' Shear Axlat scan.
Shuidown Cooling HX 2E35A UT70* Shear Axial
/
The indication is a point reflector UT70* Shear Cire
/
originating from the clad con-figuration.
03 032 CA UTO' LAM Scan
/
Upper Shell to Top Head Torus C 1.20 UTO' DAC Scan
/
Steam Generator 2E24 A UT45' Shear Axial
/
UT45' Shear Cire
/
UT60' Shear Axlal
/
UT60' Shear Cire
/
i EPG92033 Page 12
[
CMLQw*
i)R W % ; W e g 4 ONE. UNIT 2
?O AVO 4 ! t UE NO. 9 (2R9) 2NJ 2H MfW.ON 3 fi m.1ST INSPECTION PERIOD ISI COMPONENT EXAMINATION
SUMMARY
N O
Exam No.
ASME O G T
Component Description Code Exam Method R
E H
Remarks Line */ Component Type Category E
O E
Hem No.
C M
R 03-035 CB UTO' LAM Scan
/
One Codo (IWC 3500) rejectable Irw Fcedwater Nozzle to Upper Shell C 2.21 UTO' DAC Scan
/
dication recorded with the UT60' Steam Generator 2E24A UT45' Shear Axlal
/
Shear Axlal scan. The Indication, UT45' Shear-Circ
/
which was confirmed to be slag upon UT60' Shear Axlal
/
review of the original RT film, is of an UT60' Shear Circ
/
unacceptable size per Table IWC 3511 1. An analytical eval-untion was performed per IWB 3600.
The fracture mechanics evaluation performed (Calc #90 E-0013-07) determined that the Indication is ao-ceptable per IWB 3600.04-034 C-B UTO' DAC Scan
/
This examination was performed as Main Steam Nonle to Top Head Dome C 2.21 UT45' Shear Axlal
/
additional scope due to the IWC 3500 Steam Generator 2E248 UT45' Shear-Circ
/
rejectable indication deteded on UT60' Shear-Axial
/
03-035. One Code-acceptable in.
UT60' Shear-Cire
/
dication reconded with the UT60*
Shear Axlat scan. The Indication is a mid wallinclusion with no measurable through wall dimension.
03 043 CB UT45' Shear
/
Feedwater Nozzle Inner Radius Section C 2.22 UT60' Shear
/
Steam Generator 2E24A 17-026W C-C MT
/l l
Integrally Welded Attmnt 2DBB-1-H1 C 3.20 2DBB-1 24' 17-029W C-C MT
/l l
Integrally Welded Attmnt 2DBB 1 H4 C 3.20 2DBB 124" 17-04 f W C-C MT
/l l
Integrally Welded Attmnt 2DBB 1 H16 C 3.20 2DBB-1 24' 18 023W C-C MT
/l l
Int:grally Welded Attmnt 2 EBB-1 A-H7 C 3.20 2 EBB-1 38' 18-024W C-C MT
/l l
Integrally Welded Attmnt 2 EBB-1 A-HS C 3.20 2 EBB-1 38' 53-025W C-C PT
/l l
Integrally Welded Attmnt 2GCB-3-H23 C 3.20 2GCB-3-12" EPG92033 Page 13
ARKANSAS NUCLEAR ONE. UNIT 2 REFUELING OUTAGE NO. 9 (2R9) 2ND INSPECTION INTERVAL /18T INSPECTION PERIOD ISI COMPONENT EXAMINATION
SUMMARY
N O
Exam No.
ASME O O T
Component Description Code Exam Method R
E H
Remarks Line #/ Component Type Category E
O E
ltem No.
C M
R 62 009W C-C MT(Initial)
/
Three linear surface indications (0.6",
Integrally Welded Attmnt 2DBB 1 HS C 3.20 MT(Reinspection)
/
0.7*,0.9") Initially recorded. These 2DBB 124' indications are the result of repair work performed during 2R$ a id are not service-induced. After surface preparation, the lugs were re-examined with no indications detected.
/l l
Int grally Welded Attmnt 2DBB 1 H19 C 3.20 2DBB 124' 63-039W CC MT(Initial)
/
Two linear surf ace indications (0.4',
Integrally Welded Attmnt 2 EBB 1 H2 C 3.20 MT(Reinspection)
/
0.7") initially recorded. The in-2 EBB-1 38" dications, which appear on lugs 6 and 7, are not service-induced. After surface preparation, the lugs were reexamined with no indications detected 30-006 C-F 1 PT
~
UT45' Shear Axial
/
Pipe to Elbow Circ Weld 2GCB 5-14*
UT45' Shear Circ
/
30-007 CF1 PT(initial)
/
Three linear surf ace indications (1.2",
Elbow to Pipe Cire Weld PT(Relnspection)
/
0.4",0.375*) initially recorded. One 2GCB 514' UT45' Shear Axial
/
indication caused by weld undercut UT45' Shear Cire
/
and the other two by grinding marks.
None of the indications were service-Induced. After surface conditioning, the area was reexamined with no indications detected. One Code-acceptable indication recorded with the UT45' Shear Axial scan. The in-dication is porosity, confirmed by the original RT film, thct has no measurable through-wall dimension.
55-Of9 C-F 1 PT
/
Elbow to Pipe Circ Weld UT45' Shear Axial
/
2GCB 710' UT45' Shear Cite
/
UT70' Shear-Axial
/
55 022 C-F 1 PT
/
UT45' Shear-Axlal
/
Elbow to Pipe Circ Weld 2GCB-7-6*
UT45' Shear-Circ
/
UT70' Shear-Axlal
/
55-030 C-F 1 PT
/
Pipe to Elbow Circ Weld UT45' Shear-Axial
/
2GCB 714" UT45' Shear-Cire
/
UT70' Shear Axial
/
EPG92033 Page 14
ARKANSAS NUCLEAR ONE o UNIT 2 REFUELING OUTAGE No. 9 (2R9) 2ND INSPECTION INTERVAL / iST INSPECTION PERIOD ISI COMPONENT EXAMINATION
SUMMARY
N O
Exam No.
ASME O
O T
Component Description Code Exam Method R
E H
Remarks Line #/ Component Type Category E
O E
Item No.
C M R
7640f C-F 1 PT
/
Flange to Reducer Cire Weld UT60' Shear-Axlal
/
2GCB-116' UT60' Shear Circ
/
UT70* Shear Axial
/
UT70' Shear Cire
/
76-003 C-F-1 PT
/
Elbow to Pipe Circ Weld UT60' Shear Axlal
/
2GCB 11 12' UT60' Shear-Cire
/
76408 CF1 PT
/
UT60' Shear Axial
/
Elbow to Pipe Circ Weld 2GCB 11 12' UT60' Shear Circ
/
ff445 CF1 PT
/
Pipe to Elbow Circ Weld UT45' Shear Axial
/
2GCB-9-6' UT45' Shear Clrc
/
UT70* Shear Axial
/
- f483 C-F 1 PT
/
Elbow to Pipe Circ Weld UT45' Shear Axial
/
2GCB-9-8' UT45' Shear Circ
/
UT70' Shear Axial
/
30-006A CF1 PT
/
Elbow Long Seam Weld-Heel UT45' Shear Axial
/
2GCB 514' UT45' Shear Cire -
/
304068 C-F-1 PT
/
Elbow Long Seam Weld Throat UT45' Shear Axial
/
2GCB-5-14' UT4 5' Shear Cire
/
65-020AB CF1 PT
/
Elbow Long Seam Welds UT45' Shear Axial
/
i 2GCB 710'
' UT45' Shear Circ
/
$5 DJ0AB C-F 1 PT
/
Elbow Long Seam Welds UT45' Shear Axial
/
2GCB-714' UT45' Shear Cire
/
- f 070 CF1 PT
/
Pipe to Elbow Circ Weld C 5.21 UTS2' Shear Axial
/
2CCB-12-3' UTS2' Shear-Circ
/
UT70* Shear. Axial
/
- 3-0JJ C-F 1 PT
/
Reducer to Pipe Circ Weld C 5.21 UTS2' Shear Axlal
/
UTS2' Shear-Circ
/
UT70* Shear Axial
/
f 7 00f CF2 MT
/
Transition Piece to SG Nozzle C 5.51 UTO' LAM Scan
/
I 2DBB-1 18' UT45' Shear-Axial
/
l UT45' Shear-Circ
/
l EPG92033 Page 15
ARKANSAS NUCLEAR ONE. UNIT 2 REFUELING OUTAGE NO. 9 (2R9) 2ND INSPECTION INTERVAL / iST INSPECTION PERIOD ISI COMPONENT EXAMINATION
SUMMARY
N O
Exam No.
ASME O
G T
Component Description Code Exam Method R
E H
Remarks Line #/ Component Type Category E
O E
lte m N o.
C M
R 17 002 C-F 2 MT
/
Pipe to Transition Piece Circ Weld C 5.51 UTO' LAM Scan
/
2DBB-1 18' UT45' Shear Axial
/
UT45' Shear Cire
/
63 00fA C-F 2 UT45' Shear Axial
/
Augmented volumetric examinations Flued Pen to Elbow Circ Weld C 5.51 UT45' Shear Circ
/
performed per Branch Technical 2 EBB 138' Position MEB 31.
63 00fB C-F 2 UTO' LAM Scan
/
Augmented volumetric examinations Elbow to Elbow Circ Weld C 5.51 UT45' Shear Axlal
/
performed per Branch Technical 2 EBB-1 38' UT45' Shear Cire
/
Position MEB 3-1.
63 002 C-F 2 MT
/
Augmented volumetric examinations Elbow to Pipe Circ Weld C 5.51 UT45' Shear-Axial
/
performed per Branch Technical 3 EBB-1 38" UT45' Shear-Circ
/
Position MEB 31. Surface exam-Instion also performed for Category C F 2 Code credit.
63-002AB C-F-2 MT
/
Augmented volumetric examinations Elbow Long Seam Welds C 5.52 UT45' Shear Axial
/
performed per Branch Technical 2 EBB-1 38" UT45' Shear-Circ
/
Position MEB 31. Surface exam-ination also performed for Category C-F 2 Code credit.
63 003 CF2 MT
/l l
Pipe to Sweepolet Branch C 5.81 2 EBB-1 38" 72-027W D-B VT-3 l
l/
An engineering evaluation was per-Integrally Welded Attmnt 2HBC-33-H21 D 2.20 formed per 1RF 6532 in response to 2HBC-33-20*
an ISI finding (attachments not welded as indicated on design drawing). The evaluation concluded that the existing field condition is acceptable and that the attachments will perform their intended design function. Corrective measures not required.
l/
An engineering evaluation was per-Integrally Welded Attmnt 2HBC 35-H4 D 2.20 formed per IRF 6571 in response to 2HBC-35-16" an ISI finding (shim plate corroded) i and an observed design discrepancy (1/4" gap between plates). The eval-uation concluded that the support is acceptable and will perform its in-tended design function. Corrective measures not required.
EPG92033 Page 16
i ARKANSAS NUCLEAR ONE. UNIT 2 REFUELING OUTAGE NO. 9 (2R9) 2ND INSPECTION INTERVAL / iST INSPECTION PERIOD ISI COMPONENT EXAMINATION
SUMMARY
N O
Exam No.
ASME O
O T
Component Description Code Exam Method R
E H
Remarks Line s/ Component Type Category E
O E
ttem No.
C M
R 72-038 W D-B VT 3
/
An engineering evaluation was per-Integrally Welded Attmnt 2HBC-33-H1 D 2.20 formed per IRF 6513 in response to 2HBC-33-20' an observed ISI concem (light rust).
The evaluation concluded that the support is acceptable and will perform its intended design fundion. Cor-rective measures not required.
<l l
Integrally Welded Attmnt 2HBC 59 H4 D 2.20 2HBC 5914' 72-054W D-B VT-3 l
l/
An engineering evaluation was per-Integrally Welded Altmnt 2HBC 59-H6 D 2.20 formed per IRF 6572 in response to 2HBC 5916*
an ISI finding (clearance not as indi-cated on drawing). The evaluation concluded that the support is acceptable and will perform its in-tended design function. Corrective measures not required.
/l l
An engineering evaluation was per-Integrally Welded Altmnt 2HBC 59-H8 D 2.20 formed perIRF 6515 in response to 2HBC-59-16" an observed design discrepancy (shims used to achieve proper gaps not indicated on design drawing).
The evaluation cone.luded that the support is acceptable and will per-form its intended design function.
Corrective measures not required.-
72457W D-B VT-3
/l l
Integrally Welded Attmnt 2HBC-59-H10 D 2.20 2HBC-59-16" 72 058W D-B VT 3
/l l
Integrally Welded Attmnt 2HBC 59 H11 D 2.23 2HBC 5914" 72 086W D-B VT 3
/l l
Integrally Welded Attmnt 2HBC-33-H14 D 2.20 2HBC-3318" 72 095W D-B VT 3
/l l
Integrally Welded Attmnt 2HBC-85-H1 D 2.20 2HBC-854' i
l EPG92033 Page 17
.2.
ARKANSAS NUCLEAR ONE - UNIT 2 REFUELIN3 OUTAGE NO. 9 (2R9) 2ND INSPECTION INTERVAL / iST INSPECTION PERIOD ISI COMPONENT EXAMINATION
SUMMARY
N O
Exam No.
ASME O
G T
Component Description Code Exam Method R
E H
Remarks Line #/ Component Type Category E
O E
ltem No.
C M
R 72 099W DB VT-3
/
An engineering evaluation was per-Integrally Welded Attmnt 2HBC-85-H5 D 2.20 formed per 1RF 6534 in response to 2HBC-85-6*
an ISI finding (stanchion corroded) and an observed design discrepancy (2x2 angle iron not indicated on design drawing). The evaluation c2ncluded that the support is ac-ceptable and will perform its intended design function. Corrective measures not required.
72166W D-B VT 3
/l L
Integrally Welded Attmnt 2HBC-85-H7 D 2.20 2HBC-85-8" 72168W D-B VT 3
/l l
An engineering evaluation was per-Intrgrally Welded Attmnt 2HBC-85-H10 D 2.20 fomied perIRF 6518 in response to 2HBC 85-8' observed design discrepancies (ex-cessive baseplate gap, unidentified 2x2 angle welded to baseplate, cutout section on baseplate, apparent grout cracking, anchor bolts cut off at ends). The evaluation concluded that the support is acceptable and will perform its intended design function.
Corrective measures not required.
72175W D-B VT-3
/l l
An engineering evaluation was per. -
Integrally Welded Attmnt 2HBC-35-H2 D 2.20 formed per IRF 6519 in response to 2HBC-35-16" observed design discrepancies (interference with line below welded attachment, unable to verify exist-ence of weep holes). The evaluation concluded that the support is ac-ceptable and will perform its intended design function. Corrective measures not required.
/l l
An engineering evaluation was per.
Integrally Welded Atti--at 2HBC 59-H9 D 2.20 formed per IRF 6520 in response to 2HBC-59-16" an observed design discrepancy (weep holes not verifiable). The evaluation concluded that the support is acceptable and will perform its intended design function. Corrective measures not required.
73 044W D-B VT 3
/l l
Integrally Welded Attmnt 2HBC-64-H9 D 2.20 2HBC-64-8" EPG92033 Page 18
ARKANSAS NUCLEAR ONE - UNIT 2 REFUELING OUTAGE NO. 9 (2R9) 2ND INSPECTION INTERVAL /1ST INSPECTION PERIOD ISI COMPONENT EXAMINATION
SUMMARY
N O
Exam No.
ASME O G T
Componeet Description Code Exam Method R
E H
Remarks Line #/ Component Type category E
O E
Item No.
C M
/
Integrally Welded Aftmnt 2HBC 34-H14 D 2.20 2HBC-34 20" 73 075W D-B VT 3
/l l
Integrally Welded Artmnt 2HBC-60-H3 D 2.20 2HBC-60-14' 73 077W D-B VT 3
/l l
Integrally Welded Attmnt 2HBC-60-H5 D 2.20 2HBC 6016" 7J 105W D-B VT 3
/l l
Intogrally Welded Mtmnt 2HBC-64-H1 D 2.20 2HBC-64 8' 73106W D-B VT 3 l
l/
An engineering evaluation was per-Integrally Welded Attmnt 2HBC-64-H10 D 2.20 formed per IRF 6573 In response to 3HBC-64-8' an ISI finding (portion of weld missing). The evaluation concluded that the support is acceptable and will perform its intended design function. Corrective measures not required.
/l l
Integrally Welded Attmnt 2HBC 34-H1 D 2.20 2HBC 34-20" 85-104W DB VT 3 l
l/
An engineering evaluation was per-Integrally Welded Attmnt 2DBC 1 H4 0 2.20 formed per IRF 6535 in response to 3DBC-14 an ISI finding (wrapper plate not welded on bottom as indicated on design drawing). The evaluation concluded that the support is acceptable and will perform its in-tended design function. Corrective measures not required.
l 85-105W D-B VT 3
/l l
Integrally Welded Attmnt 2DBC-1 HS D 2.20 2DBC 1-4"
- 5127W D-B VT 3
/l l
l Integrally Wekled Attmnt 2DBC-1-H27 D 2.20 1
2DBC-1-4' EPG92033 Page 19
ARKANS AS NUCLEAR ONE. UNIT 2 REFUELING OUTAGE NO. 9 (2R9) 2ND INSPECTION INTERVAL / iST INSPECTION PERIOD ISI COMPONENT EXAMINATION
SUMMARY
N O
~
Exam No.
ASME O O T
Component Description Code Exam Method R
E H
Remarks Line KComponent Type Category E
O E
ltem No.
C M
/ An engineering evaluation was per-Integrally Welded Attmnt 2DBC 1 H38 D 2.20 formed per IRF 6537 in respease to 203C-14' an ISI finding (grout cracked) and an observed design discrepancy (missing weep hole). The eval-untion concluded that the support is acceptable and will perform its la-tended design function. Corrective measures not required.
73-09 f AW D-B VT 3
/l l
o integrally Welded Attmnt 2HBC 104-H2 D 2.40 2HBC 10412' i
85120W D6 VT-3
/j l
Integrally Welded Attmnt 2DBC-1 H2O D 2.40 2DBC 14' 73-088W D-B VT 3
/l l
Integrally Welded Attmnt 2HBC-104 H7 D 2.50 2HBC 104-B' 23 062 FA VT 3 l
l/
An engineering evaluation was per-Guide Hanger 2CCA-24 H18 F 1.10A formed per IRF 6548 in response to 2CCA-24 12' ISI fiadings (weep holes flame cut, grout cracked, excessive baseplate gap, no shims between plate and wall) and observed design dis-crepancies (1* conduit in contact with support item, unidentified 3x3 angle s
welded to support item). The eval-uation concluded that the support is acceptable and will perform its in-tended design function. Corrective measures not required.
23 065 F-A VT 3 l
l#
An engineering evaluation was per.
Sway Strut Hanger 2CCA 24-H3 F 1.10A formed per IRF 6560 in response to 2CCA 2412' ISI findings (bolts do not have full thread engagement with nuts, grease zerk broken) and an observed design discrepancy (bottom baseplate has excessive gap). The evaluation core cluded that the suppo,t is acceptable and will perform its intended design function. Corrective mea; Jres not required.
33 068 FA VT-3
/l l
Guide Hanger 2CCA 24-H21 F 1.10A 2CCA 24 8*
I EPG92033 Page 20 I
ARKANSAS NUCLEAR ONE - UNIT 2 REFUELIN3 OUTAGE NO. 9 (2R9) 2ND INSPECTION INTERVAL /1ST INSPECTION PERIOD ISI COMPONENT EXAMINATION
SUMMARY
N O
Exam No.
ASME O
G T
Component Description Code Exam Method R
E H
Remarks Line s/ Component Type Category E
O E
lte m N o.
C M
/
An engineering evaluation was pet.
Guide Hanger 2CCA 32-H1 F 1.10A formed per IRF 6508 in response to 2CCA 32 2' an observed design discrepancy (gap that exists between pipe stanchlon and top angle iron not indicated on drawing). The eval-untion concluded that the support is acceptable and will perform its intended design function. Conective measures not required.37-047 FA VT 3 l
l/
An engineering evaluation was per.
Guide Hanger 2CCA 12 H9 F 1.10A formed per IRF 6554 in response to 2CCA 12 2*
lSI findings (U-bolt and plate cor-roded, shim plate not tack welded).
The evaluation concluded that the support is accepteble and will perform its intended design function. Cor-rective measures not required.40-055 FA VT 3
/l l An engineering evaluation was per.
Rigid Hanger 2CCA 27 3 H4 F 1.10A formed per IRF 6510 in response to 2CCA 27 2' an observed design discrepancy (saddla clamp bolts not staked).
The evaluation concluded that the support is acceptable and will perform its intended design function.
Corrective measures not required.40-056 FA VT 3 l
l/
An engineering evaluation was per-Rigid Hanger 2CCA 27 3-H3 F 1.10A formed per IRF 6326 In response to 2CCA 27 2*
an ISI finding (weld missing). The evaluation concluded that the support is acceptable and will perform its intended design function. Corrective measures not required.
An engineering evaluation was per-Rigid Hanger 2CCA 27 3 H1 F 1.10A formed per IRF 6527 in response to 2CCA-27 2' an ISI finding (bent extension rod) and an observed design discrepancy (oversized hole in rod arm). The evaluation concluded that the support is acceptable and will perform its intended design function. Corrective I
measures not required.
40 059 F-A VT 3 VI l
l Rigid Hanger 2CCA 27 4-H1 F 1.10A 2CCA 27 2" l
EPG92033 Page 21 l
ARKANSAS NUCLEAR ONE UNIT 2 REFUELING OUTAOE NO. 9 (2R9) 2ND INSPECTION INTERVAL / iST INSPECTION PERIOD ISICOM4P tjENTEXAMINATIQN SUMMA (G j
N O
Exam No.
ASME O
G T
Componsnt Description Code Exam Method R
E H
Hamarks Line #/ Component Type Category E
O E
Item No.
C M R
/
Component Suppor120CA-14412 F 1.10A 3BCA 14-6'24-068 FA VT 3
<l l
An engineering evaluation was per.
GuZe Hanger 2CCA 23-H12 F 1.108 fonned per IRF 6567 in reaponse to 3CCA-23-12' observed design discrepancles (items not welded as indicated on design drawing). The evaluation concluded that the support is accepttble and will pedorm its intended design function. Corrective measures not required.37-042 FA VT 3
/j
]_ An engineering evaluation was per.
Guide H6nger 2CCA 12 H3 F 1.10B formed per IRF 6553 in response to 2CCA 12 2*
an observed design discrepancy (unidentified 3x3 angle welded to support item). The evaluation con-cluded thet the support is acceptable and will perforin its intended design function. CorTective measures not required.
_l l
An engineering evaluation was per.40-052 FA VT 3
/
Rigid Hanger 2CCA 27-2 H6 F 1.10B formed per IRF 6509 in response to 3CCA-27 2*
an ISI concem (support item has water standing in it) and an observed design discrepancy (weld callout in error on design drawing). The eval-uation concluded that the support is acceptable und will perform its intended design functlan. Corrective measures not required.
/l l
Rigid Hanger 2CCA 27 3 H2 F 1.108 2CCA 27 2*
23 064 FA VT-3 hI An engineering evaluation was per-Spring Hanger 2CCA 24 H2 F 1.10C formed per IRF 6549 in response to 3CCA 2412' observed design discrepancies (weld symbol incorrect on design drawing, orientation of welds between support items confilet with design drawing, wrench marks on adjusting nut). The evaluation concluded that the support is acceptable and will perform its intended design function.
Corrective measures not required.
I I
EPG92033 Page 22
ARKANSAS NUCLEAR ONE UNIT 2 REFUELIN3 OUTAGE NO. 9 (2R9) 2ND INSPECTION INTERVAL / iST INSPECTION PERIOD
@] COMPONENT EXAMINATION
SUMMARY
N O
j Exam No.
ASME O O T
Component Description Code Exam Method R
E H
Remarks 1
Line 8/ Component Type Category E o E
lte m N o.
C M R
/
Spring Hanger 2CCA 24 H2O F 1.10C 2CCA-24 8' i
l 4
Spring Hanger 2CCA 24 H12 F 1.100 2CCA-213*
/l l
Spring Hanger 2CCA 12 H1 F 1.10C 2CCA 12 2*
l/
An engineering evaluation was pea Spring Hanger 2CCA 12 H6 F 1.100 formed per IRF 6552 in response to 2CCA-12 2" ISI findings Gam nuts loose, weld symbolincorrect on design drawing).
The evaluation concluded that the support is acceptable and will perictm its intended design function.
Corrective measures not required.43-052 FA VT 3
/l l
An engineering evaluation was per-Spring Hanger 2BCA 14-H4 F 1.10C formed perIRF 6511 in response to 2BCA 14-6' an observed design discrepancy (pipe clamp bolt not staked). The l
evaluation concluded that the support is acceptable and will perform its intended design function. Corrective measures not required.
l/
An engineering evaluation was per.
Rigid Hanger 2CCA 24 H22 F 1.10E formed perIRF 6551 in response to 2CCA-24 8' an ISI finding (support items not welded on top as indicated on design drawing). The evaluation concluded that the support is ac-ceptable and will perform its intended t
i design function. Corrective measures not required.
I 16 Of 7 FA VI 3 l
l<
Finding Tall end bolt nuts missing M:chanical Snubber 2BCA 1 H2 F 1.10F and bolt corroded. Action Taken.
2BCA 1 12' Replaced load studs.
l/
Finding. Lack of sufficient thread erk Mechanical Snubber 2BCA 1 H3 F 1.10F gagement. Action Taken. Adjusted 2BCA-1 12' pipe clamp bolt.
/ !
l Mechanical Snubber 2CCA-21 H12 F 1.10F 2CCA-21 12" EPG92033 Page 23 l
y y
-s---
o, y
y
-w-y w
-g m-w+
-s-
--w
.g
-y e
ARKANSAS NUCLEAR ONE. UNIT 2 REFUELING OUTAGE No. 9 (2R9) 2ND INSPECTION INTERVAL / IST INSPLCTION PERIOD s
ISI COMPONENT EXAMINATION
SUMMARY
Exam No.
ASME O
O T
Component Description Code Exam Method R
E H
Remarks Line #/ Component Type Category E
O E
Item No.
C M
/
M:chanical Snubber 2CCA 21 H18 F1.10F 2CCA 21 12' 2 f-06 f FA VT 3
( I l
Mechanical Snubber 2CCA 21 H10 F 1.10F 2CCA 21 12' 2f 062 FA VT 3
/l l
l Mechanical Snubter 2CCA 21 H17 F 1.10F 2CCA 21 12' 2f467 FA VT 3
/l l
M:chanical Snubber 2CCA 21 H15 F 1.10F 2CCA 218' 2f 068 FA VT 3 (I
l
~
M:chanical Snubter 2CCA 21 H19 F 1.10F 2CCA 218' 2f472 FA VT 3
<l l
M:chanical Snubter 2CCA 21-H16 F 1.10F 2CCA 218'22-050 FA VT 3
<l l
Mechanical Snubter 2CCA 22 H22 F 1.10F 2CCA 2212'22-052 FA VT 3 (I
l Mechanical Snubber 2CCA 22 H21 F1.10F 2CCA 2212' 22455 FA VT 3
/l l
Mechanical Snubber 2CCA 22 H19 F 1.10F 2CCA 2212'22-056 FA VT 3
/l l
M2chanical Snubber 2CCA 22 H18 F 1.10F 2CCA 2212' 22457 FA VT-3 l
l<
Finding Washer on telescoping end M:chanical Snubter 2CCA 22-H17 F 1.10F and cotter key on extension need re-2CCA-2212' placement. Action Taken Washer and cotter pin deficiencies conrected.
Mechanical Snubter 2CCA-22 H15 F 1.10F 2CCA 2212*
/l l
M:chanical Snubber 2CCA 22 H14 F 1.10F 2CCA 2212' 22464 FA VT-3
/l l
Mechanical Snubber 2CCA 22 H13 F 1.10F 2CCA 22 8' EPG92033 Page 24
ARKANSAS NUCLEAR ONE. UNIT 2 REFUELING OUTAGE NO. 9 (2R9) 2ND INSPECTION INTERVAL / iST INSPECTION PERIOD ISI COMPONENT EXAMINATION
SUMMARY
N O
Exam No.
AAME O
G T
Component Description Code Exam Method R
E H
Remarks Line WComponent Type Category E
O E
Item No.
C M
/1 Mechanical Snuteer 2CCA 24 H15 F 1.10F 2CCA 2412' 23 06f F.A VT 3 l
l/
Finding. Piston wear. Action Taken.
Mechanical Snutber 2CCA 24 H17 F 1.10F Piston rod wear cleaned up with 2CCA 2412' Scotch Brite pad.
l/
Finding End cap loose (piston end).
M:chanical Snuteer 2CCA 24 H19 F 1.10F Action Taken. Loose end cap re.
2CCA 2412' palred.23-076 FA VT 3
<l l
Mechanical Snut6er 2CCA 24 H27 F 1.10F 2CCA 24-8' 23 076 FA VT 3
/l l
Mechanical Snuther 2CCA 24 H24 F 1.10F 2CCA 24-8' 24 067 FA VT 3 vl l
M:chanical Snuteer 2CCA 23 H11 F 1.10F 2CCA 23-12*
<l l
Mechanical Snuther 2CCA 23 H26 F 1.10F 2CCA 2212" 24 076 F-A VT-3
<l l
Mechanical Snutter 2CCA-23 H27 F 1.10F 2CCA 2312' 24 077 FA VT 3 (l
l M:chanical Snuther 2CCA-23-H18 F 1.10F 2CCA 23-8" 24 079 FA VT 3
<l l
Mechanical Snutber 2CCA 23-H28 F 1.10F 2CCA 23 8' 24 080 FA VT 3
/l l
Mechanical Snutect 2CCA 23 H21 F 1.10F 2CCA 23-8' 24 084 F-A Vf 3 l
l/
Finding - Snubber pipe clamp loose Mechanical Snuther 2CCA 23-H23 F 1.10F on extension end. Action Taken-2CCA 23-B' Pipe clamp bolts torqued.
25 074 F-A VT 3
/l l
M:chanical Snuther 2CCA-25-H3 F 1.10F 2CCA 2514' 25 075 FA VT 3
/l l
Mechanical Snutter LCA 25-H4 F 1.10F 2CCA 2514" 25 077 FA VT 3
<l l
Mechanical Snubter 2CCA-25 HS lF 1.10F 2CCA 25-14" EPG92033 Page 25 J
ARKANSAS NUCLEAR ONE UNIT 2 REFUELING OUTAGE NO. 9 (2R9) 2ND INSPECTION INTERVAL / iST INSPECTION PERIOD ISI COMPONENT EXAMINATION
SUMMARY
N O
Exam No.
ASME O
O T
Component Description Code Exam Method R
E H
Remarks Line #/ Component Type Category E
O E
ltem No.
C M
R
/
M:chanical Snutter 2CCA-25-H6 F1.10F 2CCA 258" 25 082 FA VT 3
/l l
M:chanical Snubber 2CCA 25-H10 F 1.10F 2CCA 25-3*
l M:chanical Snubber 2CCA 25H14 F 1.10F 2CCA 253'25-088 F-A VT 3 l
l<
Finding - Front eye rod washes M:chanical Snubber 2CCA 25 H13 F 1.10F missing. Action Taken Washer 2CCA 25 3*
Installed.
<l l
Mechanical Snubber 2CCA 14-H2 F 1.10F 2CCA 14 3*
26 028 F.A VT 3 VI l
M:chanical Snubber 2CCA 15-H9 F 1.10F
?CCA 15-3*
<l l
M:chanical Snubber 2CCA 15-H27 F 1.10F 2CCA 15-3*
M:chanical Snubber 2CCA 15H26 F 1.10F 2CCA 15-3*
<l l
M:chanical Snubber 2CCA 14-H5 F 1.10F 2CCA 14-3*
/l l
M:chanical Snubber 2CCA-15-H45 F 1.10F 2CCA 15 3" 26 055 F-A VT 3
/l l
Mcchanical Snubber 2CCA 15-H44 F 1.10F 2CCA-15-3*
<l l
M chanical Snubber 2CCA 15-H41 F 1.10F 2CCA 15-3*
/l l
M:chanical Snubber 2CCA 1EH39 F 1.10F 2CCA 15-3*
Mechanical Snubber 2CCA 13-H4 F 1.10F 2CCA 13-3*
27034 F-A VT 3
/}
l Mechanical Snubber 2CCA 15-H24 i-1.10F 2CCA 15 3" l
EPG92033 Page 26
ARKANTL. 'rik'? LEAR ONE. UNIT 2 h
REFOdLING OUTME NO. 9 (2R9) 2ND INSPECTION INTnVAL / iST INSPECT 10N PERIOD ISI COMPONENT EXAMINATION
SUMMARY
N O
Exam No.
ASME O
O T
Component Description Code f ram biothod R
E H
Remarks Line #/ Component Type Category E
O E
ltem,No.
_ _C M R
, _li k'
27 067 FA VT 3 M:chanical Snubber 2CCA 15 H00 F1.10F 2CCA 15-4*
/l l
M2chanical Snubber 2CCA 15-H50 F1.10r 2CCA 15-3*
/l l
M:chanical Snubber 2CCA-15-H53 F 1.10F 2CCA 15 3*
/l l
Michanical Snubber 2CCA 15-H50 F 1.10F 2CCA 153*
27 08f F-A VT 3 vl l
Mschanical Snubber 2CCA 15-H48 F 1.10F 2CCA 15-3*
/l l
Mechanical Snubber 2CCA 15-H29 F 1.10F 2CCA 15-4*
<l l
M:chanical Snubber 2CCA 15-H30 F 1.10F 2CCA 15-4*
/l l
Mechanical Snubber 2CCA 15-H31 F 1.10F 2CCA 15-4*
/l l
l Mechanical Snubber 2CCA 15-H34 F 1,10F 2CCA 15 3*
/l i
Mechanical Snubber 2CCA 15 H36 F 1.10F l
2CCA 15-3*
\\
/l l ~
Mechanical Snubber 2CCA 16-H19 F 1,10F 2CC? 16-2*
29 036 F-A VT 3
/l l
l Mschanical Snubber 2CCA 16-H3 F 1.10F 2CCA 16-2*
/l l
Mschanical Snubber 2CCA 16-H4 F 1.10F l
2CCA 16-2*
l 29 062 F.A VT 3
/l l
Snubber 2CCA 10-H21 F 1.10F 2CCA 1R-2*
/l l
Snubber 2CCA-16-H16 F 1.10F 2CCA 16 2*
EPG92033 Page 27
ARKANSAS NUCLEAR ONE UNIT 2 REFUELIN3 OUTAGE NO. 9 (2R9) 2ND INSPECTlON INTERVAL /1ST INSPECTION PERIOD ISI COMPONENT EXAMINATION
SUMMARY
N O
Exam No.
ASME O
G T
Component Description Code Exam Method R
E H
Remarks Line GWComponent Type Category E
O E
hem No.
C M
R 29444 F-A VT 3
/
Snubber 2CCA-16-H12 F 1.10F 2CCA 16-2*
/l l
Mechanical Snubber 2CCA 32 H2 F 1.10F 2CCA 32 2*
/l l
~
M:chanical Snubber 2CCA 26-H2 F 1.10F 2CCA 26 2*
/l l
M:chanical Snubber 2BCA-14-H7 F 1.10F 2BCA 14-3" 43 044 FA VT 3
/l l
Mechanical Snubber 2BCA 14-H14 F 1.10F 2BCA 14-4*
/l l
Mechanical Snubber 2BCA 14-H3 F 1.10F 2BCA 14-4" 43 047 FA VT 3
/l l
i Mechanical Snubber 2BCA 14-HS F 1.10F 2BCA 14 4" 43 049 FA VT 3
/l l
Mechanical Snubber 2BCA 14 H13 F 1.10F 2BCA 14-4" 43 050 FA VT 3 l
l/
Finding Tall piece has interference Mechanical Snubber 2BCA 14 H12 F1.10F with snubber support. Action Taken-2BCA 14-4' Rotale snubber 180*.
43 051 FA VT-3
/l l
Mechanical Snubber 2BCA 14 H15 F 1.10F 2BCA 14-4" 43 054 FA VT 3
_/l l
Mechanical Snubber 2BCA 14 H1 F 1.10F 2BCA 14-8" 17 04f FA VT 3 l l~/
An engineering evaluation was per-Rigid Hanger 2008-1 H16 F 1.20A formed perIRF 6547 in response to 2D88124" an ISI finding (loose anchor bolt nuts). The evaluation concluded that the support is acceptable and will perform its intended design function. Corrective measures not required.
EPG92033 Page 28
.~
ARKANSAS NUCLEAR ONE. UNIT 2 REFUELIND OUTAGE No. 9 (2R9) 2ND INSPECTION INTERVAL /1ST INSPECTION PERIOD ISI COMPONENT EXAMINATION
SUMMARY
N O
Exam No.
ASME O O T
Component Description Code Exam Method R
E H
Remarks Line #/ Component Type Category E
O E
tte m N o.
C M
/
An engint ering evaluation was per.
Guide Hanger 2GCB-5-H19 F 1.20A formed p.tr IRF 6568 in response to 2GCB 5-14' ISI findiags (excessive baseplate gap, loose nut, flame cut holes in base.
plate, abandoned ungrouted anchor bolt hole). The evaluation concluded that the support is acceptable and will perform its intended design function.
Corrective measures not required.
l/
An engineering evaluation was per-Guide Hanger 2GCB 7 H19 F 1.20A formed per IRF 6579 in response to 2GCB-7-6*
an ISI finding (grout cracked). The evaluation concluded that the support is acceptable and will perform its intended design function. Corrective measures not required.
/l l
Sway Strut Hanger 2GCB 7 H22 F 1.20A 2GCB-7 6*
/l l
An engineering evaluation was per-Rigid Hanger 2DDB 1 H19 F 1.20A formed per IRF 6512 in response to 2DBB-124' observed design discrepancies (unidentified 2x2x3 angle welded to baseplate, unidentified 3x3x1/4 angle welded to support column, emergency light attached to support column, field configuration and tolerances of some items differs from design drawing, excessive baseplate gap). The evaluation concluded that the support is acceptable and will perform its intended design function.
Corrective meaures not required.
630J9 FA t/T 3 l
l/
An engineering evaluation was per.
Sway Strut Hanger 2 EBB-1 H2 F 1.20A formed per IRF 6531 in response to 2 EBB 138' ISI findings (broken tack weld on nut, loose jam nuts and lack of fullthread engagement, missing grease zerk) and observed design discrepancies (hammer marks, weep holes drilled in weld area of strut). The evaluation concluded that the support is acceptable and will perform its intended design function. Cor-rective measures not required.
/l l
Support 2DCB-3 H33 F 1.20A 2DC B-3-4*
EPG92033 Page 29
ARKANSAS NUCLEAR ONE o UNIT 2 REFUELING OUTAGE NO. 9 (2R9) 2ND INSPECTION INTERVAL / iST INSPECTlON PERIOD ISI COMPONENT EXAMINATION
SUMMARY
N O
Exam No.
ASME O
O T
Component Description Code Exam Method R
E H
Remarks Line #/ Component Type Category E O E
lte m N o.
C M R
/
Support 2DCB 3-H24 F 1.20A
/l l
An engineering evaluation was per.
Support 2CCB 7 HS F 1.20A formed per IRF 6521 in response 2CCB.7-3*
to an observed design discrepancy (beam member length differs from design drawing). The evaluation concluded that the support is acceptable and will perfonn its intended design function. Cor-rective measures not required.50-034 FA VT 3 l
l/
An engineering evaluation was -
Rigid Hanger 2GCB-5-H6 F 1.208 performed per IRF 6576 in response 2GCB-514' to an ISI finding (improper gaps on guides) and an observed design discrepancy (excessive baseplate gap), The evaluation concluded that the support is acceptable and wlil perform its intended design function. Corrective measures not required.
/l l
Rigid Hanger 2GCB 7-H18 F 1.20B 2GCB 710'
- 0-564 FA VT-3
/l l
Support 2DCB-511-H13 F 1.208 2DCB 5112*
80 57J FA VT-3
/l l
Support 2DCB-511 H14 F 1.208 2DCB-511 2" 17 026 F-A VT-3
/l l
An engineering evaluation was per.
Spring Hanger 2DBB 1 H1 F 1.20C formed per IRF 6507 in response 3DBB 124' to observed design discrepancies (spring can in field differs from design drawing, undersized cotter pins). The evaluation concluded that the support is acceptable and will perform its intended design function, Conective measures not required.
30 032 F-A VT-3
/l l
Spring Hanger 2GCB-5 H2O F 1.200 2GCB-5-14' EPG92033 Page 30
ARKANS AS NUCLEAR ONE. UNIT 2 REFUELIND OUTAGE NO. 9 (2R9) 2ND INSPECTION INTERVAL 11ST INSPECTION PERIOD ISI COMPONENT EXAMINATION
SUMMARY
N O
Exam No.
ASME O
O T
Component Description Code Exam Method R
E H
Remarks Line #/ Component Type Category E O E
Item No.
C M R
/
Spring Hanger 2GCB 5-H7 F 1.20C An engineering evaluation was per-formed perIRF 6577 in response 2GCB-514' to an observed design discrepancy (nut not flush with pipe clamp). The evaluation concluded that the support is acceptable and will perform its intended design function.
Corrective measures not required.
l/
An engineering evaluation was per-Spring Hanger 2GCB 3 H2O F 1.20C formed per IRF 6530 in response to 2GCB-3-12" on ISI finding (loose baseplate anchor bolts) and an incidental observation (loose baseplate anchor bolts on two other supports in area). The evaluation concluded that all of the supports are acceptable and will perform their intended design function. Corrective measures not required.
5510J FA "VT-3 l
l/
An engineering evaluation was per-Spring Hanger 2GCB-7 H1 F 1.20C formed per IRF 6580 in response to 2GCB 710" an ISI finding (rod bent to provide clearance around adjacent pipe).
The evaluation concluded that the support is acceptable and wil' perform its intended design function.
Corrective measures not required.
/l l
Spring Hanger 2GCB 7 H6 F 1.20C 2GCB-710' S f-02 f FA VT-3 l
l/
An engineering evaluation was per-Rigid Hanger 2GCB-5-H30 F 1.20E formed per IRF 6578 in response to 2GCB-514' ISI findings (holes in stiffener plates, conduit in close proximity to base-plate, washer plates not installed) and observed design discrepencies (additional stiffener plate, anchor bolts lacking hillside washers). The evaluation concluded that the suppo't is acceptable and will perform its intended design function. Corrective measures not required.
80 565 F-A VT 3
/l l
Support 2DCB-511 H12 F 1.20E 2DCB-511 2" EPG92033 Page 31
ARKANSAS NUCLEAR ONE UNIT 2 REFUELING OUTAGE NO. 9 (2R9) 2ND INSPECTION INTERVAL / iST INSPECTION PERIOD ISI COMPONENT EXAMINATION
SUMMARY
N O
Exam No.
ASME O
G T
Component Description Code Exam Method R
E H
Remarks une #/ Component Type Category E
O E
hem No.
C M
' /
Finding Spot rust on clevis welds &
Mechanical Snubber 2DBB-1 H3 F 1.20F bido structure attachments. Action 208B-124' Taken - Job Request issued to address rust.17-028 FA VT 3
<l l
M:chanical Snubber 2DBB-1 H2 F 1.20F 2DBB-124"17-029 FA VT 3
/l l
Mechanical Snubber 2DBB-1 H4 F 1.20F 2DBB-1 24' 17 030 F.A VT 3
<l l
M:chanical Snubber 2DSB-1-H6 F 1.20F 20B8 1-24' f7-03f FA VT 3 l
l<
Finding Position indicator loose, Mechanical Snubber 2DBB-1 H11 F 1.20F tube will rotate. Action Taken - Cor-2DBB 124" rected when snubber removed for functional test.
Mschanical Snubber 2DBB 1 H9 F 1.20F 2DBB-1 24'17-034 FA VT 3 VI l
Mechanical Snubber 2DBB-1 H8 F 1.20F 2DBB 124' 17 035 FA VT 3 VI l
Mechanical Snubber 2DBB-1-H10 F 1.20 F 2DBB-124' 17 037 FA VT 3
<l l
M:chanical Snubber 2DBB 1-H13 F 1.20F 2DBB-124' 17 038 F-A VT 3
<l l
Mschanical Snubber 2DBB 1-H12 F120F 2DBB-1-24" 17 039 F-A VT 3 vl l
Mechanical Snubber 2DBB 1 H14 F 1.20F 2DBB-124"18-020 FA VT 3
<l l
Michanical Snubber 2 EBB 1 A-HS F 1.20F 2 EBB-1 38' 180/ f F-A VT-3
/l l
Mar 5anical Snubber 2 EBB 1 A H4 F 1.20F 2 EBB-1 38' 18 023 FA VT-3 VI l
Mechanical Snubber 2 EBB-1 A-H7 F1.20F 2 EBB-1 38' EPG92033 Page 32
ARKANSAS NUCLEAR ONE UNIT 2 REFUELING OUTAGid NO,9 (2R9) 2ND INSPECTION INTERVAL / iST INSPECTION PERIOD ISI COMPONENT EXAMINATION
SUMMARY
N O
Exam No.
ASME O G T
Component Description Codo Exam Method R
E H
Remarks Line 9/ Component Type Category E
O E
ttem No.
C M
/
Mech:nical Snubber 2 EBB 1 A H6 F 1.20F 2 EBB-1 38'19-028 FA VT-3
/l l
M:chanical Snubber 2DDB-2 H2 F 1.20F 2DBB-2 24' 19-029-FA VT 3
/l l
M:chanical Snubber 2DBB-2-H16 F 1.20F 2DBB-2 24' f 9 032 FA VT 3
/l l
M:chanical Snubber 2DBB 2-H19 F 1.20F 20B8-2 24' 19 033 FA VT-3
/l l
M:chanical Snubber 2DBB 2-H8 F 1.20F 2DBB-2-24*
{
l/
Finding - Pipe clamp bolt loose on Mechanical Snubber 2DBB 2 H17 F 1.20F board side. Adlon Taken - Pipe 2DBB-2 24" clamp bolt tightened.
19-0J7 F-A VT 3 l
l/
Finding Snubber housing screwin Mschtnical Snubber 2DBB 2-H11 F 1.20F contad with support item. Adion 2DBB 2 24' Taken Snubber rotated 180'.
19 039 F-A VT 3
/I l
Mechanical Snubber 2DBB-2 H13 F 1.2JF 2DBB 2 24" 19 04f FA VT 3 l
l/
Finding Loose pipe clamp bolt.
M:chanical Snubber 2DBB 2 H15 F 1.20F Action Taken Pipe clamp bolt 2DBB-2-24' torqued.'20-018 FA VT 3
/l l
Mechanical Snubber 2 EBB-2A H4 F1.20F 2 EBB-2-38" 20-Of9 F-A VT 3
/l l
Mech:nical Snubber 2 EBB 2A-H5 F 1.20F 2 EBB-2 38" 20 02f F-A VT 3
/l l
Mschanical Snubber 2 EBB 2A-H6 F 1.20F 2 EBB-2 38'20-022 FA VT 3
/l l
Mechanical Snubber 2 EBB-2A H7 F1.20F 2 EBB-2 38' 30-Of8 FA VT 3
/l l
Mechanical Snubber 2GCB 5-H21 F 1.20F j
/l l
Mechanical Snubber 2GCB-5-H23 F 1.20F 2GCB-5-14" EPG92033 Page 33-
- _ = _ - - -. _.. -.. - - -.
ARKANSAS NUCLEAR ONE. UNIT 2 REFUELING OUTAGE NO. 9 (2R9) 2ND INSPECTION INTERVAL / iST INSPECTION PERIOD ISI COMPONENT EXAMINATION
SUMMARY
l N
O Exam No.
ASME O G T
Component Description Code Exam Method R
E H
Remarks Line #/ Component Type Category E
O E
Item No.
C M
R 52440 F-A VT 3
/.
l M:chanical Snubber 2GCB-5-H31 F 1.20F 2GCB 5-14' 62 042 FA VT 3
/l l
Mechanical Snubber 2GCB 2 H3 F 1.20F 2GCB 214' 57 025 FA VT 3
/l l
Mechanical Snubber 2GCB-3-H22 F 1.20F 2GCB-312" 58 028A FA VT 3
/l l
Mechanical Snubber 2GCB-3-H24 F 1.20F 2GCB-3-12' 6f445 F-A VT 3
/l l
Machanical Snuther 2CCB-4 H2 F 1.20F 2CCB-4-6'63-038 FA VT-3
/l l
Mechanical Snubber 2 EBB-1-H4 F 1.20F 2 EBB 138' 63-04 f FA VT 3
/l l
Mechanical Snubber 2 EBB-8-H2 F 1.20F 2 EBB-810'65-035 F-A VT 3
/l l
Mechanical Snubber 2 EBB-2-H4 F 1.20F 2 EBB-2 38"65-037 FA VT 3
/l l
Mechanical Snubber 2 EBB 2 H6 F 1.20F 2 EBB-2 38" 65 038 FA VT 3
/l l
Mechanical Snubber 2 EBB 2-H5 F 1.20F 2 EBB-2-38' 75-04 f FA VT-3
/l l
Mechanical Snubber 2GCB-10-HS F 1.20F 2GCB-10-12'76-046 F-A VT 3
/l l
M:chanical Snubter 2GC3-11-H5 F 1.20F 2GCB 11 12*
/l l
Mechanical Snubber 2HCB 15-H15 F 1.20F 2HCB 15-14' 7947f F-A VT-3
/l l
Mechanical Snubber 2HCB-27-H7 F 1.20F 2HCB-27 20' Sf124 F-A VlT
/l l
Mechanical Snubber 2GCB-9 H24 F 1.20F 2GCB-9-8" EPG92033 Page 34
ARKANSAS NUCLEAR ONE UNIT 2 REFUELING OUTAOE No. 9 (2R9) 2ND INSPECTION INTERVAL / iST INSPECTION PERIOD ISI COMPONENT EXAMINATION
SUMMARY
N O
Exam No.
ASME O
G T
Component Description Code Exam Method R
E H
Remarks Lina #/ Component Type Category E
O E
lte m N o.
C M
R 72-052 F-A VT 3
/
An engineering evaluation was per-Rigid Hanger 2HBC-59 H4 F 1.30A formed per IRF 6514 in response to 2HBC-59-14' observed design discrepancies (undersized welds, slag on welds).
The evaluation concluded that the support is acceptable and will perform its intended design function.
Corrective measures r.ot required.72-058 FA VT 3
/l l
Rigid Hanger 2HBC-59-H8 F 1.30A 2HBC-50-16' 72 058 FA VT 3 Vl l
Guide Hanger 2HBC-59-H11 F 1.30A 2HBC-5914'73-044 FA VT-3
/l l
Rigid Hanger 2HBC-64-H9 F 1.30A 2HBC-64-8*
I 73 045 FA VT-3 VI [
Rigid Hanger 2HBC-64 H11 F 1.30A 2HBC-64-8*
85-126 F-A VT 3
<l l
Support 2DBC-1.H26 F 1.30A 2DBC-14*
72-099 FA VT-3
<l l
Rigid Hanger 2HBC-85-H5 F 1.30B 2H BC-85-6*
720f68 F-A VT 3
/l l
An engineering evaluation was per.
Guide Hanger 2HBC-85-H7 F 1.308 formed per IRF 6517 in response to 2HBC 856' observed design discrepancies (undersized frame welds, under-sized lug welds, unidentified 2x2 angle welded to support item). The evaluation concluded that the support is acceptable and will perform its intended design function.
Corrective measures not required.
73 076 FA VT 3 dl An engineering evaluation was per-Guide Hanger 2HBC-60-H3 F 1.30B formed per IRF 6574 in response 211BC M 14' to observed design discrepancies (additional 1 1/2" pipe attached to support, excessive baseplate gaps, incorrect weld syrnbots). The eval-uation concluded that the support is acceptable and v.
perform its intended design function. Corrective measures not required.
EPGE2033 Page 35
i ARKANSAS NUCLEAR ONE - UNIT 2 REFUELING OUTAGE NO. 9 (2R9) 2ND INSPECTION INTERVAL / iST INSPECTION PERIOD ISI COMPONENT EXAMINATION
SUMMARY
N O
Exam No.
ASME O
G T
Component Description Code Exam Method R
E H
Remarks Line s/ component Type Category E
O E
Item No.
C M
/
Support 2DBC-1 H'24 F 1.30B 2DBC-1 -4*
l/
An engineering evaluation was per.
Support 2DCB-1 H25 F 1.308 formed per IRF 6536 in response to 2DBC-1-4' 1S1 findings (baseplate loose, anchor bolts loose, washers loose, excessive gaps between wall and baseplate and between baseplate and washers).
The evaluation concluded that the support is acceptable and will perform its intended design fundion. Cor-rective measures not required.
l/
An engineering evaluation was per-Spring Hanger 2HBC-59-H1 F 1.30C formed per IRF 6533 in response to 3HBC-5914' ISI findings (loose hex nuts, loose U bolt nuts) and an incidental ob.
servation (loose anchor bolt: on other support in area). The e'tatuation concluded that the supports are ac-ceptable and will perform their in-tended design function. Corrective measures not required.
73 09fA F-A VT 3 fl l
Spring Hanger 2HBC-104 H2 F 1.30C
~
An engineering evaluation was per.
formed perIRF 6555 in response to 2HBC 10412*
an observed design discrepancy (two additional beam attachments welded to support item). The evaluation concluded that the support is acceptable and will perform its intended design function. Corrective measures not required.
/I l
An engineering evaluation was per-Rigid Hanger 2HBC-59-H10 F 1.30E formed per IRF 6516 in response 1o 2HBC-59-16' an observed design discrepancy (excessive baseplate gap). The evaluation concluded that the support is acceptable and will perform its intended design function. Corrective measures not required.
/l l
An engineering evaluation was per-Support 2DBC-1-H27 F 1.30E formed per IRF 6522 in response to 2DBC-1-4" an observed design discrepancy (excessive baseplate gap). The evaluation concluded that the support is acceptable and will perform its intended design function. Corrective measures not required.
EPG92033 Page 36 i
ARKAN3AS NUCLEAR ONE. UNIT 2 REFUELING OUTAGE NO. 9 (2R9) 2ND INSPECTION INTERVAL / iST INSPECTION PERIOD ISI COMPONENT EXAMINATION
SUMMARY
N O
Exam No.
ASME O
O T
Component Description Code Exam Method R
E H
Remarks Line s/ Component Type Category E
O E
ltem No.
C M
R M:chanical Snubber 2HBC 103-H22 F 1.30F
_ l/
Finding - Saddle bolt loose on ex-72 134 FA VT 3 tension end of pipe clamp. Adlon 2HBC-103-12*
Taken - Pipe clamp inner bolt lightened.
72 136 F-A VT-3
/l l
M:chanical Snubber 2HBC-103-H18 F 1.30F 2HBC-103-12*
72 137 F-A VT 3
/l l
Mechanical Snubber 2HBC 103-H2O F 1.30F 2HBC-10312' 72 138 FA VT-3
/l l
M:chanical Snubber 2HBC-103-H17 F 1.30F 2HBC-103-12" 7215J F-A VT 3
/l l
Mechanical Snubber 2HBC-105-H4 F 1.30F 2HBC-105-12' 72-159 FA VT 3
/l l
Mechanical Snubber 2HBC-105-H14 F 1.30F 2HBC-105-12' 7216f F-A VT-3
/l l
Mtchanical Snubber 2HBC-105-H17 F 1.30F 2HBC-105-12" 72 162 F-A VT 3
<l l
Mechanical Snubber 2HBC-105-H16 F 1.30F 2HBC-105-12*
72 163 F-A VT-3
/l l
M:chanical Snubber 2HBC-105-H18 F 1.30F 2HSC-105-12*
03-00fS F-A VT-3
<l l
Support Skirt F 1.40 Steam G nerator 2E24A 33 0f 0 F-A VT-3
/l l
Pump Support s1 F 1.40 Reactor Coolant Pump 2P32C 46-003 F-A VT-3 l
l/
An engineering evaluation was per-Pump Support (s)
F 1.40 formed per IRF 6528 in response to LPSI Pump 2P60A ISI findings (spalled concrete, loose nut). The evaluation concluded that the support is acceptable and will perform its intended design function.
Corrective measures not required.
I EPG92033 Page 37
ARKANS AS NUCLEAR ONE. UNIT 2 REFUELING OUTAGE NO. 9 (2R9) 2ND INSPECTION INTERVAL / iST INSPECTION PERIOD
^ ISI COMPONENT EXA MiNA TION SUMMAR Y.
N O
Exam No. -
ASME O
G T
Component Description Code Exam Method R
E H
Remarks Line #/Componeni Type Category E
O E
Item No.
C M
R 48-Of0 F-A VT 3
/- An engineering evaluation was per.
Shell Supports Class 3 F 1.40
~
formed per IRF 6529 in response to Shutdown Cooling HX 2E35A an ISI finding (loose anchor bolt nuts). The evaluation concluded that the support is acceptable and will perform its intended design function. Corrective measures not required.
90 00f FA VT-3
<l l
Pump Support (s)
F 1.40 HPSI Pump 2P89C EPG92033 Page 38
?
ATTACl{ MENT 3 FORMS NIS OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS 9
I.'
1 f.i
[..
l.
ABSTRACT Repair and Replacements were conducted during the nii,th operating cycle concluding with the ninth refueling outage (2R9) in accordance with the ASME Code,Section XI, 1986 Edition with no Addenda.
Arkwright Mutual Insurance Company (Factory Hutual Systems) served as the Authorized Inspection Agency as defined in ASME Section XI, IWA-2120, reviewing applicable procedures, witnessing examinations and checking for general Code compliance as specified in IWA-2110, of the applicable edition and addenda of the Code.
The " Summary and Conclusions" section provides a summary of the results for repairs and replacements'for 2R9 on the Form NIS-2.
Refueling outage 2R9 is the second outage of the first period of the second 10-year interval. This report covers repairs / replacements performed between April 20, 1991 and October 20, 1992.
u
FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS DAIE COMPONENT 4/22/92 2SI-1035 1
4/27/92 SPARE VALVE 4/29/92 2PSV-1002 4/29/92 2PSV-1056 5/13/92 2PSV-4634 6/2/92 2BS-12A 9/4/92 2SI-50 9/5/92 2CVC-1004 9/9/92 - 10/11/92 SUPPORTS 9/12/92 2SV-5021-1 9/14/92 2SI-15B 9/14/92 2SV-5061-2 9/15/92 2CCW-1033 9/19/92 2SV-8263-2 9/22/92 2CVC-1174 9/22/92 2CVC-26 9/28/92 2PSV-4633 9/28/92 2PSV-4634 10/2/92 2CV-2400-2 10/3/92 2CCA-25-H9 10/4/92 2CCA-32-2" 10/5/92 2SI-44 10/5/92 2SGS-1047C 10/5/92 2SV-5006 10/6/92 2PA-1003A, 2PA-1003B 2PA-1004A, 2PA-1004B 10/7/92 2SV-5044 10/7/92 2CCA-6-30" 10/7/92 2CV-5082 10/8/92 2CCB-9-1-H6 10/9/92 2SV-4636-2 10/9/92 2CV-4690-2 10/9/92 2SI-60 10/9/92 2CV-1052 10/10/92 2SV-5001-1 10/10/92 2SV-5046 10/10/92 2SV-5843-2 10/10/92 2SV-5633-2 10/10/92 2BS-189 10/10/92 2BS-5700 10/10/92 2BS-5701 10/10/92 2BS-1042 10/10/92 2SV-5066 10/11/92 2CV-2401-1 10/11/92 2SV-5064 10/11/92 2SV-5064 10/12/92 2SV-5833-1 10/12/92 2BS-12A 10/12/92 2CCB-13-H7 10/14/92 2SV-5024 10/15/92 2PSV-1054 10/17/92 2PSV-1002 10/17/92 2PSV-1005 10/17/92 2PSV-1056 10/17/92 2PSV-1055 10/19/92 2SGS-1047C 10/19/92 2PSV-1053
o
^
-FORM NIs-2 APPENDII !! - IEND&TOET REVISD ENG 021 06/30/89 PORN.3r!$ 2 048E1'S REPot! FOR REPATRS OR REP 1&CIMElffs As Required by the Previsions of the AAaB Code Sectian_I!
1.
0WNER int /Emme opetitimrt. inc.
MIR
+'- #1-M Name nr. s. nor ist a. menernm'. AR. noon snErf
/
et
/
addren 2.
PLANT Atraittit WDetrat Off WIT Two Name
~
RT. 3.101 137c.10strt t YTt t v. A1. 72801 Ja Co&W4W
~
Address Repair Organisatian 70 No., Jeb No., etc.
3.
WORK PERFORMED BT AML/E5FetW ops.
118e.
TTPt 0003 81390L ST&MP R/A Base
&UTHORIE&T!W NO.
E/A RT. 3. Box 1370. RUSSELLYT1.LE. AR. 72001 a uress mInnW mTE 4.
IDENTITICATION OF SYSTEM p Nu/ivv ION
-[J6C8-f)
/
V V
5.
(a) APP!.!C1311 CONSTRUCTION CODE M.l Y 19 1 EDITI W, F-7#
&DDEND&,
CODE CASE I
l (b) APPLICA8LE EDIT!cel 0F SECTION E! trf!LIZED POR REPAIRS OR REPLAGMDrr$ 19 P6 i
6.
IDENTIFICATION OF COMPCNDfTS REP 12 RED OR REPLACID AND REP 1AGMDrf COMPQNDffS REPAIRED "E
U"II'
.00M e
NAME OF MAME OF N&NUF1CTURER OfMER TEAR
- RDIACID, COMPONDfT MANUFACTURER SERIAL NO.
IDerTIMCAT!cel SO21.T W
s REMACEMENT
)
80/
NM 2SZ-/015
/973 f[yM ht,
!\\
l
!N j
f c
l Ni j
l L
N I
l ll i!
7.
DESCRIPTION OF WORK I MfM M A m /3 /_h/ d w/d M hM//aIMA 8.
TESTS CONDUCTED: NTDROSTATIC D-PMEWATIC D NOMIX&L OPERATING-PRIESURE O OTHER Q PRESSURE NA poi TRST TEMP.
w/
'_F NOTE: Supplemental sheets in form of-lists, sketches, or drawings may be used, provided (I) size is 84 in. s 11 in., (2) laformation in items 1 through 6 en~ this report.is -
included on each sheet, and (3) each sheet is nuat>ered and the mnber of sheets is
. recorded at the top, of this form.
1
i 1
i
--... ~ -
....**==
- asussa.
ENG-021
- 1
- gjgg, FORN Els=2 (teck) 9.
RDEsAs N#
Applicable Manufacturer's Data Reports to be Attached 1
I czanncars or courL2alus l
I
-1 I
we certify that the ' statements made in the report are correct and this 1-1 Autra conforme to the rules of the ABE code, section II.
l l
repai( or replacement I
i i
I I
i Type code srubel stamp w/A l
-l
.I i
certificate of Authorisatlan No.
E/A Rapiratian Data E/A l
l siped [dN
//-
Data
/o/7-Z--
i
' owner er owner's Desierwe, Title
, 19 1 l 1.
R. D. Cfllespie - Manager Central Support l
1 i
Il 1
. czarInCETE OF ZMEERVICE INSPECT 105
-l I
I I
2, the meersiped, holding a valid eamaissima issued by the National Seard of *.
l l
Beiler and Pressure Yessel !aspectors and the state er Prwince ef l-i ARIAssAs and esplayed by *nKWRICRT MUTUAI, INSURANCE Co.
of 1 l
I wonwoOD. MASS.
have inspected the esgocents described La this4 c.m l
owner!s Report Atring the period 4-?o-91 to - /4-/8-72
,1 1
and state that to the best of my knowledge and belief,- the Owner has performed l
I examinations and taken corrective measures described la' this owner's Repc-t ta i
I t
accordance with the requirements of the ASME Code, Sec' tion II.
11 I
l-I ty siqpting this certificate neither. the laspector nor his aglorer makes any warranty, azpreaseo e6r lay 11ed, comeerning the asaminatiens and carroctive measures-li-1 I.
described in this owner's Report. Furthermore, neither the Inspector nor his l
I employer shall be liable in any manner for any personal lajury or property damage.
l i
i er a less of any kind arising from gr connected with this inspection.-
1 l
1
$ O. d.,%9 FACTORY MUTUAL SYSTEMS I
Camaissions NB-9947. ARK-1133 "N" "18' 'A" l'
l
-(Saspector's sipature.
I National Soard, State, Province, and Endorsements !
J. O. Elliott I
Deto O c T A.t:t 19 D,
.I l
l
\\
l
~.
1 FORM NIS 2 APPINDIE II
- HEtDATOET REVISED ENG 021 06/30/89 FORM NIs 2 CWWI1's REP 017 FOR RDAIR$ CR REPL&CIXDf73 As Required by the Provisions of the A5ME Code Section II 1.
0WNE1 Ayst/tyrnev cPt1171ert. IIc.
DLTE
- -J 7 - 94 Name
, Rt. 3.10T 157 C. IUS$YLLYT1.LI. AR. 72801 SIEIT
/
ef
[
Address 2.
PLANT 11riMsAs wuctrAn our tatIT Two Name RT. 3.10I 137c. BUssrLivittY. 11. 72801 k 8.
98 //F8 Address Repair organisation PO 50., Job Wo., etc.
3.
WORJ PER10RXID ET AP&t/trmcY opt.. Tuc.
TTPE CCCE STMDOL STAMP W/A Ease EUncRIZATIcat310.
v/A RT. 3, Box 1370, RUS$tLLvfLLE, A1. 72801 Address EXPIRATICIf DATE v/A 1DtNTIv1CATICu or sistsu f$dhrbn (d286-/) & Walst.
4.
5.
(a) APPLICARLt CONSTRUCTICW CODE I 19 7/ EDITICII, S'-/978
- ADDENDA,
/5 74/
CODE CASE (b) APPLICABLE EDITICal 0F $3CTICet II UTILIZED FOR REPAIILS OR RIPLACIXDfr$ 19 cP4 6.
IDENTITICATION OF CCEPCKDfr$ RIPAIRID OR REFLACID AND REPLhC3XDtT COMPCEDf73 REPAIRED NAMI 0F NAMI 0F MANUTACTURER ODtIR TEAR REPLACED U
COMPONDif MANUTACTURER EERIAL NO.
IDOf71FICATIcel BUILT OR a.
PuCExDrr yA
.s 88i ~
l buNYMC l Ce - 60//
d NSE090 ~.1
> S/JM E JMPE rf n d ottr
/Eul ten w.t El Y l b l l
l de n I
1 NA 1 VM t v 2
' !f79 i j\\
l l
F l
u lN i
c c
j i
N1 1
L n
l l
N i
u o
i i
7.
DESCRIPTION OF WORK Id/4 dl b_
//14 6'
8.
TESTS CONDUCTED: NYDROSTATIC D FxrVKATIC D WCMIX1L OPEuTDIG PRESSURE O OTHER D PRIsscu NA oti itsT Txxy.
NA
- F NOTE: Supplemental sheets in fem of lists, sketches, or dravings mey be used, provided j
(1) size is sh in. x 11 in., (2) informatico in itses 1 through & oc this report is -
1 included on each sheet, and (3) each sheet is mnbered and the enaber of sheets is
. reco ded at the top of this fana.
. _ ~ -
no-cal
-asvissa 06/M/es
_FCEDI N15 2 (Back) 90 RDERKs applicable Manufacturer's Data Reports _ to be Attached 014dYb
~~*b N 9/F62-TS-802/ A b o M O,
h #k C1JSfs2-- SC-Ce/L
,S m/d/21$21a W b l
'~
/
/
~
l~
l I
carnr2 cars or ccecrLtants l
l l
I W3 eert,1fy that the" statements made in the report are correct and thia l
JeaIAcr/Amd conforms to the rules of the ABE code,Section II.
l l
l (epair of replacement I
i I
i I
type code symbol stamp w/A I
1 l
I l
certificate of Autherisation No.
3/A REpiraties Date N/A l
I siped Ad N
Data
/0 -27
, 19 I
owner er owner's Desimee,'yttle I
R. D. Gillespie - Manager. Central-Support l-l l
i 1
. carrrrrcars or zusarv2cz Instscrzam I
i 1
2, the undersiped, holding a valid commissian issued by the National Seard of
- l-l l
Boiler and Pressure Yessel Inspectors and the State er Province of 1
- ARIANSAS l
1 and esplayed by *nxvRICFF MtmfAI. INStmANCE CO.
of l
NoltVOOD. MASS.
I owner!s Report daring the period have insted the components described la this4 m.
4-20-91 te
/# - ## - 91
.I I
and stata that to the best of my knowledge and belief, the owner has performed l
i examinations and taken corrective measures-described in this owner's Report in accordance with the repirements of the AsME code, Sec' tion II.
1 l
i 1
By siping this certificate neither the Inspector mer his emplorer makes any l
warranty, espressed er implied, concerning the _===inations and corrective measures ll
[
described in this owner's Repert.
Furthermore, neither-the !aspector ner his -
l i
employer shall be liable in any manner for any personal injury or property desap i
i er a less of any klad arising from gr connected with this inspection.
l FACTORY WTDAL SYSTEMS
.I I
9 & 6 lL4D commissions WB-9947, ARK-I133 "N" "18 h'.-
l l
l (7 Inspector's.sipature I
National Board, State, Province, and Endorsements l J. O. Elliott I
Date
/ o/a 9 19 9.t I
L I
l I
h
- _ _. - ~.
FORM NIS-2
'&PPENDIE II = R&lS& TORT REVISD FORN MIS 2 ot0ER'S REPot? FOR REPAIRS OR REPL&CDWrTS As Required by the Provisions of the ASME Code Secties E!
[
2.
OwHER Amst/rwyrner oprentiers rue.
8625 6-#f-94 l.
Name f
nr. s. nor 127 c. ressettmte. AR. 72s01 ans:T
/
of
/
Address i
2.
PLANT inric ts rectein our WIT Two Name p
- 17. 3. nor 137c Russfit vitte. Am. 72001
- 8. d.
f#//f'I Address Repair Organisat.iam 70 Bo., Job No., etc.
3.
WORK PERFORMED ST APat/rsrvacy ops.. Twe.
TTPE C005 STISQL STLEP W/A Name
&UTHORIZATION NO.
n/A RT. 3. Box 1370, RUSSELLVII.LE, AR. 72801 Address EEPIRATION D&TE n/A 4.
IDENTIFIcAfroW OF SYSTsu AA
(#EEP -l) 5.
(a) APPLICAR12 CONSTRUCTION CODE M T 191 DITICBf, O-/f71 ADDEND &,
/S'7#
CODE CASE (b) APPLICA3LE EDITION OF SICT!Gt II UTILIZED FOR REPAIRS OR REP!ACIMENTS 19825 IDENTITICATION OF COMPONDfTS RIP &IRD OR REPIACID AND REP!ACIMDff CCMPCN 5.
NAME OF NAME OF M& NUT &CTURER "II' RIPAIRD OTHER TEAR REPIACED[ "D COMPoNDf7 MANUTACNRSR SERIAL NO.
!DDrTIFICATION SUILT OR Am2.M.,,
,1=g,
.s fitN Y tre o/
HR YPSV-Jb62 Iri9 Y -> & &
N j
+
Ej
+
jN t
s j
Ni g
j i
h h
h h
h b
a 7.
DESCRIPTION OF WORK 60/6 >
8.
TESTS CONDUCTED: HTDROSTATIC O PMEWATIC O WCMINAL CPERATING PRIS5URE O OTHER Q PRZ55URE N#
Dei TEST TEMP.
pp
'F NOTE:
Supplemental sheets.in form of lists, sketches, er dravings me? be used, provided
.(1) size is-8% in. m 11 in., (2) information in items I through 6 en this report is -
-included on each sheit, and (3) each sheet is numbered and the-rnaber of sheets is
- recorded at the top of' this farm.
i
navassa.
s p o21 06/m/st FORif N18 2 (Back) i 9.
RIMLER$
applicable Manufacturer's Data Reporta to be attached A vW nl1Ab
- YN N 9 /[d2 ~ EJ ~ C00TYMms~d'uk
- % N 9/542
.TS-De/9
, hrs h wAeb11l Y N i
e I
"~ l I
czanncars or courL!auts 1
I I
I W9 cer$1fy that the ' statements made in the report are correct and this I
i 2M7mfvownf conferns to the rules of the ABIE Code,Section II.
l I
fepair et replacement I
I i
l I
I Type Ceds symbol Staep N/A I
I I
I certificate of Authorisatian
- N/A EIpiratian Date N/A l
l Siped M
Date
/o "2 F, 19 _ I l
' owner er owner's Designee, title l __
R. D. Gillespie - Manager. Central Support l
l t
I cautncus or zuszav2cs Instscrzas
.I I
I l-1, the meersiped, holding a valid ecmaissian issued by.the National-Beard of '
l
'l neiler and Pressure vessel Inspectors and the State or Proriace'er:
(L I
ARIA 35AS and esplayed by *mwnicer Mim!AL INSinusCE CO.
of l*
l 1
NORV00D. MASS.
have taspected the cents described ta-this4.is.
I ownerts Report during the period 4-?o-91
'te
/4 -## - 9'1
.I l
and state that to the best of my knowledge-and belief, the Owner has performed I
l.
smaninations and takaa corrective sensures described -in this owner's Report la l
1-accordance with the requirements of the AsME code, socition II.
l.
I I-1 By siping this certificate neither the taspecter mer his esployer makes any l-i verranty, aspressed or implied, concerning the ammminations and corrective measures.1 I
described in this owner's Report. Furthermore, neither the Inspector nor his l
o
.l employer _ shall be liable in any manner for_ any personal injury or property damage l
'~ l or a less of any kind arising from gr comoected with this laspection.
.I I-FACTORY MUTUAL SYSTEMS l
.I i O. AA4 caenissions WB-9947, ARK-r133 "N" "18' 'A ".
j l
(Inspector's sApature National Board, state, Province, and sadorsements 1
. I J. O. Elliott I
l Dete
/o/.29 19 9 A
(.I l
l i
~ -.- r,
~~--
-~~
' - ' - ^ ^ -
~ ~ ~ ~ ~
l F0M NIS-2 APFINDIE II - MutDLT W T RIVIstD ENG-021 06/30/89 FotM KII 2 06Mn's RD0tf FOR Ep11Rs OR RE?IACIMDC1 As Required by the Provisions of the AsME Code Section II I. ' OWNER m/Enmf ottRiners. Inc.
D&TE
'/'.:f 9-M Nhme RT. 3.10f 137 C. RU5ffLLvitif. AR. 72801 SMIT
/
ef
/
Address 2.
PLANT DJ1Nsts NUCtFA* off INIT Two Name P*
- 1. **uC 137C. RUS$fuYTt t 7 12. 72801_
E 8, # PS/857 Address Repair Organisation 70 50., Job No., etc.
3.
WORK /ERFORXID ET iP&L/EN7ir f ops.. Tve.
TTPt C005 81100L ST3MP W/A name AUDDR.IZATION N0.
W/A RT. 3, fez 137G, RUSSELLVT11E, A1. 72801 Address EIPIRATI N DATE n/A 4.
IDENTIFICATION OF ST37EM Y4df
[htuO beff 88-/ )
5.
(a) APPLIcitLI CONSTRUCTION C005 _lu/M 19,y,4, DITIQW, S-M 73
- ADDINDA,
/579' CODE CASE (b) APPLICA&LE EDITIoW OF IICTION II 1771LIZID FOR REPAIRS OR RE?IACIXDffs 19 N IDDCITICATION OF CCHPONDf75 AkPAIRED OR IIPLACID AND REFLACIMENT COMPWDffs 6.
ASMI ggyggggy HAMZ OF NAMI 0F MANUTACTURIR CTHER TIAR
- REPLACED, 00DE COMPONDIT MANVTACTVRER SIRIAI,30.
IDDfTIFICATION SVILT OR D
RI?tACEMINT 0
)
Ife" Y l1 bulup lee - ee&
. NSB c N -
11 n
h u -t*htf i
l4 Nh
' Dsr-!n ss "!97 9 Aufaw~odi LA% l b
l
~
l L
]
lN i
c L
i j
\\j L
L j
l
\\l L
4 i
\\1
.l I
0 1
I I
i 1
J DESCRIPTION OF WRX MEIMIMA>h[L.
7.
(d/
8.
TESTS CONDUCTID: NTDR0 STATIC D PMEW.1 TIC D NOMIX1L OPnATDIG PRIS5URE o crrHIR o PRIs5URE NA-psi TEST TEMP,
- /
'T NOTE:
Supplemntal sheets in form of lists, sketches, or dravin;s may be used, provided (1) size is 8% in. x 11 in., (2) informtico in itses I through E co this report is -
included on each sheet, and (3) each sheet is marbered and the nur.ber of sheets is recorded at the top of this form.
..... ~
ING-021 i
agvansa PCM N18=2 (Seck) g.
RDGAKS Applicable Manufacturer's Data Reports te he Attached AM M1bs*VM N 9 /S4 0_ aY AHlY ACMbl-
/
0 ind$$Aur m A ~ %
.)
iwnbs 9 1 C A 0 - % - e n 2 9.
$12 dd)21bRk$h
/
/
I i
I czanncast or ccMrs.IAmts i
I I
,#448tule w (fWe certify that the' statements ande in the report are correct and this I
l l
' repair %r replacessat conforme to the rules of the nas code, section II.
l l
l l
)
l I
Type code symbol stamp F/A l
l l
I certificate of Authorisatiam pe.
N/A I
h piratica Date _
R/A l
l sigrwd /
I 4
Data
/o-21 l __
owner er owner's Designe*~, title
,191 l R. D. Gillespic - Manager. Central Support l
1 I
czarrrtem or Imav2cs nestscrzas I
1 I
Boiler and Pressure vessel !aspectors and the State er Prw I
l l
I ARKARtas I
and emplope by *nrvnicHT WTUAL INSIDLANCE CO.
f NORV00D. Mass, of l
owner's Report Aring the period have 4arnted the components described la this4m.
I i
l
- t. -? o-91 to /4-#d-M
.1 esaminations and takes corrective esasures described I
l 1
- accordance with the requirements of the AsME code..Sec' tion II.
i I
I By siping this certificate neither the Inspector nor his employer makes a l
I warranty, aapressed or implied, concerning the ammahations and corrective m i
-I described in this owner's Report.
Furthermore l
employer shall be liable in any manner for any, personal injury or proneither th I
I er a less of any klad arising from gr connected with-this taspection.perty damage i
ll QO.dttlofA FACTORY MUTUAL. SYSTEMS l
caenissions i
Ginspector's sipature M-994 7, ARK-T!33 "N" "I 'N '.
l I
J. O. Elliott sational Board, state, Province, and Indorsements i I
1 Date
/ e/.7 9 1 3 9 2.
I l_
~
I 4
l i
A FCIM N!S-2
&FFENDIE II - E NDETOET 3Evtsp Fotn r!s.1 Ot8tER'S RDOET FOR RD&TRS OR REFTACEMENTS As Required by the Previsions ef the ASNI Code Secties II 1.
,0WNER,&g&L/trTrner openaffenre, fue, g33 -
g,/J-fg Name 21M 157 c. testettvr"*. Am. 72001 SMIT
/
of
/
Address 2.
PLANT inrin u weeteAn err WEIT Nhne u
I RT. 3. ROI 137C. RDISFTTYtttv. J, 72301 J, A CCcPg70 99 address Repair Organisatian F0 50., Jeb No., etc.
3.
WORK PDJORMED ST ML/EzrtacT gn.. Tue.
TTFE 0005 ST W OL STR W n/A Ema AUTH0k!ZhTI M M.
M/A
,17. 3, lex 1370, RUSSEL1.yTU.2, AA, 72801 j
Address EDIA& TIM DhTE B/A IDENTITIC& TION OF NYSTER h/Udb
/# [EdM-7) 4.
5.
(a) APPLICASLE CONSTRUCT!cN C005 M,.D 19 g B IT1 W,
J-74 ADDEND &,
NA COD: Cast (b) APPLICABLE EDIf!CII 0F SECTICat II UTILIZED FOR RDAIRS OR REFIACEMENTS 19 8d 6.
IDENTIFICATION OF CCMPONDtTS AEPi!RD OR REPLACID AM REP!ACIMENT COMPWDffS "II' REP & IRED M&ME OF.
NAME OF M& NUT &CTURER OTHER TEAR
- REMACID, o
ST D
COMPONENT MANb7&CTURIB SERIAL 30.
IDENTIFICATICII WILT M
=-
4%
. m set =,
! /- / W"//dl ll 1 $*S-J $4 FSJ'?
u o
E j
l N,A
$P.T V-V43 Y /17/ M n 16-l i
l 1
-l i
I ll-l'// Nib l GL
" Gl-94 f'/
Nk sfPSYMSIV 1992 dsl~ d ffr-l K
f I
L u
i i
l N
y 4
0 4
7.
DESCRIPTION OF WORK IM /- 34d/
M Y
8.
Tests coNLUCTED: HTDROSTATIC D PNEUMATIC D WOMIM&LOPERATINGFRE13 UREX OTHER Q PRESSURE EFSo esi TEST TENF. $ VO
'F s
- supplemental sheets.in form of lists, sketches, er dravfags may be used, provided NOTE:
(1) size.is' 44 in. x 11 in., (2) information la items 1 through 6 an 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.
d.....
~. _. _ _ _. _. -..... _ - - _..
.spo-cal asvassa-06/M/es reset sis 2 (seek) 9 RDGAKS nyplicable Manufacturer's Data Ecperta _ to be Attached 0 Au 1 lbtts h $ $ A AA &t b
( A W A fA /JE b d Y b AddIkh d Ah mL.
c i
r I
I I
cartr2 cars or catrLzancs I
1 v
1 i
md. ritfr $i as stata==ts
= in ne report are correct ad this I
i ca. form to as rol.s.f as ans e.e. s.etim xx.-
i emu i
repair.,re,1..e 1
i I
I l
Type Coos symbol stamp N/A l
1 l
l Certificate of Authorisa No.
N/A Rapirstlen Data W/A l
I I
siped IU h A, ~ '
Data
/*-W
, 19 I
owner er owner's Desiebee, title l __ _
R. D. Gillespie - Manager, Central Support l
-l l
I I
i martr2 cars or zussaV2m zustscrzas l
1 I
f, the undersiped, holding a valid emmissian-issued by the National Board of *
-l I
l Boiler and Pressure vessel !aapectors and the-state or Prwriare of' 1
l.
ARKAstas and esplayed by *mvRIGHT MUTUAL INSimANCE CO.
Of
.- l.
I wonv00D. MASS.
I ownerts Saport during the period have insoested as scoponents described la this4.u.
4-20-91 to
/8-## - El
.I and state that to the best of my knowledge and belief, the Owner has perfereed
.I
-l 1
examinations and taham corrective measures described in this Ovner's Report in l
I accordance with the requirements of the ASME Code, Section.II.
l
-1
- - l 11 sy siping this certificate neither the faspector nor his empityer makes -any I
i warranty, aapressed or implied, concerning the====Ntions and corrective asasures 1.
I described in this owner's Report. Furthermore, neither the laspector ner his-
.l.
I esplayer shall be liable in any manner for any personal injury or property damage I
- l-or a less Of any kind arising fra gr connected with this-Laspection. ~
l" l
- h. C. difM FACYORY MUTUAL SYSTEMS l
l Commissions 1
(finspector's sipature -
NB.994 7, - ARK-It 33 "N" "18' "A "
,l I
sational_ soard, atate, Province, and todorsements-1 J. O. Elliott Date del /m.2 A - 19 9 A p
l g
.._-_~ -..-
F0M ggg.3
&PPENDIX II = NMS&TOET REY!sO 1
gno. cal 88/H/8' Fotn Nis.: One:ER's aport Poa Ro&tts on atPtaCzerfs i
as Required by the Previsions of the &BMI Caes section II l
, 1, OWNER APst/Ertener opruaTrann. rue.
SkT5
/
- - M name at.1. nor 137 c. Restri t vi. AR. 72801 SERT
/
ef
/
Address
- 2.
PLANT Anrotit rectrAn err Wr!T Two Name
- 17. 3. 101 13 ?c, nog gr,, ytt t v. AB. 72801
[8, 6 0 8 7 l/,7 Y Address Repair Orpainatian 70 Se., Jeb No., etc.
' 3. -
WOM PD10MED BY AP&t/EErraeY 072.. Tue.
TTPE C003 STISOL STMF m/A Rans AIPD00kIE&T! W Wo..
m/A RT. 3 Box 1370 RUSSELLVILLE. AB. 72301 Address EIPIR&T! W D&TE n/A 4
id 1DruT1nCn10N or sTsTIn.8wYdike&[JGCB-ygf
- s.
(a) APPLICA3LE CONSTRUCTION CODE u 72 19 g EDITIN,
- fX
- ADDENDA, NA CODE CLSE (b) APPLICA8L1 EDITICW 0F SECTION E! UTIL12ED FOR RDAIRS OR RUIACEMENTS 19 PS 1 DENT 2TICAT!0N OF COMPONDrfs Ri:PMRED OR REPLACID AND REPLhCEMElff COMP 6.
NME OF NAME OF MDrD7ACTURER " U'"II' ROMSED OTNER TEAR REPLACED -
COMPONENT.
MurwTACTURER SERIAL Wo.
!DerTIFIC& TION SETILT W
g=g",
R iACs.,,
' thMkwell l WN~d/b NM 285~ /2A 97Y Oua$tob-Y
/
h l
l s
\\
lN l
1
'l
\\l k
i n
a c
k DESCRIPTION OF WORK MM aa/Az4dNM tt//.ht/, M.
[.
TESTS CONDUCTED: HYDROSTATIC C PMItMATIC D WOMIMAL CPERATING PRE 55URE D cTHEA c PRIsscRE w#
est TEsf Tsur.
- 4
'r-iOTE:
supplonental sheet:.in fora ef lists, akstches, or erevings may be used. Provided i ) size is 8% in, a 11 in.. (2) information in items 1 through 6 en this report is.
t
- ncludsd on each sheet, and (3) each sheet is numbered and the nueber of sheets is incordad at ths top'of this farm.
... * * * =
- h021 asvaass 06/30/09 70m N18 3 (Back) t.-
ADukR$
N/A 4pplicable Manufacturer's Data P.rta te he Attached 7
I I
cuartr cars or c arL1ames I
I I
l I
we es pify that the' statements meds in the report are correct and this I
l JtMaw eenferas ta the rules of the has code, Sectice II.
I repart er replacessat l
I i
I I
I Type code symbol Stag _
N/A l-l l
I certificate of Authorizatian us..
M/A
-Rapiraties Date N/A I
1 l
Siped M
2.
4db Data
/ O "2 2 -
. 19 I
owner er owner's Desionesi fitle
_l_
R. D. Gillespie - Manager, Central Support l
l I
l i
l
. czarrrrears or zusamvzcz zustscrza I
q I
r, the moersipodi holding a. valid commisatan issued by the Natiemal Board of 9 t
toller and Pressure vessel laspectors and the State er Prwince of l
l ARFJJi&AS I
and egleyed by *MrVRICET' MLm!AL-INSL7RANCE CO. NORV00D MASS, Of
{
i owner's Aspert during the period
'h5To ia m ted the ge g enents described la this 4.h j
4-20 to /dMD -M
.I i
i and state that to the best of my kaswledge and belief, the.0wner has performed I
ensinattens and taken corrective esasures described in this owner's Report la
-l accordance with the requirements of the ASME code, Sec'tien.E!.
1 i
l By siping this certificate neither the laspector nor_ his employer makes anyi I
warranty, sapressed or implied, cancerning the esaminations and eerrective measures-l1.-
1-described in this owner's Report. Furthenssrs, neither the laspector nor his l.
- egleyer shall be liable la any manner for any personal injury or property damage l i
.I_
cr a less ef any kind arising from gr conneetod with this.inspectica.
l J
I FACTORY MUTUA1. SYSTDt3 I_
l OC. [ffM cammissiang l
i (j1nspeeter's sapature NS-994 7. ARK-T133 "N" "18' "A
- I I
National-Soard, State, Province, and todorsements !
l J. O. Elliott l-Date-O e,Gh J 1 19 M I
I l'
~ '
4 I
a
4 70M NIS-2
' &PPENDIE !! = IENI&T002 Spy 23D '
FORN WIS 2 OWNER'S RDOET FOR RD&tts OR RD14CDeffS As Required by the Previsions of the asNE Code Secties II 1.
0WNER Amst/Entruer oprearimrn. Inc.
D&25 P-@ 94 Name RT. L tot 137 c. Ressettvr"*. Am. 72801 SMIT
/
of
/
Address 2.
P1 ANT AnrAnin unct *An out IMIT Two Name RT. L 101 137C. RD11Ft t YTt t v. Am 72301 1 d, 0086Y4fd address Repair Organisation 70 No., Job No., etc.
3.
WORK PIRFORMID ST APat/rsrrter ops.. tue.
TTFE C005 ST 2 0L SnNP m/A Base ADENotIZATI(Bl 30.
n/A RT. 3. los 1370, _ RUSSELLYTt!.E. AR. 71801 Address EDIR& TIM DATE E/A 4.
IDENTITICATION OF 8737ER Ma&/4t/
b[.Mcf-//)
y y
lum. S 19g EDITION,.5% 75~
ADDEND &,
5.
(s) APPLICABLE CONSTRUCTION CODE NA CODE CASE (b) APPLICA3L1 DITION OF 15CTION II trf2L12ED FOR 201.723 OR REP!ACEXINTS 19 N 6.
IDENTITICATION OF COMP 0NINTS REP &IRD OR RDIACID AND RD1& CEMENT COMPCNDf75 IINI MAUCN11' REP & IRED NAME OF-NAME OF M&NUFACTURER OTNER TEAR REF1&CEDh-CODE U
COMPONENT MANUTACTURER T'11&I,30.-
IDENTIFICATION BUILT W
=-
g=4
.s Rosac I/'.4644-IM-1 u
h
$ 4tA M0 ; b lI l f&
l #ev4v i
/ 9/ 9 A/A
'137-S0 1979' l
(
\\
v l\\
l i
i l
i i
I Ni e
c h
k 4
i DESCRIPTION OF WORK M 'I d >t e f//s/ d p I A M M M,
7.
8.
TESTS CONDUCTED: NTDROSTATIC D PMItMATIC D IKMIX&L CPERATING PM&SURE D CTHER D FRISSURE a#
Dei TEST TEMP.
NA
'F NOTE:. supplemental sheets in form of lists, sketches, or drawings may be used, provided (I) size is t\\ in a lat in., (2) information in_ items 1 through 6 en this report is -
included on each sheet, and (3) each sheet is nebered s.nd the maber of sheets is recorded at the top of this form.
1
~
. _.. _.. _. _ _.. ~ _. _.
m
..... ~ -
-D00-021 asvassa-.
06/M/09 Po m N18*3 (tesk)
.= umann.
9.
RIMLRA$
NM applicable Manufacturer's Data Reports to be Attached l
I_ _
i i
czar 1nchrs Or cars.zAucs l
l 1
I We certify that the ' statements mods la the report are correct and this i
'l l
A/Aavv conforms to the rules of the Ams coes, sectian E!.
I I
rspair er replacement I
l i
l-1 Type code symbol stamp N/A 1
I l
3 I-l Certificate of Autherisatian me.
3/A E g iratian Date n/A I
I siped - [bl d
/8e '
sata
/o-17_
19 I
owner er owner's Desiebee, Title.
l R. D. C111espie - Manager Central Support l.
l l~
I I
currrnears or zussat2cz Instscrzen l
1.
1 1, the undersiped, holding a valid commissimo issued by the Natiemal teard of
- 1 I
l.
Boiler and Pressure Vessel Inspectors and the Stats-or Prwinee of t
l-AzrARSAS tad employed by *nKVRIGHT MUTUAI, INSURAFCE CO.
I MORV00D. Mass, Of
-l I
Ownerts Report during the period have laspected the segements described la this:4 as.
4-?o-91 te
/4-#d - 91
,l' l
and state that to.the best of my knowledge and belief, the Owner. has performed
_I l
examinations and takaa corrective measures described la this owner's Report in.
I accordance with..the requirements of the AsMs Code,'Sec'tice II.
I l
l I
I ty siping this certificate neither the Inspector ner his employer makes-any I
warranty, expressed or implied, concerning the saaminations and corrective measure.n ll
- )-
described in this owner's Report. Furthermore, neither the Inspector nor his -
-l l
employer shall be liable la any manner for any personal injury or property danape 1
or a less of any kind arising free gr esenected with this laspectiaa.
il l~
l FACTORY MUTUAL SYSTEMS l
9 O. [.1 A &
Canutissises l
I O!aspector's sipature NB-9947, ARK-Y133 "M*' "18' "A "
l I
National Seard, rtate, Province, and Andersements 1.
J. O. Elliote l-Date denA 4.:t it M I
.1 l-I
.m 9
f 7
-r wi rw
-q-r-
r
-w yo,---.
-i,y-
~
,w
.c*-a e-w-..
,a-w-
- e e-
,e t--
r.
TORM N!s 2 APPENDIX II - M&MD&TCET RDIstD ING 021 06/30/R9 FORM nil 2 OWNER'S REPORT FOR REPitts OR RDLACDGMTS As Required by the Provisions of the ASME Code $+ction II 1.
OWNIX iP&t/DtTncf _ OPE 11T10W1. INC.
DLN 9-~f-9/
Name nr. 3. 301 ist e. nitrurit.tr. AR. 72801 susuf
/
er
/
Address 2.
PLANT 11r E S A3 IrD Ct rie O Y E WTT Tvo N8he RT. 3.10I 137C. RUS$ttivTt t v. 11. 72801_
1 d.
OO<9J78J 9 Address Repair Organisatico 70 No., Job No., etc.
3.
WORK PIRfCRXED ST AP&t/Z3TncT 073.
T1rc.
TTF1 CCCE SVfBOL ST3MP M/A Name AUDERIZATION 300.
M/A RT. 3. Box 1370, RU55E11VT112,11. 72801 Address EXPIRATION DLM X/1 IDENTIFICATION OF DSTEM [Iutl4/ 9 /Itb b AIIMb f 7//t 8-/'$
4.
5.
(a) APPLICA3LE CCHSTRUCT!Cei CODE Iu/. TIT" 19 7/ EDIT 15, J-7L
- LDDENDA, A/A CODE CA51 I
(b) A.PPLIC13LE EDITION OF SICTION II UTILIZED FOR RDAIRS 08 RI?1ACEMDff$ 19 P/4 6.
IDDITIFICATION OF CCMPOKDITS IIPAIRED OR RDIACED AND RUIACIMDff CCMPWDf75 RDAIRID'
~
NAXE OF NAXI 0F MANUTACTURE1 OTHER v'AR
IDDrTIFICATICte arILT OR J"A
=.
== TAC =xDtT
.s A
tY
/V.3'/
NM
,16 VC- /0 0 Y
/97Y f$v4 aid >
$/b IN l
s' l
lN j
u j
.i N!
L u
l 1
N i
q u
o i
l DESCRIPTION OT WORKMf6RdaMAtAW//Je4MdI5bM(JAIAd, 7.
a 8.
TISTS CONDUCTED: HYDROSTATIC 0 FxrVMATIC D ROKIXAL OFIRATING FRISSURE O OTHER O PRES $URI N4 Dsi RST TEEP.
N#
"F HOTE: Suppleur.tal sheets in form of lists, sketches, or dravings may be used, provided (1) size is 85 in x 11 in., (2) inforsatico in iteas 1 through 6 on this report is -
included en each sheet, and (3) each sheet is nel>ered and the number of sheets is j
~
. recorded at the top of this form.
x_
F
...... -...... =
- Dee.021 asyassa 06/M/89 FORN Els=2 (Back) s-i 9.
ADnAR$
NA applicable Manufacturer's Data Reports te be Attached
)
1 i.
r
~
j j
i I
czanncut or coeLIamcz l
t l
I I
we certify that the 'statensats made la the report are correct and this i
l AuMp conferne to the rules of the hsIE code,Section II.
l 1
l repaM or replacement l
1 i
1-l I
l I
Type code symbol Stag N/A I
1 l
l certificate of Authorisa De.
N/A EEpiratian Date N/A l
I l
Siped. [d k
bd Date
/s - 2. t I
owner er owner's Designee, title
, gg 7 l
R. D. Gillespie - Manager, Central Support
~l l
1 i
I I
. carnnent or 2mssav2cs zustsetzer l
1 I, the undersiped, holding a valid esamissian issued by..the National Seard of
- I I
Boiler and Pressure Yessel !aspectors and the State er Frwince of l
t
_ AREA 3tAS
(
and employeC by *ARTVRICHT WTtfAL INSITRANCE CO.
I m wood. MASS.
of Tl I
ownerfs Report durlag the period have insted the components described la this:4 as.
4-20-91
.te
/O-#d - PJ
,1 1
and state that to the best of my knowledge and belief, the owner has performed
.I examinations and taken corrective measures described in this owner's napert la l
I accordance with the requirements of the ASME code, sec' tion-II.
l
-1 l
'l By siping this certificate neither the Inspector nor his employer makes any I
I l'
described in this owner's Report.-warranty, empressed er implied, concerning the es l
Furthermore, neither the Inspector mer his l:
I esplayer shall be liable la any manner for any personal. injury or pro i
l-er a less of ant kind arising from gr connected with this taspection.perty danap i
l-9.O./lb C FACTORY MUTUAL SYSTEMS l
l Commissions WB-9947. ARK-T133 "N" "I8A' l
C/2nspector's sipature l
I National seard, state, Province, and Endorsements !
J. O I=
nate. Ellio*be n/- em 1, 9.2_
I
.l-l I
l FORM WIS-2
&FFINDIX II
- MM Sh20ET RITI52 FORM NIS 2 068tER'S RDorf FOR RD&TRS OR REFL& CEMENTS as Required by the Provisions of the ASME Code Section II 1.
OWNER AP&t/ENTrtW Open Aff srt. IEC.
ShEE P-f-94 To /d-//- M N8me RT.3.Ref157S.RD$ffttYttt'. AR. 72801 SMIT
/
ef d
Address 2.
PLANT israirgA.s weet'As err M
Two Name
~
1A* COP 77/00 RT. 3. 101 13 70. RDif ft T VTi t t. 11. 72801 Address Repair Organisatian F0 No.,- Job Me., etc.
3.
WRK FERFORMED ST PAL 1EyffET 071.. TEL_ TTFE CCCI SDSQL ST3MP R/A same AUTHORI21T1(El NO.
u/A RT. 3. Box 137G, RUSSELLYTLLE, AR. 72801 Address EIFIR&TICEI hkTE n/A 4.
IDENTIFICATION OF ST3fDL 8422Ht6 5.
(a) APPLICABLE CONSTRUCTION CODE M/hd.
19g DITION,
,/f/
ADDEND &,
NA-CODE C&st
-(b) APPLICABLE EDITION OF SECT!Cet II UTILIZED FOR REPM33 08 RIFIACIMDff819 86 '
6.
IDDITITICATION OF CCMPONDfTS RIPMRED OR REPLACED AND REFLhCIMDr! CCHFCEDfTS y
Asur asFum:D ornsa TzhR REPLACID,',7$g "m"
x1xt OF NAMr 0F nnNUFACTURsk e0mMD<T xiwriemn
- Rm m.
reinnneaTIoM son.T on
,g;>
mC.D,T
.s
\\
i?ro heAtud/ fs- ]
_ Y l PSA I l34 77 NA-seu-iv-n 1-l
$ Y l 4lS 6/279 /6/
Nh 18eA -N-H Y 1992 bband l Y l % /e b 6 %0 "
NA saen-w-mo /?70 blatt 6-l; W
- l. S C/.7)9//el NB JBdM-N- mo
/9ff
'f kD
'754I U
Ato V908-J-HJJ H /f70 I$
DESCRIFTION OF %RK hfA1Ab knYA af.LMdkut 2$*]
+ - 1..
8.
TESTS CocUCTID: HYDROSTATIC D FMEtMATIC O NOMINAL OPERATIM PRI55URE o CTMER O PRES $URE-N4-Dei TEST TEMP.
A/A
_F
. NOTE: Supplemental-sheets in form of lists, sketches, or drawings mey be used, Provid#d
-(1) size is 84 in. x 11 in., (2) information in items 1 through 4 on this repert.is -
included on each sheet, and (3) each sheet is atabered and the enaber of sheets is irecorded at the top;of this fun.
l
- )'L
s m asp N021 NIs2 M
?be AnuYahwMt/ Inbd rivYMmakow<?! <t/An' 9.
EtMux$
Applicable Manuf acturer's Data Mports to be Attached
/ <-
Yktbdnb nitklrkl<tb aM'Mhtit? Aw lbYuhMAu 5
/
J IR!ninntaW h 24 u ati at W R
.b)p/?P cr1-PH. / e P 7./-Spor
/ P %7-fM a au Df PPS,70 77, [ IL t%Jh2i curs l m O A, n oluis
' dbttb I,E a S A y;ZYieb.
I l
l cInancm oF ccMPLIAmCs 1
I I
I We certify t, hat the ' statements made in the report are correct and this l
l o a d m. tex 7 cmforms to the rules of the ASPE Code, 5+ction II.
I I
repair or replacement l
1 1
I i
l Typ's code symbol stamp w/A l
1 I
l Certif.cate of Authorizatico No F/A Expiration Data W/A l
l Signed M
1 Data
/d ~ E9
, 19 w e_
I wner or ovner's Desiones, title l.
l R. D. Gillespie - Manager, Central Support l
1 1
I cIrTInc17 0F mnVICI IX171CTION l
1 I
I I, the undersigned, holding a valid ecume.ission issued by the National Board of
- l 1
Boiler and Pressure Yessel Inspectors and the state er Province of l
I
__ ARIn 1As and suployed by *pMfGET M7TUAL INSUPAFCE Co.
of l
I NORV00D. Mass, have inroected the camponents described in this.t4.m I
ownerts Report during the period 4-?n-91 to
/d,70 - P4
.I l
and state that to the best of my knowledge and belief, the owner has performed i
I examinations and taken corrective measures described in this owner's Esport in l
l accordance with the requirements of the 13MI Code, sec'tlon II.
l 1
l i
By signing this certificate neither the Inspector nor his employer sales any I
i varranty, expressed or implied, coocerning the azaminations and corrective measures l I
described in this Ovner's Report. Furthenmore, neither the Inspector nor his l
l employer shall be liable in any manner for any personal hjury or property damage l
I or a loss of any kind arising from gr cocnected with this inspection.
l l
FACTORT MUTUAL SYSTDiS l
l
- 9. 6 [/& M Commissions NE-9 9 4 7, ARK-r133 "N" "1" 'A
I i
61nspector's signature Betional Board, State, Province, and Endorsements l I
J. O. Elliott Date
/o/ J. 9 19 /R I
C
.I I
JC'00EZZf00 ft A &{f f
ASU REPAIRED H
ONAL CODE HAME OF NAME OF MANUFACTURER OTHER YEAR
- REPLACED, BOARD STAMPED COMPONENT MANUFACTURER SERIAL NO.
IDENTIFICATION BUILT OR REPLACENENT 0
)
lb=
l A,unist,
kD 732 N#
ABCB ~2-N32 ll992 Ih & 1 &
l I
\\
l nuf Yw f Ps#-/
1 / 2 e25' N#
! ACCA H V /9 0 4>-
l lWl Psn-t 2G/99 NM 2e en-t T-M y 1994 Iud fr-l l
m/
PSM3
/ s ~r yS' NA seen-tr-//24 1970
- Aud. l #fe-l 4***#
l l
l
- d P3n3 30/ 74 NA se en -1,r-MJ V 1914 he/ttunud Y/t-l l
e l
l
/ut
- D 7/R g/6 NA sc es-jr.H;f sqre RafttsiL l
lC4 l
l h.4 V. h t W&D 7/R
// e f 84
- e ep-tr. ust itsa LQrafttuninf fr l
Auf 1
l
" nt<1t i
r I'
l lxamtl ko 71R
/'rA 1
NA ac es-it-n2 trio thfut4
$r l
HD 7/R l
/097 l
nh (seep-it-s x 't992 luinedi $
l I
l1wnf6Myunar I
i l
ie l
I l
PS kJ b l
/3888 Np Vee A-21-if/l(A}/9ye L((y/M.td/ l $4-l l)Mienent i
I I
I I
l muf I' S Nto 998S' up 2een-at-MiWX/tt.t Am/nmtat b l
l l
PSM/t>
Af/
Nk lxces-si-M/JGt) 19 o tAlntd) I.WJ-I)Q*tuf ~1wnf PSM/O
/7983 NR
\\seen-JI-Hit (s)ll192 0xlutsunt $
l l
I l
l ll M9W l
I e l
l w_pf l
P3M/0 2 34 l
NR Laec y m 9
/970I[kM$ntd)
$P l
l
'Wf I i
l I'
/992 h$tentat' W+-
l lswisd P Sn /a Soyy NR Lte e p -zs-ni9 l
l l
E I
l uf l
HD 7/l 73/
NR' 1.te e n-24 -Hz ' / 9 7 0 S ulw d l $/-
l l
w 1/
1/S 6/zs7/o9 RA cen-26-H2 t994 stlusmix fr l
l (ye.xcur i
e 1
l l
n 1'
\\ #D 7/ R l
7 36 N4
&CcM H2 1978 $$)</uch l W2-l l
- vi i
i ll992 ku/wmtsf $
lI l-wjd AD7/R 7,2 9 NA
\\ teep 32-H2 l ~ pxtur 750 l
NR Lle e B -sy-H 3 1970 A WlLLtd l Ylf-l I
l e l
l Mud I ko7lA l
T lI Wr l l
l 1
I I
gr4v1/
kD7/R
/D 98 NA 26e8-Sy-H3 '/992
$$dlMintnf $b-l l
Wt i
1 r
l l.rMMS~
AD 7/R 790 NR Jees - t 9-Hf 19 ro lhA/ ugh Ws-l r Mt i AD 7/R l
76 9 l
NA Lec eB-f 9-ft/ '1992 LL uAumsd1 $-
l l
fMe# l l
l l
E l'
1 l
l ti l A D 7 / ('
l 75/
NA L?ceB-/p H3 \\t9 70 \\Sc/Ol Ytb I
l
- l l
l l
l #
l l
l gwst I HD7/R i
9V9 l
NL Ve e 6 H 3 lff94 thy)antd1Yh-l Et1C-021 C0!!T1rJUATIo!1 REVISED 06/12/8!
T,0 *00 S 7 Th00
$1r3db ASME REPAIRED; NA ONE CODE REPLACED NAME OF HAME OF MANUFACTURER OTHER YEAR BOE ST M ED COMPONENT MANUFACTURER SERIAL NO.
IDENTIFICATION BUILT OR NO.
FEPLACEMENT 0 NO)
. l Cos7tseud T
l 1
I.Annuvf l PSA
/S'/
NA JDBC-J-H/3 /910 Aa/uth l $P
.I PSA VSO NA 2pst-l-H13
/991 xmix l
o Y PSA 2287 NA 1988-s-M.2 ll Pro abab fi-l habawd &
l PSA 26 igr NA 12 pet-s-94 1992 Y
- b 77/
NA l2D B B - el-N2
/!10 l6 l
RD 952 NA 2 pts-4-HJ'1992]
bere w' 1
.9D 73h NA 2pff-4.Mfp)'/970 bal 6
l h '
// 0 4 NA (2089-v-HWA) / 992 bumtuYl N-
$cYt kD 75E NA 2 DEB-4-MdB)/970 tafub Gl+-
$Y AP l //10 NM \\20B B H3(b l9 92 gbotek 6-l lY h RD 753 N4 2 DS t -/y-M/
/fre l <//r l
4iS
& usr/>6 Na L.t DBF-se-M/
/992 M
l l
l E
l l
gy>d 80 737 NA 2 pts-iv-Ha \\/tro (Aiirbrib l
lliwAY l L/S sus 7/d NA l2D B R -N-HX / 192 l bowbf 6-l l%h*/ l so nr Goes-n-Hz L h a a.
l NA f
AD l
758 NA (20B B - /</-H3
/992 I bantdl 6-l lh"ypuub l
l z
l l
l lismf
- D l
1.1 NA JECB //2 1/1/D l$lnAld.
6-l Yl
- D 7 'IE NA l2288-7-H2 I/9921 bumudI$-
l l
Yl Psp 2 76/
l NA 2GC8-E-MS/
1970 ebub &
l l
/6735 NN Lu c B-s'-H3/ 1994l luwaf1 %.
l l2eec-Jos-Hto 1976 Yulnud 196-Y PSA
/06 NA PsA 7 <ff/
NA XH2C -/o1-N20 /992 Aueid 9//-
l l
l d
E l
l PsA l 12 7,To NA l2pec-nc-pid)i976 AixAtted,\\ b-l l
I I
i l
l l
l, _
l PsA l Jed P S l
NA IGBC-Jos-Hs4(A/99A l0 bundufl $~
l l
traf-l l
I i
i E I I
I l
l]yxsf l
AD l
7 9'1 l
WA LtHCE-t/- Ht16 l /9 70 bxubi W l
E!!G-021 CONTI!1UATION REVISED 06/12/85
3:0. A 00e776eo Must 4' d i REPAIRED NAME OF NAME OF MANUFACTURER OTHER YEAR REPLACED $
ST ED COMPONENT MWUFACTURER SERIAL NO.
IDENTIFICATION BUILT OR NO.
REPLACEMENT 0 0)
NM JHes-9-M/ 76 1 9 92 Andumid 10--
1 AD JO 97
/
l RD 9/3 NA JHe c NF 1976 bled lYlr l Cid%2nr I
l j
l hmf HD 725~
NA JNe e H&
1992 $sktw w$ $
l
- D 7ff nn Isnee-6 -it9 irro st4 ' fr-l I
R0 757 NA L2 Net N'/
/f92 R$tu m t $lr v
/Sislin NR ans-persE
/9 o laud l
$ttlMed $b-l l
I l
l 6
L/S 7es79 //O NA lJMS-Re F A E
' / f12 PM iatalin Np JMs-per n w 197o
/wh Yk-li E
n l baut I,YY 19,2 lblurnsd &l l
Lts re g 71/e i xp
\\;as-p ep a us l h w1 I
~ PM I38/
NA l2MS - A C P B E
/ t76 v)xuS ' flP l
irra D E ismi t th-l Y
LIS ross71As No tzus-s eea r l
l2M-n e e e w Y
f/A
/ 9/ V lts) l NA itro 1 ufatidi l 6 l
lJ9?? h4f/humtlI h ll l r l ce/fmer l
l l hw.nf
.L / S 7es 71/4 NA lJHS-Re9 R W l
l s i
l lb+f%ut 70 lbx/ned) 97r-l l Jauwf P/A i m (ID l
NA tsas-Rep e s l limut l
L1S l 7e r 7 9 / c c ll ll912 ANilars, ant fr-l l
lwp.ur No L7Hs-se ee s l
l f
PM Itit(17)
NP L2ps-R e P6 W
/ 70 treeUl $b-l NR tfRS-E e P C W
/912L{$Rlt1181$ Y/r l l
.a L. ls ro3 79,/ed vY l PM ll9/4[ts)
NM 2H3-Re P D E 19 0 lJ112/
'ffs-Y LIS 7c379/e Y NR l2HS-RtPDE
/VTE At> W V1 fl/-
l L
hl Pm i719 Id NR tays-p e p c W i97of udvidi fk-l 199t Ylvinexf$r Yl
'To379lo!
NA LtHs'- n e P c W l
l LIS l AuY '
PA 18/0 (8 0 NA Lws-scs-s / l197e a/ntd> ' fr l
l Cad /m *r i
i 1'
I l.)wstfll l1969Ces)l No trNs-sa 8-E i li9,1 t AaAume flt-l g
PA RD A 32 Na L2 den-is -//sy \\/976 Edi l WP l
l Csffwe l 176en-ts-H3y f/992 kti/uts*Jnt]I h I
I i
I lANsW l
/rb l
9W l
NG
/s f
ENG-021 CONTINUATION REVISED 06/12/8!
S46
- 5. 0.#C0877/C0 _
ASME REPAIRED;CODE NATIONE REPI. ACED NAME OF HAME OF MANUFACTURER OTHER YEAR BO E S N ED COMPONENT MANUFACTURER SERIAL NO.
IDENTIFICATION BUILT OR k
N0*
REPI.ACEMENT 0 E
l
\\
l
. l W"T
_,\\getp ir.y36 ' /rn f[alwh ! 4(e l l 9 ad RD
/S Hy y
lAu Y \\
FD 12 Np see M-is-Hst '/992 ex&1misi 'A6-pg seep,g y371 97p h4ui 1 ffr.
l kD gip 1
1 w
&D 707 0 NA-2d th-IF-N39 'I9 92 0 /xanad
')(P
- D It NA
'acep.ty.yyp(s)I j976 wtfurdj I 'fb-ou lh LIS
&las7lfC '
Nb iseen-Is-H /fle) 19921 a b rex tet $1-l j
frD Noh Np
\\peet->s-uygg) 197o i ufasjb i fr LIS r,1,rs1/e &
Np ZeCh-IS-//W($ 1992 herbwntdl '$r l
N' E
l l
lhjumeM#
HD l
8/7 NA deen-tr-Hro l1970 AtAltterdj ' db-l l
vati AD l
P,72 NF teet-ts-Hso 1992 dauntd 'f//-
l RD Jood NB
.Jeen-tr-H53 ' /970 U/Mid)
'fb-l l~
l l
l ur' l kD 4)7 NA
'2CCA-IC-Hs3 il?9 7 h1u$ vined Wr l t.,t e en-tr-ns & \\ t r r e Ya/and) l&
vzsY
- D 7 72 NP l
6 FD 977 NA de e n-tr-Hsb 19 91 SlulntuuY $k '
I
. e l
uf^- l RD 2&
un L2een -it-H12 ll970 Adwd) l ft - I l
l pr l.li sY l OD J00f NP^ L2een-//-Ha 1992 1 xlnw<sd fr -
scex-it-pit lirn Lhylwdj
'ffe h
&D
</,7/
Np I
lh l
HD l
'/JA NA l!ce p -1/~ /Hf 1992 g!!athk.wl fr I
~ $ta HD
'l/ /
l NA Ade A-97-}?/
i 9 7 0 l. ?t/ / w h N"
\\ /99.2 l${p!lkgxwll W lI l
rn
<t i
l l
l L/S 6/.757/02 l
NA l2tC$-t/7-///
I a
i I
i s
l 1
l l
- D 775 l
NG Lff66 - /- #,74 ' tq76 J W
hl Y
'6/27,t/R'/
NA
\\2FCC-/~/AJ6
/ 9 92
!$xtx 0 'fle--
l Yl LI.s l6/2le lJ2 NA ilfe c-l-H2 7 \\t 9 92 d/a fk-l l
L/S 6/2/9/97 i
NA tafee-t-//Als 1992 l YW l
lWw.
I l
l
\\1Fec-/-yMCblll79% \\%v/dbho l $b -
I uur 1
//
L_] S
\\& /21T/92 l
NA l
ENG-021 CONTINUATION REVISED 06/12/8:
x 0. *c0877600 Af s.4 g 6 y
REPAIRED}
H ONE CODE NME OF NAME OF MANUFACTURER OTHER YEAR REPLACED B
S D
COMPONENT MANUFACTURER SERIAL NO.
IDENTIFICATION BUILT OR REPLACEMENT OR HO)
'lY Y 4lS wi3/s>
w 1cce y st 'tru _ AfAdik Ar l
lTC:d as vin s.?
ncs-,~,,
,,,, &3ss nc l
l22%
~,,,,hr
, s l
so nn.
l127
.?,ec-i-surai<ez k ts.! r/
ess zsis as 12211 mc -,--< >ire, Drss ' 2-l eu rne '
nn l2%
,nes-s-n ru % dus!
u m
n 16' M i
- w-i l
xt i
AD 731 NA
.tBtB-3-Hyl& 19M bubYlA h ! $P \\
l AN Y '
ko 7+'o nn nes-r-xv{s) 191.1 DE1/8 fr $
l$$~
- D 74 6 NA L7Be 9-3-Hs[& 1992 Y
$ $ b^H'OI $ P
$D AD 73 7 nn LtBes-s-H2(eY/912 %8%$se $/P l
N i
l N
i l
l
^\\
l I
l l
l
\\
I N
I N
l
'N i
i i
i x
i I
x
\\l l
I l
l N
i l
i N'
i i
i i
i i
i x
i i
k I
IN i
s i
l I
i 1
1 I
NI I
I I
I K
l l
1
-1 I
I i
ENG-021 CONTINUATION REVISED 06/12/8
rom nil 2
&PPENDIE !!
- Nhm&TW T REftsp F0DI N18*2 OtetER's R u ott FOR REPhits OR REF14CD Wrfs A.s Required by the Previsions of the ADIE Ceds Secties II 1.
OWNER 17&L/tirrener opre ATTfurt. Inc.
MIE Y-/.~/ - M Name RT. 3. 102 137 8. RUttTttYttt#. A1. 72801 WEET
/
of
/
Address 2.
PLMff AnF A4til EUct ' At ONE INIT Wo Name RT. 3.101 137C. RUgget t Tff f #. A1. 72801
_ J, 0. # 00&75SVO Address Repair Orgaalastian 70 No., Job No., etc.
3.
WORK PERF0MID B7 APat/tsrener ops.. time.
TTPt C005 51390L STRNP m/A mame
&UTHOR.IZhT!W NO.
m/A RT. 3. Rex 1370, RUSSELLYTLLE. AB. 72801 Address EIPIR& TIM MTE n/A 4.
IDENTIT1 CAT 10N OF ETSTDE h^t4Lwl abbD $d?t
( *fe e n - s d t
i V
V 5.
(a) APPLICABLE CONSTRUCT!cs 000E lae/#
192 BIT 15, S-7f ADDEN M,-
NA CODE Cast I
(b) - APPLICAALE EDITICW 0F 83CT!cN II UTILIIID POR RD&lRS OR REF14CDIDrfs 19 Pd t-6.
IDENTITICATION OF COMPONDfTS RIPAIRED OR REF1 ACID Mtp RIFL&CEMDrf COMPCEDffS I
a "I
a NAME OF MAME OF NWfUT&CTURER OfMER TEAR REFT &CED ST D
COMP 0hDrf MANVFACTURER SIRIAL NO.
IDerf!FIC&T!0N SUILT M
=.
=,iaC iDer Ja4
.s
/
NA 2SY-S02-/ /ft/
OnAnsdd
' 4(/1L l\\
l
!N.'
I l
\\
I l
N, j
u e
u 1.
DESCRltT10N OF MORK A40Na'9Atmelh/>NDb tYAbwhDMid.
V 8.
TEST 5 CONDUCTED: HYototTATIC D P9tEWATIC D WCMDt1L OPERATING PRESSURE D Oth'R D PRIssUns NA est TRaf TDEP.-
NA-
- F-
. NOTE: Supplemental sheets.in form of lists, sketches, or drevings may be used, Provided L
(1) size is 8% in. a 11 in., (2) information in items 1 through 6 en this report is -
4 included on each sheet, and (3) each sheet is numbered sad the number of sheets is recorded at the -top, of this form.
L
--.~..- --
INb021 asvassa M/M/99 FCat N18*2 (Seek) 9.
RENuuts N/A W11 cable Manufacturer's Data Reports to be Attached t
f I
l l
czar 1ncus or cenrL1ames I
o H
I We certify that the 'statensats made la the report are correct and this I
A M 4As eenferas to the rules of the nas code, sectian II.
i l
repat( or replacement L
l l
H l
Type code symbol stag s/A H
l-certificate of Authorisation me.
n/A aspiration Date B/A L
si.ed dJ A.A,//m.s--
t.
-> />, /c >
,i y1 W i
Owner er Owner's Detienee, fitne j_
R. D. Gillespie - Manager, Central Support l
I
. cszytncars or asssav!cs InstscTsom d
l l
1 I, the unosraiped, holding a valid reunissise issued the setional Seard of
- 1 I
Boiler and Pressure Vessel laspectors and the State er of,,,,
L
.l AREANSA$
and og by 'AntwRfCRT MLMAL INSURANCE CO.
af l
MDRWOOD. MASS.
138Detted the eenpemente described la thle4 i
Ownerts Aspert Airing the period I. -?o-91
'te M afd-U 1
ase l
and state that to the best of my knowledge and belief, the Owner has performed l-i esaminations and tahan corrective measures described la this owner's Report in l
accordance with the requirements of the ASME code, Sec' ties II, I
l i
l ty signing this certificate neither the Ins 1
I warranty, aupressed or lay 11ed, concerning the =pector mer his employer mak
==
1 described in this owner's Report. -Furtherwere, neither the Easpector mer his 1
employer shall be liable in any manner for any personal injury or pro l
er a less of any kind arising from gr esamected with this laspecties.perty damage l=
I l
l 1 C. A. n S >
FACTORY HUTUAL $YSTEMS l
l consiseions NB.994 7, ARK-M 3 3 "N" "18 "A
l i
Claspector's sapature patiemal neard, state, Province, and todorsements l _
I
.' o. I11tott
~
I I
to
&cA <.u n _19,,7,A, I
g.
l 1
v
--r,--.
.--.,wr,,,,..~.._m-._-.m-_.m-.._
.. ~....
..4
.-4 4-m
FOM N!S 2 hPPINDIE !! = M&B& TWT RSTISO suo.021 06/30/e9 FotM N!p.2 064tER'8 REP 0tf PCs RD&its OR RDuCIMENTS As Required by the Provisiens of the AmlE Ce6 Section II 1.
OWNER Apst/rwTrne opre Anars. Inc.
MIB 9'-/9-f'4 Nane mr. s. mer $7 e menseviviste. Am. noon sus T
/
of
/
Address 2.
PLANT Alf A1(111 NDc1 *A5 DER IMIT Two Nhne RT. 3.101 137Ci 1033t1 t ytt t r, Am, 71301 1 6.
00 85(4 0 V Address Repair Organisatian 70 No., Job No., etc.
3.
WORK PERFORMED WT Apat/rstram ops.. tue.
TTPE CODE ST 2 0L STnRP R/A Name htfDI0tIZhT!W NO.
n/A RT. 3, les 1370.._RUS$tLLYT1.LE AR. 72801 Address ED IR& TION MTE n/A 4.
2 DENT!FICATION OF ST37EN OM4u444 I Iob_'!k bec#-J/)
/
V U
5.
(s) APPLICA3 M CONSTRUCT!QW CODE dtM.d 19 1 RDIT!cN, S-/fY/
ADDEND &,
NA CODE C&St I
(b) APPLicA8La ED1720N OF 83CT10N II UTIL12ED POR REFAIRS OR REF1ACINDrFS 19 #4 6.
IDENTIFICATION OF COMPCNDrfs tD&IRD OR REP 1 ACID AND RDIACEMENT CCDEDffs AINE NAME OF NAMI 0F MufRACTURER mkt 1M&I' RDAIRED OTHER TE&R REFL&CED,'
CODE COMPONDit MANWACTURia SERIAL W.
IDENf1FIC& TION BUILT NED
.-uOR
=.
OPA m
C-r, d
1 'll b 9-12(e n
187-/F8 19 T'/ Aaanid
$lL l\\
l
!N l
h l
i N,
L l
u 7
DESCRIPT10W OF WORK _ /#AAw//14.4/aB A MmA sh b A wA4,
/
r v
r
- 8. -
TESTS coWDUCTED: HYDR 05fATIC D PNEWATIC D NOMINLL OPEP&T!m PRES 3t/RK D OTHER D PAISSURE NA Del TEST TEMP.
N/.
'F NOTE:
Supplemental sheets la form of lists, sketches, or drawings any be used, Provided (1) site is 8% in. m 11 in., (2) information in items 1 through 6 en this report.is included on each-sheet, aM (3) each sheet is numbered and the number of sheets is irecorded at the. top,of this farm.
_ i l_ _;.
,_ u.
u 1 - - - -- --
--l
L no.ott asvansa 1
M/M/M Pons mis a (sesk) 9.
RD ERK8 NM applicable Manufacturer's Data Reports to be Attached 4
Y l
l I
c annCars or conrLinses l
I i
I ve certify that the ' statements ande la the report are correct and this l
A r>fa$v conforms to the rules of the nas code, Sectica II.
l l
l repair er replacement i
i i
l I
Type code symbol stasy w/A I
1 l
I l-certificate of Autherisattaa No.
M/A Rapitaties Date I/A i
siped AJD J4--2 fo-i.,,i,s t.
I owner er owner's Desionee, title 1
R. D. Gillespie - Manager. Central Support 1
p i
I 1
czattrickyt or DEIRVICs INEPscr20s l
U l
l-1, the undersiped, holding a valid commissian issued by the Natannal Board of
- l U
Seiler nad Pressure Vessel taspectors and the stats or Prwince of _
l-l
_ AIKA35AS and employed by 'AmrvarcBT WimfAL IN9t 'ANCE CO.
I nowooD. Mass,
~
of ~ l
.I ownerts Report during the period have inspected the components described La this 4as.
a-70-91
' to
/d f1 1
I and state that te the best of my Inowledge and belief, the Owner has performed l
l eaaninatiens and taken eerreetive seasuree described la this Ownsr's Repert in.
I accordance with the requirements of the AsME Code, Sec' tion II.
l I
l 1
l By siping this certificate neither the taspector mer his esplorer nahes any i
I wartan'y, aspreased or taplie4, esoceraing the saaminations and corroctive asasurea l I
described in this owner's Report. Furthermore, asither the-Inspector aar his l
1 esple er shall be liable in any manner for any personal injury or pro er*a less of any kind arising from gr connected with this taspection.perty damage i
i I
I l
- 9. C. d/AM FACTORY MUTUAL SYSTIMS l
Camsissions WB-9947. ARX-f!33 "N" "18' "A "
l l
(/!aspector's sipature National leard, State, Province, and Indorsements l Date *
/0/.19 l-
__ 19 3 l
I e
y vw r-y,,
rey.
-r--.me,v-,--,,-,a-w=wyy+ws-.-v..%--
9
..,y
<r---
.y--
--v.er-
- ~ ~,.-
r
. +,.,.- - - - -,,,
...,.-w-rv,~.
=
--,-r-
TORM N!s.2 7FFINDIE 11 - IGJtD&TotY RgvIggD FORM KIS 2 OWWII'S RDORT FOR RDATR8 OR REFuCEMDff1 As Required by the Provisions of the A5ME Code section n 1.
0WNtt _ APst/DrrucT OPERATIDWI. IEC.
MTE 9-//-M Nhee RT. 3. MT 1h7 C. IVf ffLLYI111. AR. 72001 SMIT
/
of
/
Address 2.
PLANT _ DI1FEA3 WDCtFM R I2f!T Two Nhne Rt. 3. BOI 137c. tes1titvittv. 11. 72801 l O. #6C 6' 73S/ F Address Repair Organisation 70 Do., Job Mo., etc.
3.
WORK FIRFORMID RT Ayat/ryrncr 071.. inc.
TTFI C004 STMBOL STAMP R/A name WDDRIZ1 TION N0.
y/1 RT. 3. Box 1370, RUSSELLYTLLE. A1. 72801 16 dress EDIRATION DATE v/A 4.
3DENTIT1 CATION 01 ET5ftn x*w hAtuMt b kDSJbebie (.7de M-53) 5.
(a) APPLICIALE CON 57RUCTION C004 j)/M.
19 #O EDITICN,_ W - &/
ADDIND&,
NA CCDI CASE (b) APPLIC13LI EDITICW OF SICTION II UTItiffn FOR REFAIRS OR REFLACIMDf7519 86 6.
IDDff!TICATION OF C0KPORDf75 RI? AIRED OR RDLACED AMD RIFMCIMDff CmMS3XTS RDAIRED E"
I HAME OF NAME OF KINUTACTURIR OTHER YEAR REFL&CED N
N COMPOND(T MANVTACTVKIA SIRIAL N0.
IDDff!FICATION BUILT CE a.
R ruc=x=r !=4 s
0 3
4'A hJSV-A 0 $ /
.~2 /9P/ hum 04 " $1b lN l
P l
l lN j
j N'
L l
l N,
l u
n 7.
DESCRI11IOH 01 fo0RK.lltMM4dVAta h td h D 4-MMMbMb AAN*
L/
l 8.
TESTS CONDUCTED: HTDR0 STATIC D FNIWATIC D WOMIX1L OFIRATIM PAISSURE O OTHIR O PRES $URE NA psi TEST TEMF.
NA
'T l
NOTE: supplemntal sheets.in form of lists, sketches, or dravings mat be used. provided (1) size is e\\ in. x 11 in., (2) informatice in items 1 through 5 cc this report is -
included en each sheet, and (3) each sheet is em6ered and the number of sheets is recorded at the top of this farm.
.--~ -.
J END-ell asvasse 06/30/09 r
70M N18 2 (Sesk) i v.
acutax:
N/A Applicable Manufacturer's Data Asperts to be attached I
~l I
czannears or omrLthus i
I 1
i ve certify that the ' statements ande la the report are serrect and this l
Aumbs l
eenferne to the rules of the Ass Code,Section II..
l-l repair or replacement I
i I
I I
type Coos symbol stamp w/A l
I I
I certificate of Authorisa No.
5/A Empirettan Date w/A l
I l
siped d bl/M s-Date
/O-L" I
owner er Owner's Desi m6e, fitle
, 19
-l_
R. D. Cillespie - Hanager. Central-Support d
[
i I
l c annem or zustana zustscrzam l
I I, the undersiped, holding a valid esamissian issued by the Bational Beard of
- l l
l Seiler and Pressure vessel !aspectors and the State er Prwince of l
AREAstas I
i and employed by *ntwarCRT MIMA 1. IN$tmANCE CO.
NORWOOD. MAS 5.
of 1~*
1 Ownerts Report 4tring the pertad have inspected the gegements described is this# M.
a-?o-91
'te
/0 Jo 91
,1 I
and atate thet to the beat af my knowledpe.and belief, the Ownsr has periormed I
emaninations and takaa corrective seatures described La this owner's Report in-i I
1 accordance with the requirements of the 15Ms Cede, Sec'tlam II.
l I
l l
Sy siping this certificate neither the las l
l l
warranty, sapressed or iay11ed, concerning the =pector nor his esplayer make
=
t described in this owner's Report. _ rurthermore, neither the taspector nor his I
esplayer shall be liable in any manner for any personal = injury or pro l
-1:
l or a less of any kind arising from gr eennected with this inspecties.perty danege 1
i L
I 9.C.f b FACTORY MUTUAL.8YSTENs commissises l
I 01aspector's sapature WB-9947 ARK-T133 "N" 18' A
- I Battenal seard, state, Province, and todorsements.1 I sh. ! ""%#.u 2,n l
u i
4 i
G pee gg.
-t----
,.pm.,,
- mmr,
,yo---.ye g..
4 p,g ywmg-wi,,.9g.w.-s,.<y p w g.
w,+wvy--+
greww,g.
se or-v--&w--,-
m
ro m NIS-2
&FFINDIE !!
- NhMD& TORT RITISD ENG 021 06/30/09 F0iut Irts.2 OtMD's RDot! FOR RDitts OR RD!.ACDerTS As Requiredi by the Provisions of the AsNE CoesSection II l
2.
0WNER APat/ENTener oPesantart. Inc.
In2E
'/~/f-M Name
- 17. 3. nor 137 c. Rest?f f Vf"*.
AB. 72801 SMIT
/
of
/
Address 2.
PLANT Aarantin weet_ van err WIT Two Name RT. 3. ROI 137C. RUlstt_t ytt t e. A1. 72:01
_ J d, CO8f8 7Y3 address Repair Organisatian 70 Se., Job No., etc.
3.
Won PERFORMED 57 AP&L/Eyrener ops.. tue.
TTFE C008 STW OL StaMF m/A
' llame
&UTH00LIEATION NO.
m/A RT. 3. Box 1370, RU$stLtVILLI. AB. 72801 Address EIPIRATION DhTE m/A 4.
1DENitT3 CAT 10N 09 ETSTER f1wrtw kad V $uuldibD f
[5H48-Y r
v 5.
(s) APPLICA3LE CONSTRUCT!0N CODE b 6 19 1 D ITION, 8-/f/J._ ADDEND &,
CODE CASE I
(b) MPLICA3LE EDITION OF SECTICN II trTILIZID FOR RDifts OR REPLACIMDf7519 c96 s.
IDExtzrtcafr0N or Conro60tNTs atrA2nzD Da apuctD anD a Fucsxper ecocNDtTs ass -
asparan R TION 1L CODE e
NAME OF NAME OF EWT&CTUut OMER TEAR RIPMCED sonan stacD C0xtoNEw?
nwractvun stant so.
recrr2rzCATION wrLT OR
=.
= rue. -.m
.s l15 $
t$r $
I.277/
NA 10l'M'- Jo 53 '/17f $1AndA Nr
!\\
l
!\\
i
- l-
'\\'
l l
\\i j
n n
1.
DE5CRIWT1ON OT NORK SAM &SAMW1d>
b
- w.lbelab&,
s.
tests CONDUCTED: NTDR0s7ATIC D PMEUMATIC D WOMIE L OPruTIM PMS3VM D-OTHER D PusscRE N#
esi TEST TEMP.
N#
_*F NOTE: supplemtal sheets ia form 'of lists, sketches, or dreviags may be used, provided (1) size is 9% in, a 11 in., (2) information in items 1 through 6 as this report is -
included on each.sbest, and (3) each sheet is mad >ered sad the maber of sheets is-
. recorded at the top,of this farm.
L
...o.
6 nm.02g asviEED 04/%/89 FCON mis *2 (Back) 9.
Rtxt*At 4'A Applicable Manufaeturar*s Deta Reports to be Attached
?
I
~
l l
I crutricars or ecocnsscs l
I W
1 I
Aq/e certify that the ' statements made in the report are correct and this l
l vnxur conforms to the rules of the Ass ceae, 5+ction XI.
l l
repair er replacement I
l I
I l
Type code symbol stamp x/4 l
I I
I I
certifieste of Authorisa se.
y/A tupiration Date N/A l
l siped
[ d d < b d,:
Data
/s ~ V
, 19 I
tvner or owner's Designee, 71tle l_
R. D. Gillespie - Manager, Central Support Ij l
1 I
czutrictra or 2nsw2cs Ixsrser2cm i
I I
I, the smdersigned, bolding a niid coemission issued by the National Board of
- I l
l seiler and P; assure Yessel Inspectors and the state or Frerince of l
l AM,13535 and employed by *RKVRICHT MUTUAL INSITRANCE CO.
of 1
I NORVOOD. MSS.
h8?e 1ASDect44 the Compocents described in this:
i ovtarts Esport during the period.
t.-?o-91
~te
/4 -:Jo-FA
,1 4 asa l
and state that to the best of my knowledge and belief, the owner has performed I
e aminations and takan eorreetive nei,surea deseribed in this Ovner's Report in l
I accordance with the requirements of the AsMT code, sec'tico II.
I l
l I
ey siping this certificate neither the Inspector nor his employer arkes any 1
varranty, aspressed or implied, coocarning the szaminations and corrective measures ll
[
described in this Cvner's Report.
Furtherisors, neither the Insp+ctor nor his l
1 employer shall be liable in any manner for any personal injury or property damage l
i l
or.a loss of any kind arising from gr econected with this inspection.
TACTORY MUTUAL SYSTDtS l
l
- 9. C. El&M consissfoes NB.9 94 7, ARK-It 3 3 "N" "I" "A "
l l
1 dnspector's signature I
J.' O. Elliott sational loard, ' state, Province, and Endorsements l I
I Date
/o /A 9 19R l-I l
S
FORM NIS*2
&PPEND!I II
- MIS &TCET RIVISED ENG.021 06/30/09 i
FORM Wis.1 06051'8 REPOET FOR REP &Its OR REMACIMENTS la Required by the Provisions of the asNR Code section Et 1.
OWWtt Apat/rwirney opreinars. tue.
Sh2R P-/f-N
+
Name 17.1. ser 137 c. RestFtt VT"*. AR. 72801 SMIT
/
ef
[
Address 2.
PLANT anrweit rect rin our WIT Two Name
- 17. 3.101 137c. nossrt t n,, v. Am. 72801
- 38. #00PD// #
Address Repair Organisatian F0 No., Job No., etc.
3.
WORK PERFORMED BT Apat/rsrney ops.. rue.
TTPE 0008 STISOL ST&MP E/A same
&UTHORIZnTI M 30.
n/A RT. 3, Box 1370, RUS$ZLLYIllt, AR. 72801 Address IIPIR& TIM D&TE n/A l
4.
1DENTZFICATION OF STSTDE Mt euut WafNe B-//s~)
5.
(s) APPLICABLE CONSTRUCT!0N CODE M.~23C19 1 EDIT 1 5,
M 75 ADDCfD&,
NA CODE CASE 3
(b) APPLIC& ALE EDITICN OF SECTION II UTILIEID FOR REPAIRS OR REP!ACEMDffs 19 86 6.
IDENTIFICAT!0N OF COMP 0NDffs AkPAIRED OR REMACID AND REMACEMDff CCMPNDffs RDAIRED H UON&L 0008 e
NAME OF NAME OF MUfUFACTURER OTHER TEAR REMACID I0 IO ST&MPED
- COMPOND(T MANUTACIVRER SERIAL NO.
IDWrTIFICATION BUILT OR
=-
p4
.s
=M..S.,7 of NA fsr-92/3-W /174 famid, 4]tt, l
!\\
l j'
!\\
l l
l
\\'
l l
N, u
n j
c e
u a
7.
DESCRIPTION OF WORK Nm(MIM 9_.Mwc/ML Ib/p/-m/4,,
/
s.
TIsis CONDUCTED: HYDRO $7& TIC D FMEWATIC D NORDt1L OPERATIM PRIE8URE D OTHER D PRES 3URE
- A psi 713T Tggy, pp
- P HOTE: _ Supplemental sheets.in form of lists, sketches, er drawings met be used, Provided (1) size is 8% in, a 11 in., (2) information in items 1 through 6 em this report is -
i included on each sheet, and (3) etch sheet is numbered and the number of sheets is i recorded at the top, of this form.
q
une. cat asvaasp 06/M/89 Poul N18 3 (tesk) i 9.
REMuss N/A
' Applicable Manufacturer's Data Ecycrts to hv attached
{
i i
e 1
1 cuartnc&rs or emFLzams 1
I I
1 I
We certify that the 'statensats made in the report are correct and this l
l JLM4@
conferas to the rules of the 1BE Dede, Secties II.
l repat's or replacement l
l i
l l
Type code symbol Stamp N/A t
l l
Certificate of Authorisa No.
N/A Impiration Date n/A l
I l
Siped
.I hA
/o/2 >_,191 l u- -
Date l
owner er owner's Desteee, fitle
{_
R. D. Gillespie - Manager, Central Support l
1 I
. carnnear er zustav2cz zustscrza i-1 1
I t, the moorsiped, holding a valid essedssian-issued by the National Seard of
- 1 l
l Seiler and Pressure vessel taspectors and the state er prwinee of _
l l
ARIANSAs and esplayed by *mvatCET MUTUAL IN$tfRANCE CO.
I m voon. Mass.
of l
I ownerts asport during the periac have insoested the esoponents described La this4 as.
6-70 te
/d- #d-PJ I
and state that to the best of my knowledge and belief, the Owner has performed
,)
l esaminations and tahan corrective sensures described in this owner's Report ta l
l l
accordance with the requirements _ of the ASME code, Sec'tica II.
l
-l i
l-By siping this certificate neither the taspector nor his employer makes-any l
warranty, expressed or 1splied, concerning the saaminations and corrective measures ll I-deacribed in this Ovner's Repert. Furtheroere asither the Inspecter ser his l
l employer shall be-liable-ia any manner for any, personal injury or pro l
or a less of any kind arising fra gr connected with this laspection.perty-demage i
L
.l
- 9. O. [ h9 FACTORY MUTUAL SYSTEMS-I l
Commissions WB-9947, ARK-T133 "N" "18' "A ".
l L
i
- (,Anspector's sipature l
Battenal'Seard, State, Province, and Endorsements !
I-J. O 1
Date. Elliott6cLAs A.i 19 R I
1 l
l t
.~ _
i FORM N!s.2
&PPENDIE II - MhlEMWT trYISD -
ENG 021 M/30/89 4
PORM Iris.2 068tn's RD0t! POR RD&!R$ OR RDuCDer!1 As Required by the Previsions of the &Dit Code section II 1.
OWNER Apat/twTn er openATians. Tsc.
MIR Y"##~ M Name RT. L B01 137 S RD$fff f ff"*. AB. 72801 SERT
/
of
/
-j Address 2.
PLANT Anrivate reetrin our argT Two Name
- 17. 3. ROI 1370. EDItrt t yft t v, A,3, 72301 18, #dd860998 l
Address Repair OrganisatAan 70 Be., Jeb No., etc. *I 3.
WORK PERPORMED ST AP&L/EstranT ops.. tue.
TTPE 0008 fD SQL STEMP n/A i
name
&DENDRISTItal 30.
n/A RT. 3. Box 1370, RUS$tLLYTLt.E. 12. 72001 Address EEPIRATION hkTE m/A 4
4.
IDENT!T2 CAT 20N OF STS7DI d
met /Ita b [.7668-N 5.
(a) APPLICARM CONSTRUCf!0N CODE N 191 EDITION, 8-74 ADDEND &,
NA CODI CASE I
(b) APPLICABLE EDITION OF $5CT20N E!_ UTILIZED POR REP & IRS OR REPMCINDrFS 19 %
[
6.
2 DENT!r!cATIoM 0F COMPCNDffs RhP&2 RED 04 REF1 ACID & ED RDL&CEMDrf COMPEDr E
Sph! RED "I
"II' OTHER TEAR RUKA<ID,'
NAME OF NAME 0F-M& NUT &CTURER ST D
COMPONDef MAWFACTURIA SRIAL 30.
IDDrTIFICATION BUILT OR
=
0P,':
.s RUuc=Wr 3
{$v l /tM8 M4
$0 W ~ //7'l MM' Abw54 Ytb j\\
j l
!N l
L ;-
x 4 L!
N h
j c
7.
DESCRIPTION OF WORK 8J:4VMaweb Atat[/tds]*d7M 114A 2W/M, -
(
v 8.
TESTS CCWDUCTED: NfDRO$TATIC D PMEtM& TIC D
. NOMIMkL OPERATIM PRESSURE D' i
OTHER O PRESSURE
- Dei TEST TWIP.
h4
'F NOTE: supplaneatal sheets.in fons ef lists, ahetches, or erevings ney be 'usod, previded
-(1) size is 4% in, a 11'ia., (2) laformation in items.1'through 6 on this report is.-
included'en each sheet,'s.ad (3)-. etch sheet is numbered and the ma6er of-abeets is:
. recorded at the : top, of this form. _
1
,,.a.,
~.~n,
.a m
e r
n-e--~~-.
,-,.,m
--v--.
,-e..>
~ - < -
i e
END-021-asvassa 06/30/09 reau us-3 (nask)
+
i 9.
RothkKs 8/A Applicable Manufacturer's Data Lwrts to be attached i
i
=
l 9
l l
cuartncars or courtzhnes 1
I I
we cert.ity that the ' statements maen la the report are eerrect and this ArMtv senferme to the rules of the has coes, Settles II.
I repait er replacement i
i i
l i
Type Code Symbol Stamp N/A I
1 l
I l
certificate of Autherisatlan Be.
M/A RQirstles Date N/A l
l Siped 23M
//k4 Date
/ o -
- L.
. 19 h l l
Owner er owner's Deci mee, yttle l_
R. D. C111espie - Manager, Central Support l
1 1
carnnears or Inssancs t'estsey1cu h
1 t
I, the edersiped, holding a valid eemaissian issued by the Battenal seard of
- l t
teiler and Pressure vosoel Inspectors and the state or Proviaes of l
I H
_ AnxAstAs and empisyed by *nrvarcar wrnt INstmANCE CO.
l-M0 WOOD. MASS.
of L
l Owner!s Report during the yeried h8Te inseeeted the Seep 0DeSts described la thiS4 WBe a-70-0t
'to
/4-Jo - FJ l
and state that to the best of my knowledge and belief, the Owner has perfereed
,I I
esaminations and takaa corrective measures described is this owner's tapert ia' l--
l I
accordance with the requirements of the AsMs code, see' ties II.
l I
y ty siping this certificate neither the taspect9r not his employer makes any l
I described la this owner's Report.verranty, tapressed or implied, concerning the aman I
Furthermore, neither the taspector ser his i
esplayer shall be liable in any manner for any pereenallisjury or pro 1
i i
er a less of any kind arising frem gr eennected with this inspostica.perty damage H
i-l
- 9. O. /~ h M FACTORY NUTUAL SYSUMS I
l Ceemissions W3-9947, ARK-f133 "N" "18'"A"
.I (Jaspector's Sapature l
Bettenal Seard, State, Province, and todorsements 1
-I J. O
-I Date. Elliottder/,o,:2.1 19 R I
l l
i 4 I
=
e-i.-,__a._..__...._._.__
- u..
~.
~.. _ _ _,,
s.
FOPM N!s.2
&PPEND!I !! = IMM&W RIT!8D ENo 021 M/H/M PORM NI5*! OWD'8 RDORT POR RDAIR$ 04 RDIACDWrFS As Required by the Previsions of the AsNE Code Sectica II j
1.
OWD AP&L/I3rTF1ef Opet ATimit. IBc.
ETE 7.M - N i
Name RT.3.101157 Si RUf fft tYf"'. AR. 72801 MIT
/
of
/
~
Address 2.
PLANT aeriggis weet vit mrt WTT Two Name
- 17. 3. EDI 1370. 101trttYtttv. 11. 72801 38, OO87f898
~
A4 dress Repair Orgsaisatian 70 So., Job Wo., etc.
3.
WORK FIRFORMED ST AF&t/IEFFSCf BPB., tee.
TTPE 0008 ST330L ST&RP n/i Wane
&UTHok!Z1 TION NO.
n/A RT. 3, Sex 137G,_ RUSSELLYT115 AB. 72801 a44r.ss
- D zR&n 0N n =
.ri IDENTITICATION OF ETSTDi bMY5&b M b4l
($0C39-~J7]
4.
5.
(a) APPLICABLE CONSTRUCT!0W CODE AM22C 191 DITION, [S-78)
&DDEND&,-
N#
CODE C&SE (b) APPL!cASLE EDITICet 0F $3CTICet II UT!!.1EED POR RDAIRS OR RDIACEMENTS 19 JM 6.
IDDIT!TICAT!0N OF COMP 0NDrFS REPA! RED on REF1 ACID AND RDIACIMDff COMPCB3NTS REPAIRED ON11' e
NAME OF NAME OF M& NUT &CTURER OTHER TEAR REF1&CID E
COMP 0NDff MAWTACTURER SERIAL NO.
IDDff1FICAT!0Il WTLT M
s
, RIP!& CEMENT
)
O 5
'.7 3' 7 Vf NA 2C VC -2 4. /977 bjAiurJA of/tb
!\\
l l
iN j
c x,
c l
N, 3
l n
1 7.
DESCRIPTION or WORK.32mfambmdAM]<WONM/>u/ w/d v
.8.
72575 CONDUCTED:- HTDROSTATIC D PNEWATIC D WC9LIX&L OPER& TIM PRf15VRE D OTHER O PRES 5URE N4 Dei TEST TEMP. _ NA
'_F NOTE: Supplemental sheets ia form of lists, sketches, or drawings may be used, previded l
(!)' aise is t\\ in. s 11 in., (2) inforsation in items 1 thro @ 6 en 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.
i
.u
~
~ ~ * * * * * * ~
M -021 antass yon 313 3 (seek) 06/M/M to REM 1AKs N/A applicable Manufacturer's Data Reports to be Attached
~
1 I
czartricart Or conrL2&acs l
i I
I We certify that ths
- statements made la the report are sorroet end this 1
1 A//44v senterms to the rules of the has code, Seettaa II.
I repart er replacement I
l I
l i
type code stubel stamp m/a I
l 1
'l Certifieste of Autherisa No.
u/A Ig iration Date -
n/A l
l siped A
- Mb - t Date
/o - 2 L 1
cvner er owner's Designee, Title
, 19 l_
R. D. Cillespie - Manager, Central Support i
J l
1 1
I
. csartncars 0F Inssay1cs InspscT1m U-i I, the maar:1 ped, holding a valid eemaissian issued by the satismal Board of '
l i
Bailer and Pressure Tessel Inspectors and the State er trwinee of t
l A3XA35AS J
l and employed by *nevnicar Him!A1. twstmuser co.
MORWOOD. MASS.
of.
l i
Ownerts Report Alting the period h5To inspected the eenpenents jescribed in thiS4 m a-?o-91 to /o 92
,I l
and state that to the best of my uledge and belief, the Owner has performed l
esaminations and takta terrective seatures described in this Ovoer's Report-in l
I accordance with the requirements of the asME Code, see'tten II.
l I
I l
By siping this certificate neither the Inspector mor-Ms espierer makes any l'
i warranty, aspressed or implied, concerning the amaninetiens and corrective sensures ll l
described in this Dwaar's Report, Furthermore, neither the taspector mer his 1
employer shall be liable la any manner for any personal injury or pro l
i i
er a less of any kind arising free gr esaaected with this inspecties.perty demage l-l S. O. f./td9 FACTORY NUTUAL stSTIMS I
l Claspector's siguture NB-994 7, ARK-T133 "N" "18' k".
j Commissions l
I National Seard, State, Province, and Radorsements !
J. O I
Dato. Elliott Ih a 1 19R I
i l
4 I
+
d m.
m
FOM W!$=2
&PPDtDIE !! = MMIhhTOET trvf30 DG 0!!
06/H/tt
- FNot r!$.2 068tER'S RDORT POR RD&fts OR REP!ACIMErrs As Required by the Previsions of the AsNE Code Section E!
1.
0 W N E R,, g g / r w r e n nt e P r* A vitars. I E e.
Akts
'7 - 7 # - M Name
- 17. L nor 157 si testvtttT"*. Am. 72801 EMET *
/
of
/
t address i
2.
F1 ANT inrima rectrin our 1317 7 two Wane RT. L 101 137c 101snivit t v. A1. 71E Id, doJ'76~9//
Address Repait OrganisatAsa 70 Be., Jeb No., etc.
3.
WORK PERIORMED ST APallEN11CT QPR,i incm TTF1 0008 33390L SD RP E/A Rame Atr!MORISTIM NO.
M/A RT. 3. los 1370, RUSSELtv!LLE, D. ?!$01 14dr..s Er1R&n a u n nii IDD(!!TICAT!QN OF SYSTDI Md>
[.7 Ft' A - / )
4.
5.
(a) APPLIC&3LE CONSTRUCT!Cel CODE
@ _ 19 D171W, J-/F75 20END&,
/S 79 CODE CASE (b) APPLICA8LA DIT! Cat 0F BICf! Cat II trr!L12ED FOR REPAIRS OR REF1ACEMENTS 19 P4 6.
IDENT!TICATION OF COMPONDffS RIPA!RD OR REP! ACID AND REF!aCEMENT COMPEDfTS l
AsME R D &!a n '-
EI"II' CODE e
NAME OF MAME OF MhWUT&CTURER OTHER Tuk REP! ACID, M
ST&MPED COMPONDff MANUT&CTVRER SE11&L N0.
IDDrTIFICAT!001 BUTLT M
g=g,
=.
R=.c s
"l l6 1
Nssben 1
\\
.I $" y 1 OtM v2 1 ce - eee 2 MS APsr 'l/.f3 inr A&nd, da. l bM
/-
V NM 2PSV-t/l3 3 l/91/
riwrf A
L a
V t
l N l
l X,
l u
n 7.
DESCRIPTION OF WC*K d 4tI4 h
e 8.
TESTS CONDUCTED: NTDR05fATIC D PNEWATIC D WOMIMLL OPERATING PRISSUREX OTHER D FRISSURE F Md psi RST TEMP, 4fC
'F' NOTE: supp!amental sheets.in form of lists, sketches, or drawings may be used, provided
(!) else. is #4_ in, a 11 in., (2) information in items 1 through 6 en this report.is -
inetuded.on each sheet, ard (3) each sheet is numbered and the number of sheets is -
- . recorded at _ the top, of this farm.
waa sm.021 06/M/n rces us 2 (ta.ck) ntnas $r AW-/ $/ Etat /w/$inabbtk bu.e ita dddAbs) s.
i,,uca31e no o.cturer's o.ta epor a v
h HuYN,t$ h Ab6tw as A1/N Hab) MitMubntIbitd o
b Mel-Afl$t0/H/H H W-LAD)D AMbE& $
4/4/
_kk 4! $ /!
tuaalks AM/A1lA YAhtbM'L.
r
/
v,
/
V I
l I
crutricm oF cenrLiancs t
l l
l We certiti that the 'statseents made in the report are corrtet and this
(
l
. A r/t/Aust/n7 conforms to the rules of the Ass coes,Section XI.
l l
repair or replacement l
l l
l l
l Type code 3ynbol stamp y/A l
l I
l Certifieste of Authorizat' 5o.
F/A Kapitatlee Date N/A l
l
/1J8 ~ <>4
. tid l oat.
//- ?
sisn.d l
Cvner or Owper's Desf orAs, Title l_
R. D. Gillespie - Manager, Central Support l
1 l
l CERTIFICATE OF Dt1ERVICs Dt171CTION l
1 l
1 1
1, the undersigned, holdir4 a valid ca==f asion issued by the Naticeal Board of
- l l
Boiler and Pressure Yessel Inspectors and the State er Frwince of l
I
___ u m til and employed by *MVRIGHT MUTUAL INSUPAFCE CO.
of j
I woRuoop. mss..
have inspected the compcoents described in thisg.m i
ovnsr?s neport during the period 4-?0-91 to //-#4-FJ
,l I
and state that to the be t of wy kwwls6pe and bellei, the Owner has performed l
i 1
examinations and tahan corrective U.sures described in this Cvner's ** port in l
I accordece with the requirements of the AsMI code, Sec' tion II.
l l
l l
sy signing this certificate neither the Inspector nor his emplorer males any l
l varranty, expressed or implied, coocorning the azaminations and corr +ctive measures I t
I described in this Cvoer's Eepert. Furthermore, neither the Inspector nor his l
i employer aball be liable in any manner for any personal injury or property damage l
l 1
or a loss of any kind arising from gr cocnected with this inspection.
l l
FACTORY MUTUAL SYSTDiS l
l S. C. d./AM-commissions NB-9947. ARX-I!33 "N" "IA' l
l (/ Inspector'ssignature sational Board, state, Province, and Endorsements l Dbe *
///9 19 '? A
,I i
FORM N!S*2 APPENDIX !!
- NUfDAT00tY Mv!5gD FORM K!$=2 CWND'S REPORT FOR RDAIRS Ok RI?LACIXDfT$
As Esquired by t.be Provisions of the AsMI Code Sectico XI 1.
OWNER AP&L/NTncT OPnATIDW1. INC.
MTE 9.78-M Wome
- RT. 3. MT 137 C. RUf frLLMtit. AR. 72001 SMEET
/
of
/
Address 2.
PLANT 1711MI A3 IrcCtm OYE INTT _Tvo Name RT. 3 B OI 13 7 C. RU S $ t"Lt VTitt. 11. 72801_
J, C, #O08 */5'WJ Addre ss Repair Organisatico PO 90., Job Wo., etc.
3.
WORK PERPORXED BY AP&L/tyTnef 6Ps.. Yve.
TYPE CODE STMDOL STAMP v/A Name AUT}OctIZATIC8f 30.
v/A RT. 3, Box 137C,_10$$tLLVILI.E. 11, 72801 Address
- IIPIR17100f DATE 3/1 IDDiTITICATION OF 5757EM _NEM[
h6 I#86# -J) 4.
5.
(a) APPLICABLE CCHSTRUCTION CODE d M M 19 *M EDITICIf, 8- / f 73
- ADDENDA,
/S7V CODI Cast (b) APPL! CABLE EDIT 100f or SECT! Cal XI trTILIZID Foa tr7AIts Ca RrrLACIMDffs 19 Pd 6.
IDENTITICATICH OF CcKP0KDrT5 RIP 11 RED 04 REPt.1CED AMD REPLACIXDrf COMPCKENTS RDAIRID' CODE e
NAMI of MAXI of KANUTACTURIA OTHER TEAR REFL&CID, N
D COMP 0NDrf MANVTACTVREA SIRIAL 30.
,,,ues - T
.s l fol" /
l 0 M by) l C6 - COM NA JPS V-4'S E V A7C Aubuds
' '6'?b l
\\
,. NssGes-1 o
\\1 l
l n vt lVL J l Nss f es~
l l N l 6ubt2
__ pp JPtr-e4 sy tr7s-uAtum/ 'f/tt l
l ee - ens /
l d
\\
l N l
\\\\
h 1
0 It b
h DESCRIPTION OF MORK fMlMhbMful.ANEl AAL}lMetMW T.
V-8.
TISTS CONDUCTED: MfDROSTATIC D PMIVKATIC D WOMIXAL ortRATIyo PRIS$VRE)K OTHIR D FUS$URI // 90 Dai TEST TEMP.
4f0
_'F 4
HOTE: supplemntal sheets in fons of lists, sketches, or dravings may be used, provided (1) size is sh in. x 11 in., (2) informatico in items 1 through 6 cc t.his report.is -
-included on each sheet, and (3) each sheet is numbered and the mmber of sheets is
. recorded at the top of this form.
1
......c anyasan um.o21 04/30/es FoRH Nis=2 (Back) ntnans We-NPV-/ bf6m tl$ u O h S f$u n / b A n'w s.
Applicable Manuf,s'cturer's Data Eeports ta be Attached v
r d u ^4H Y Y l lN V b $4 d tL.AdfM dh ^Lu& AAth$t$be
/ $ h AAb.AJA b 3skt A t h e bt ALO A re 8 k M t* b e n M 6 4au w w/ A b LAa, I
/
y
/
v I
I I
cxrnnem or cmruanca l
l l
l WS. certify pt the 'stattaents made in the report are correct and this l
1
, A M/h/f re>< t r cerJorms to the rules of the 13M Code, 5+ction II.
l I
rephr or replacement l
1 I
I I
I Type code symbol stamp w/A I
l l
l Certifieste of Authorization No.
y/A Expiration Date w/A l
Si ped
/
[
Iw Data
/ /- 9
, 19 I
cvner or owner's Desione4, Tit.la l
l R. D. Gillespie - Manager, Central Support j
1 I
i crrnnem or Imrav2cm ImPsenon i
I I
I I, the un6ersigned, bolding a valid consaission issued by the National Board of
- l l
Soiler and ?reasure Yeasel Inspectors and the 5 tate er Province of l
1
__ AnissAs and employed by *nKVRIGHT MUTUR IN5tfMFCE Co.
of H
I NORVOOD. MASS.
hW9 insDecterd the compcoents described in thisk ~.m i
tvnerts Raport during the period 4-?o-91 to /d _70 - 9'1
,l l
and state that to the best of ary knowledge and belief, the Cvner has performed l
I examinations and talan corrective measures described in this owner's Report in l
1 accordance with the requirements of the 15ME code, sec'tlon II.
l 1
I l
By signing this certificate neither the Inspector nor his employer makes any l
l varranty, expressed or isplied, coocorning the examinations and correctin measures i i
described in this Cvner's Report. Furthermore, neither the Inspector nor his l
1 employer shall be liable in any==r for any personal injury or pro i
or a loss of any kind arising from gr connected with this inspection.perty desage l
l l
FACTORY MUTUAL SYSTDiS j
l
- h. O. d,2 4 W Commissions NB.9947, ARK-n 33 "N" "18' l
l (jinspector's signature Eational Board, state, Province, and Knoorsesents l Dbe *
///1 19 9A I
.I-I
'w W Mxn~nx=nw = - - - - - -
"t.?,g 55MV6~%MP%%N D
^55NI(N,[hCbYb
[bNh'd~'il
[MM" l
l'...+
g ggg g g g,;g g(g AggggggC+fy,g
,t
's - -.. #e.1. W.
llenry Vogt Machine.Co.,,14uisvilla,.KY 3, y.nyvmy,g by (H
and Addrese of N ertific,ste Holcer)little Rock. AR nsas Power Ed gh t Co.,
L M6nufmured io, 4Nr no Aeo. flucTnne c or ownwiear One, Russellville, AR et Arkansas
- 3. Lustion of instaffetion __
3W N
Outlet Site atYVYE
-, Nominst inlet Site
- 4. Pump or valve _
(ere)
(ira:A) is) Model No.. (b) N Certificate Holder *8 (c) Canadian Senes No.
Serial Registration (61 Drew 4hg (0 Net'L (g) Year (f)*
orType No.
No.
No, tel Ctete
- 86. No. '
Sullt 1983 B-49832 1
o--
Gate 127-215017 Lhtu
- ^
151-715017 (See /t tached Sheet)
,76'S-5 7#d O
y; YN /3.5 ellfe/ 7 tss Y
10) m (8)
(9) 110) 1 co, e o cnynen o ee,vwe vor wcn
= wes o gneas O
r r1
- T or Vetvo Pressure Class 1500 gig c,i 6. Design Cond,tioris pse "J 00
- 7. Cold Worbag Pressurr.
piu et torrr.
& Pressu e Retaining Piet a r
Mo't No.
Material Spec. No.
Menutecturer Romerts (a) Castenpa
,o ?
W l
- =
ar
---r--
u, M f orgings J0dy Pdf_11A SA 182 F316 Voet Benntt R39_2BA SA 182 F316 Vogt R46_8A SA_182 F316 Vogt_
0
-~ ~
=.
.:n=
~
~. = = = = =.
(11 for manustly operated vafves onty,
- Applemental at eets in form of lists sketches or des *ings may t,* used provided II) site is 81f2* a 11*, (2)information in items 1. 2 and 5 on this Dets Report is incruced on each sheet. and (3) each sheet is numt4eed and numter of *Seets is recorded at top of this forrn, d
~
~
- ' =Tyd e.. or_
i
h$
hf$IW$$CN
,,,,,h6hD N,N'Mt 'lk YUM. Nib 58i h 5ENON'i$ftNd N Y i.6 N, W '
a s
M
.~...-~.n..
..c,,..n. n.e,+....,
y' p.n%,,,,,,,
Jan 5erev
';' S HRP SA 564. Cri-630 Voet (Condition H 1150)
~
=
e g
Id10ther Parte T
Cate 115C SA 564, Gr. 630 Vogt (Condition H 1075)
O V
- 1 4
-.i,
S. Womrtetic twt _ 5400 _ i. tw a oi,..,,etw,,1 p,,,v,e y
CERTIOCATE OF COMPUANCE O
We come thei the statements mode in this report see correct and that this pump or velve, conforme to the ru 1974 O
r corretnnton of the ASUE Code for Nucteer Power Plant Components. Section lit. Div. ( Edttion, Date.DeCG C
Su:rer ' 75
, Code Caw No,
~
Aodende_
fy 66 r.i rh/ml
.h w Henry Vogt Machine Co.
,,y _
6/
s;gned.
N 2/10/84__,
iii cemnese 907 to up the
- symbol espires ou ASut certificate of Authonution No.
r
<=i me CERTIOCATION OF DES 4GN Henry Vogt Machine Co.
Design informenon on file et _.
13enry Vogt Machine Co.
Str**s onetysis report (Clase 1 onty) on fife og u g D. Young Design specifications cert 2f*d by (11 4557 mans as p.g go.
PE State R. S. Pe rry t y til Stress snelyps esmfy7 5380 UEU" PE State Reg. No.
(1) Signature not required. U name onty.
CEH11nCATE OF SHOP INSPECTION t, the undersigned holding a vet.d commisson issued by the National Board of Boiler and Pressure Vessed Insoectors Kentucky and employed by.Coteercial Union Ins.Co.
and the State or Province of -
have inspected the pump, of vetve, desenbod in thle Data Report on Bes t en. MA of.
Decenber 8
_ig_83-, e nd siste that ta the best of my knowf edge and belief, the r4 Certificate Holder hae con-structed this pump, or vetve, in accedance we tge ASME Code. Section lit.
By s;gning this cert.ficate, neither the inspector riot his employer makes any warranty, empressed or implied, co the equipment desenbed in this Data Report. Tvrthermore, neither the inspector nor his employer shaft be liable iet an 4*sonaling
- e. property darnage or a loss of any kl.d arising from or connected with this inspection.
mannet tot any D, cepber f./
g/8 Kentucky #1 p,,,
- [1dM* tescoctwg?_22#M'. #
Commissions i et 6 60. Siste. Prov. eN: **o.1 h
- _ _ ~ -
z.
_ -..~ ~ ~ _ _
_ sw.--
X g.
TORN N!S 2
&PPENDIE !! - NMEl&TCEF R371sp po 021 06/30/09 FORM NIS 2 0681D'8 REPORT POR RD&Its OR RD1&CIMNTS 1
As Required by ths Previsions of the ASME Code Section II l
I j
1.
0WNER Apat/trTramr oFra ATiart. inc.
9425
/8 -/- f/
i N8ne
- 17. 3. 101 137 Si RDifettyfete. A1. 72801 M
- f
[
4
&mdr.
l 2.
PLANT Aaraugli WDetWAt Ort WIT Two Nee Rt. 3.101 137c 109trt t fit t v. A1. 72801
$ O, 808808dY Address Papair Organisataan 70 Be., Jeb No., etc.
3.
WORK PERFORNED ST AF&L/Eurtney ops.. tue.
TTPE CODE 51 3 08,STND n/A Base
&UTHORIZ&f!W W.
n/A RT. 3, los_1370, RUS$ti. LYT 1.LI AR. 72801 Address IIPIR&T!W DATE n/A 4.
IDEN72T2 CATION OF SYSTIN N>
[
- (2#88-h 5.
(s) &PPLICAatt CONSTRUCT!aN 0005 l#MN 191 DITION, S-73 ADDEND &,
NA CODE C&st I
(b) APPLICA3La DITION OF 88CTIM II UTILIZID FOR RDAIRS OR REFIACEMDffs 19 4 6.
!DDfTIFICATION OF COMP 0NDfTS REP & IRED OR RDIACID &MD REF1ACEMDff CtNEPEDffS REP & IRED MAME OF NAME OF NMfUT&CTURER M MMht' CODE e
OTHER TEAR
- REFIACED,
=
'=ra C0 0Nixt mUriCmn ERar. W.
reaTinean0N==
W
=-
J=k
.Ds C= =,
k t.s I
At/0 7 N.R
- 16tt-Med -A_ /f7Y A0tel560 $
!\\
l l
c
!N l
\\
l l
N n
1 u
~ 1.
DESCR!?110N OF NORK A&V-MNed b
th2hrlMN.
'i 8.
7117s CCWDucrtD: HTDROSTATIC D F9tEW171C D WORIMAL OPERATIM PRIESURE D 07MER D -
PRISSURE NA asi TEST TEMP.
NA
'_F-NOTE: supplemental shests.in form of lists, sketches, or drawings may be used, Provided
-(1) eine is_9% in. a 11 in., (2) information in items 1 through 6 en.this report is.
included en each sheet, sad (3) each sheet is ata6ered and the snaber of sheets.is recordedf 6t the top, of this_ f9 a --
l
....o.w.
sm.on asMEsD 0d/50/h9 Poset E s 2 (nach) t.
RtxiRxs N/4
/ Applicable Manufacturer's Det.a Reports to W Attached v
s I
l I
cx ntr2 cars or cCNM.IANCE 1
1 1
1 we egrtify that W *statenests made in the report are correct and this I
A/AM2e conforms to the rules of the Ass code, Section n.
I I
repair or replacement i
1 i
i i
Type code symbol stamp w/A l
I I
l I
certifieste of Authorizattaa me.
w/A tupiration Date w/A l
sigrad
[dS
/ I ~
Deta n-i' l
Cvner er Owner's Designes, Title
, 19 3 l1 l_
R. D. Gillespie - Manager. Central Support l
l I
I canineArs or zussavzcz Insrsey2cm I
i l
I, the undersiped, holding a valid commissine issued by & National Board of
- I l
l Soiler and Pressure Yessel Inspectors and tha State or Frswiaace of I
nrAvtis l
I and employed by *MrVRfCET WTUA1, INSUNCE CO.
el l
NORV00D. MASS.
bate insDected b campcoents described 1A this:
I Ovnerts Report during h period
' 4-20-91 to
- Moa M
.)
4h I
and state that to the best of my knowledge and belief, the owner has performed I
examinations and taita corrective masures described in this owner's Report in l
I l
accordance with the requirements of the AsMI code, sec' tion n.
I I
I I
By siping this certificate neither the Inspector nor his employer males any I
varranty, azpre:aed er implied, ecocerning the azaminatloos and cerrectin measures li I
described in this owner's Report. Furtbe3ere neither the Inspector nor his l
1 employer shall be liable in any manner for any, personal injury or pro i
l or a loss of any kind arising from gr connected with this laspection.perty damage i
l 9 O,[./6M FACTORY HUTUAL SYSTEMS l
cassaissions l
l
& Inspector's signature W3-9947. ARK-T133"N""1"'Nd L
I National soard, state, Province, and Endorsements !
J. O. Elliott l
Date G e t /.o a a 19 M I
l-I I
FORM N!5 2 APPIXDIE !! = NutDATOET REVI5ED ENG.021 06/30/49 FORM NI3 2 OWER'S REPORT FOR RDA!R$ 04 RDLACIXDrTS As Required try the Provisions of the AsME Coos section II 1.
OWNER AP&L/EMTnCT OPnATIOW1. INC.
DATE
/8-8" I4 Nhme RT. 3. 101 137 C. RUfft11TItti. AR. 72801 SMIT,,
/
ef
/
Mbireaa 2.
Pl. ANT iff1M111 NUctJn OEI ISIIT Two Nhme JT. 3. 101 137C. RU S SILLIIt t ir. 11. 72801 E d. #doFeO790 Address Repair Organisation 70 No., Job Mo., etc.
3.
WORK PERFORMID 87 Dat/nTncY ops.. tue.
TTFE CODE ITMB03. STAMP N/A Name AUDORIZATICII 300.
M/A RT. 3. Box 1370, RUSSELI.VILI.E. AR. 72801 Address EXPIRATION DATE N/A 4.
IDDIT!TICATION OF 5757DI M dc W$c Af>(,TdC#-ES) i V
U 5.
(a) APP!.!C13LE CONSTRUCTIC01 CODA 4/Sd 19 4 7 DITION,,/m/, / W Z
- ADDDfDA, NA CODE CASE (b) APPLICABLE EDITION OF SICT200f II ITTILIZID FOR RIPAIRS OR RDMCIXDffs 19 8(,
6.
IDDIT!PICATION OF C0KPONDfr5 RIPAIRED OR RDLACD AMD RDLACSXDff COMPOENTS I
ASME II' NAKE OF NAME OF MUfUTACTURER OTMIR TEAR CD$
STAMFD COMP 0NDfT KAXVTACIVR1R gnfif-No.
IDCf71FICAt!0ei WILT OR g*
,,(TIS
..s RDuCsxDer yo) l Y LldtcAlU NO M
pecA-/r-M 7 ' /f$9 kutt54 h f/H l\\ "
I i
l l
1\\
l I
i \\
i j
<x i
l l
N c
o o
7.
DISCRIPf!ON OF WORX YM/ /Ad 14t<f4
/
's' 8.
TESTS CONDUCTED:
NTDROSTATIC 0 PMEutATIC D WCMIX1L OFIRATING FRIS$URE D ODERO FRISSURE N b Dai TEST TEMP.
N4
'F NOTE: Supplemental sheets in form of lists, sketches, or dravings may be used, provided (1) size is 4% 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 ennber of sheets is
. recorded at the top of this f p.
i
~
.....w=
- ING-021 asvaass 06/M/89 FC M E8 3 (Besk) se annax:
N/A Applicable Manutaeturor's Deta Repert.s to be Attached l
l l
czar 2ncast or conFL2ames I
1 I
1 ve cer4fy that the 'statenests maes in the report are corroet and this l
c l
AfAAub oonfome to the rules of the has Caes,Section II.
l I
repai( or replacement I
l I
I i
type code symbol stamp s/a i
1 l
l l
Certificate of Authorisatlan No.
N/A Espiratian Date N/A i
siped fd Jb Data
/0-tt 19 l
owner er Owner's Desi pee, fitle l.
R. D. Cillespie - Manager Central Support l
l l
l I
cantncars Or russwzes zustscytou i
1, the undersiped, holding a valid esamissian issued by the Battamal Board of
- i i
l l
Boiler and Pressure Yessel !aspectors and the State er Prerface of l
I ARIAptAs and employed by *ntynICHT WTUA1. fM5tmANCE CO.
Of d
l MORV00D. MASS.
l.
Ownerts Aspert during the period b8?e insDetted the etapenents describgd 18 thiaM &~
a-20-91 te
//~14-FR el l
and state that to the best of my knowledge and belief, the Owner has performed I
l examinations and takan corrective measures described is this owner's Report in l
l accordance with the requirements of the AsMs code, Sec' tion E!.
l I
i l
ty siping this certificate neither the taspector mer his esployer nahes any -
i warranty, aspressed er implied,- concerning the ammainations and corrective measu 1-des'cribed in this owner's Report.
Furthermore, neither the Inspector nor his l
I esployer shall be liable in any manner for any pereenal injury or pro er a less of any kind arising from gr eennected with this Laspection.perty damage-I 1
i I
FACTORY MUTUAL SYSTEMS l
Y. O. [l/M I
Commissions N3-9947 ARK-r133 "N" "18' 'M,
l I
(/ nspector's sapature I
J.' O National Seard, state, Province, and todorsements !
l Dete _. Elliott I
O c.t h H 19 1 l
1
-C l
v-m g
vr yvr-y e m-em g+iDu,na-am a
em,,,.
n
,.4og,
....,,i.a e
mei.w -
p
.my.,.w.m.-ce,,w,..e.,,,,,o.,,p.,-,e n#, -..,
-,s,--.cw y
p-4L, w
r
FORM N!$*2 APPENDIE !! = N&lS&f MT RITISD ENo 021 06/30/M POIDI N!g.2 OtStER'S REPORT POR RDatts OR REPIACIMENTS As Required by the Previsions of the ASME Code Secties II 1.
0WNER AP&L/ElrTtteT OPreaftflitt. IEC.
/M "'Y" II Name RT.1 ter 117 c. RUttrit ff"*. AR. 72001 NEIT
/
of
[
Address 2.
PLANT Aer A4nt rect 'At birr WIT Two Name 1T. 3.101 137c. Rosset t ytt e v. A1. 72801 10,b88//84 Address Repair Organisatian PO No., Jeb No., etc.
3.
WORK PERFORMD ST AP&t/Estener 073.. Tue.
TTPE CODE STISOL St&NP n/A Name AUTHORI2& TIM B.
n/A RT. 3, los 1370, RUSSELLYTLLE. AR. 72801 Address IIPIRATION RTE n/A 2DENTIT1 CAT 10N OF SYSTSx Yib4l1xY
[ hem-Td 4.
5.
(a) APPLICABLI CONSTRUCT!cW CODE 5
19R DITION, F-J-72 DDEND&,
i N4 CODE Cast (b) APPLICA3La EDITICW 0F SECT!QN II UTILIZED POR REP &IR8 et REP 1ACIMENTS 19 M
_6.
.!DENTIT! CAT!0N OF CCMPONENTS REPa! RED OR REP 1 ACED AND REF1ACEMENT COMPCDIENTS E
RD&!RD N&MWh!'
0008 NAME OF NAME OF M&WF&CTURER 0111E3 TEAR REPt&CED, e
ST&MPD t
COMPQNENT MANVTACTURER SERIAL NO.
IDENTIFICATION BUILT M
=.
J=4 R =..E - T
.s
- 1".PN/WG 1 CE.
Nk NA Jec4-12-2" /970'M YES N
l
!\\
l l
'N l
l N
1, r
3 c
1 P7-AubE1N owmlna d 2 sr dw s.s col s T.
DESCRIPTION OF uoRR
/.
W.
8.
71575 CONDUCTED: HTDROSTATIC 0 PNEtMATIC D NOMIN&L OPERATING PRES 8URE D OTHER D P323sgRg N4 ' Dei TEST TEMP.
' F.
- NOTE: Supplemental. sheets.ia form of lists, sketches, er drwings any be used, provided (1). size is 8% in a 11 in., (2) information in items 1 through 6 en this report is - -
included on each sheet, sad (3) each sheet is numbered and the number of sheets is -
recorded at the top, of this. farm.
. X a--
. u a. -
-. ~.
. -. - ~.
i ENk021 arvatsa 06/30/09 P et s18 3 (back) 9.
RDERK8 MA -
Applicable Manufacturer's Data Reports to be Att40hed Y Dhth es AHL
, AMN A/RAANi,
=
l czartncm or cours.zancs I
I I
I t
1 1
We eerpfy that the'statemaats made.in the report are correct and this i
I
. Anutb2>
conforme to the rules of the ARE Code, pectica II.
l l
repair'er replacemaat I
)
i i
i Type code symbol stamp n/i l
1 l
I certificate of Authorisa me.
3/A Rupitatica Date 3/A l
_I Siped th
'/A =
Date
/f M 7 1--
, 19 I
owner er owner's Desi nee, title 1.
R. D. Gillespie - Hanager, Central Support U
i 1
1 l
czarrncm or Instav2cs Darscr20s l
t I, the undersiped, holding a valid esamissima issued by the sational Saard of
- l I
teiler and Pressure vessel lampectors and the State or Proviate of l
1 l
_ ARIANS&S and esplope by 'arvRient wrun iWSURANCE CO.
Of
(
I wescoD. MASS.
I ownerta tapert Aring the periad have ABSDeeted the tempensats descrped la thied '*
a-10-91 ts /4-26
- YJ l
and state that to the best of my knowledge and belief, the Owner has performs 4
,l 1
l esaminattens and tahta terrective sensures described in this owner's Report in l
l I
accordance with the requirements of the ASME Cade, Sec'tlon II.
I I
l ty siping this certificate'neither the Inspector mer his employer makes any i
I-varranty, supressed or implied, concerning the naaminations and corrective esasures i I
deseribed in this owner's Repert. Purtheroere, asither the taspecter ser his I
l employer shall be liable in any manner for any personal lajury or pro l
er's less of any kind arising from gr esanected with this inspecties.perty desage l
l l
9.b. 2. Zee FACTORY MUTUAL SYSTEMS l
l canntggions WB.9947 ARK-t!33 "N" "18"'A' l
gInspector's sapature l
I J." 0 setional Board, State. Province, and Endorsements l l
Date _. Elliotbeh.2 A 19 g
,. l-l I
FOM N!s-2
' APPEND!I !!
- MMSkTORT REVISD po.021 M/30/et PORN wis.2 0608E188 RD0tf POR RDatts et REPLACEMENTS As Required by the Prwisions of the Amit Caes secties Et 1.
OWNER AM L/ENTraef OPre m mt. tue.
BME
/d-S~ fd name
- 17. 3. 501 137 c. Restettvitt'. 11. 72801 SMIT
/
of
/
l adar...
2.
PLANT Anragets sectrAt eut IMIT Two Name
- 17. 3.1DI 137c tUlf rt t vitt v. A1. 72801 18, 608SY[ 97 Address Repair Organisatian 70 Be., Job No., etc.
3.
WORK PERFORMED ST.tP&L/tsrtist ops. % TTPE CODE STWOL ST3MP R/A same A0!MORIZ171cIf NO.
M/A RT. 3. ler 1370, RD$stLLVIL15, AR. 72001 Ida.es:
EIPIR& TIM DhTE m/A
~
4.
2DDr!!TICAT10N OF ST8TDI A 444 d 1/ u u44 A ! b M h R8-/)
v v
5.
(a) APPLICA&L2 CCNSTRUCTICaf CODE _/u/ TIC 191 BIT!W, S'- 74 ADDEND &,
NA CODE Cast (b) APPLICAALE EDITICIf 0F SECT!cu 31 trr!LIZED FOR REFAIts OR REPLACIMENTS 19 84 6.
1DDr!!?! CATION OF COMPONDf75 RkPkIRED OR REPL&CID AND REPLACEMENT COMP 4
E RDAIRED e
NAME OF NAME OF N&WFACTURIA Wh!'
OTHER TEAR REFLhCED COMP 0NDif NAWTACTURER SERIAL WD.
IDnff!FICATICII WILT 02 MMD
=-
g=4
.s Am.c=D,7 lM ltMa user a
m-w ms m &\\
I V
j x j
x<
i
~
p u
u h
, 7.
DE5CRIPTION OF WORK YM*MadbbN
_ed/214bw3d, v
8.
71575 CONDUCTED: NTDROSTATIC D PttIWATIC D NOMIXhL OPEPATIM PREESURE D l
OTHER D PAISSURE NA Dei TEST TBEP.
Nd
'F NOTI: $uppleneatal sheets in forn ef lists, akstches, or erevings may be usod. Prwided (1) sise is pg in..s 11 in.
(2) information in itens 1 theough 6 en this report.is -
ineluded on eech shest, and. (3) eoch sheet is numbered and the number of sheets is.
1
. reeerded et the top, of this fa,rs.
O.
u
~
asvasan neo-cal 04/30/**
J FORN N18 2 (56ck) wa Applicable Manuf acturer's Data neports to be Attached i
l
~'l I
carnnca~ n or connnncs I
I i
I We cor,tify that b
- statements nede in the report are correct and this I
i AfAdm eccforms to the rules of the AEM Code, Section X2.
I I
repair'or replacement l
i i
I l
i trPe code symbol stamp w/A I
I i
i certificate of Authorisa No, y/A Lapitatica Date _
D/A i
signed 3 b < / / k,, -
Bate
, o - tA
, 19 i
ovner er owner's Desiones, title i
i R. D. C111espie - Manager. Central Support
,l l
l I
ctrnneln or Destav2cs DestscTIce I
I I
I I, the unoersiped, bolding a valid ecmaissian issued by the Naticeal Board of
- l l
Soiler and Pressure Yessel Inspectors and the State or Frtwince of I
l
___ Atra tis and employed by "AMVRIGHT MUTUAL INSURANCE CO.
Of l
I Nowoop, ass, have inspected the components descrhd in this:4 as.
I wnerts 14 port &ning the period ti-70-91 to
- ~ 28 - f4
,I l
and state that to the best of my knowledge and belief, the owner has performed i
I enminations and taken corrective measures described in this owner's ** port in l
I accordance with the requireawnts of the isMr code, Sec' tion II.
I l
l I
ty siping this certificato ne(ther the Inspector nor his emplofer makes any varranty, agressed or implied, coocarning the asasinations and corrective measures ll i
l described in this owner's Report. Furthermore, neither the Inspector ter his l
l employer shall be liable in any manner for any persee.a1 injury or pro or.a loss of any kind arising from gr connected with this inspection.perty damage l
I l
l FACTORY MUTUAL SYSTDiS l
h 0 [A<Os -
Camnissions _ N3-9947. ARK-n 33 "N" "18' 'h" l
l l
(/ Inspector's signature National Board, State, Province, and Endorsements l I
J 0 l
Dale _. ElliottccT,go ;t ;t ag g l
l-t e
\\
2:
J
)
FOM N!8 2
&PPEND!I 11 = MMS &TOET 3Ey15D I.NG 021 M/30/89 j
F0M KIS 2 OWNER'S REPORT FOR RDATRs OR REPlacDWfft 1
As Required by the Previsions of the AsHE Code Section II 1.
OWNER APat/rNTre2T OPr* ATIGER. IBC.
MIE _ /M-S" 92 Name 1
RT.1. ROI 157 6. RDifettVT"'. A1. 72801 SMIT
/
of
/
Address
+
2.
PLANT AnrAU Al NDetFAt Off M
Two l-Wee nt. 3. 301 137c. Russet t vTt t e. Am. 72801 Jd, #CO857568 Address Repair Organisatian 70 Bo., Job No., etc.
3.
WORK FER10RMED BT APat/rserner ets.. rue.
TTFE CODE ST W OL STnNP m/A Name
&UTHORI D T!W NO.
E/A RT. 3, Box 1370, RUSSELLVII.LE. AR. 72801 Address EEFIRATIM MN n/A WADt AMefh{AER8'E5}
' 4.
1DDCIF2 CAT 10N OF ETSTER 5.
(a) APPLICA3M CWSTRUCTION CODE
,[]/[,191 DIT!W, J-75
- ADDENDA, NA CODE CASE I
(b) ArrLIcABLE EDITICW 0F 53CT20m II UTIC FOR REPAIRS OR REPLACIMENTS 19 N s.
2cENTIFICAT10N OF COMMsODffs itEPuRED OR REPLACID AMD REFuCUWrf COMMSG3fTS ass HAME 07 NAME Or nuevFACToss1 maTronas, urunn y,3,
,,,g3eg,,' _
m 304R0 sTanP n ConroNINT MAxvFactumER sIRIAs,NO.
teorTInCAT10m sort.T a
=-
,1=4
.s
=,
,7 8.17Y NM 0SCS-M WL ' M7/b?ld
$5
!\\
l
!N l
l l
\\
l N,
u r.
3 l
o h
c 1.
EtSCR19710N OF uoRK A DAM k h b % &-.bedub wh)anbAwld,,
v 8.
TESTS CONDUCTED: NTDROSTATIC D PME1MATIC D NOKIMLL OPERATING PR255URE D OTHER A PRESSURE M
Dsi TEST TEMP.
NA
'_F' NOTri supplemental sheets.ia form of lists, sketches, or drawings may be used, provided (1) size-is D%-in. m 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 sheets is
. recorded at the top of this form.
a.
- w u
i
-. -... - ~. -...
. -... ~
aavassa see cal 06/30/es FOM N18=2 (Seck)
L 9.
REM &AK8 WM 1pplicable Manufacturer's Data Reports to be Attached 4
t l
l cuanricm or ccMPL2 Ants i
I i
i we rerg fy that the' statements made la the report are correct and this l
WAMD conforms to the rules of the & sis code,Section II.
l l
l repat( or replacessat I
i l
l I
Type code symbol Atamp w/A l
1 l
I I
certificate of autherisatian me.
3/A h piration Date-n/A l
siped b M M ), - esta
,1shl r o - >
t- -
i owner er owner's Desi moe, title l_
R. D. C111eopit: - Manager Central Support l
t i
I i
. czarzncm or zustav2cs zustsetta l
I I-l 1, the edersiped, holding a valid commissian issued by the National Stard of
- l
-l Beiler and Pressure Tessel !aspectors and the State or Frwiace of l
l ARKA3SAS
~ and employed by *AuvntenT MUTUAL INSIMANCE CO.
Of-l*
l nonvoon. Mass.
I Ownerts Report during the period have inspected the camponents describpd La this24 as.
a-20-91 to
/4 -#d-VI
,1 1
and state that to the best of my knowledge and belief, the Owner has performed l
l examinations and tahan corrective esasures described la this owner's Report la I_
-l accordance with the requirements of the asMs Code, Sesitten II._
I l
I
.I ty siping this certificate neither the taspector nor his employer nahes any.
I described in this owner'911ed, concerning the asaminatians and corrective measures warranty, napressed or 1 I
s Report.. Furthermore, neither the Inspector nor his l:
i esplayer shall be liable in any manner for any personal lajury or pro or, a less of any kind arising from gr econected with this inspectica.perty damage I
l l
l
' l
' h. 6. /M2M FACTORY MUTUAL SYSTDt3 l
Commiseions N3-9947, ARX-r133 "N" "18' "A" l
l U2nspector's signature Beticeal Board, State, Prevince, and Andersements l I
- i. O.
I Date,,_Elliott6eL4u 3 A 19M.
I l
I-l
-,-,.n
-.,,..~.
mn FOM NIS 1
. APPENDIE !! = Mh2hTORT REVISD E30 011 M/30/st F0an NIs 1 eletER's RD05 FOR RDAIR$ OR REFlacDeffS As Required by the Previsions et the AENE Code Section XI I,
CWNER Apst/rirrrner openaT1 art. Inc.
MIB
/d - S-f#
Name
~
nr. 3. nor tst e. nesrettm'. AR. 72:01 mes?
/
et
/
Address 2.
PLANT inri m a sectrit cirr WRIT Two mana RT. 3. EDI 1370. RUtgrf f ytt t 9, Am. 72301 ld, #608$Pf88 Address Repair Orgaalaattaa 70 No., Job No., etc.
3.
WORK PER10MID ST Ap&fdEBTTsef 672.. Tue.
TTFE CODE 5tISOL ST&MP n/A same AUTHotIZhTICar 30.
n/A RT. 3. Box 137C, RU$$ELLVILLE, AR. 72:01 Address EEPIRATION MTE n/A
$AtklabYh!E*?b UF08-S) 4.
1DDalT2 CAT 10N 09 ETSTEN
/
V V
5.
(a) APPLICABLECONSTRUCTION0005_dd2IC A9 1 EDITION, 8-79
- DDENDA, NA CODE CASE (b) APPLICABLE EDIT 20W 0F SECTION II UTILIZED FOR RDAIRS OR REFIACEMENTS 19 84
- 6. -
IDENTIFICATION OF CCMPONDrfS BIPAIRD 04 RDLACED AND REPIAGMENT CQKPWDf NAME OF NAME OF M&NUFACTURER 0"II' RDAIRD 00I OTHER TEAR REF14CED COMPONDff MANUTACTURER SERIAL NO.
IDDrTIFICATION BUTLT tR D
g=,:
.s
.Diu.W,1 3
l /" M44.
lf
(
l'NhtbAL f
l A'
NA JSP-fee d MN MIS - N ll-l I
!N l
L l
l
\\'
'1 l
N, u
h r
i k
4 l
DESCRIPTION 0T \\@RK $Mi & bH(k)b
.dhe$A4VlAbl 7.
L g
8.
TESTS CONDUCTID: MTDRo$7ATIC D PWIWATIC O NOKDl1L OPERATING PRIS5URE O OTHER C PRI55URE psi TEST TEMP.
'F NOTE:
Supplemental sheets ia form of lists, sketches, or drawings may be used, Provided (1) size-is 8\\ in. x 11 in., (2) information in items 1 through 6 ao this report is -
included on each sheet, and (3) each sheet is numbered and the number of sheets is
. recorded at the top of this fa,rm.
~
-J
3-asvassa
/**/
rces azs a (sesh) 9.
RDIAAKS h/M
' Applicable Manufacturer's Data Reports to be Attached I
l I
czanncars w cours,zancs
.I l'
I l
we cer;tify that the'statemaats made la the report are correct and this l
flfA4W conferas to the rules of the ABE Code,Section II.
l I
l repa1(or replacement I
i I
I-l I
7ype code symbol Stamp N/A 1
i I
I certificate of Authoriza No.
B/A EEpirstles Dete R/A l
sipod 0_ s/$ ---
Data so-z 1-I owner er owner's Desimee, Title
,19L 1.
R. D. Gillespie - Manager, Central Support l
I l
l-I czarrncars or zussav2cx zusFscr2cm I
l 1
I I, the undersigned, holding a valid commissian issued by the National Board of
- I I
Beiler and Pressurs Vessel Inspectors and the state or Province of l-1 ARKAssAs and employed by *mvRfCET WTtfAL INSimANCE CO.
of
~l-i NOWOOD. MASS.
I ownerts Report kring the period have inspected the compeoents described la this.4 an.
e-?o-91 to
/4 -##- 71
,1 1
l and state that to the best of my knowledge and belter, the owner has performed l
l 1
esaminations and tahan corrective measures described in this owner's Report ta l
l accordance with ~the requirements of the AsME code, sec' tion II.
l l
I 1
ty siping this certificate neither the Inspector nor his employer makes any l
l warranty, aapressed or implied, concerning the amaninations and corrective measures !
L I-described in this owner's Report. Furthermore, neither the Ins employer shall be liable in any manner for any personal injury pector mer his l>
er a less of any kind arising from gr connected with this inspecties.perty damage or pro 1
I I
l l
S.8. ShC FACTORY NDTUAL SYSTDis I
Commissions NB-9947, ARK-T133 "N" "18' "A' I
-1
(.Anspector's sipature sational Board, state, province, and Endors.Nnts l I
-J. o. Elliott I
l Date deh J A 19 9 A 1.
I-l
(;
.i
. '&PPENDIX II
- NhNhkTORT R37133 FORM NIS 2 FORM NIS I 06651'8 RDCET FOR RDATRS OR RDIACDef?S As Required by the Provisiens of the ASME Code Section II 1.
OWNER APat/ENTftef OPrsaftmft. IRC.
R&T5
/8#d "YN l
Name Rt. 3. nor 157 c. ResrettYr"*. AR. 72801 NEIT
/
of
/
Address 2.
PLANT A n r A M i t N D et_r a t 0 5 2 W
Two Name RT. 3.101 137C. RUSSFt i VTT t v. A1. 72301 3 8,* O C 8 7 8 7'f C address Repair o m 4 9 tian 70 No., Jeb No., etc.
3.
WORK PERFORMED BT APat/Estvte? 0P2.. Tue.
TTFE 0008 STISCL ST&MF M/A Base
&UTM08.IZhTIW WO.
n/A RT. 3. Rex 137C, RUSSELLYTLLE, AA. 72801 Address EDIR& TION DhTE n/A IDENTIFICATION OF SYST5x ALou'$nsAln.Y$14bb (JM 88 -27 \\
4.
U 5.
(a) APPLICA312 CONSTRUCTION CODE 24M GIC 19 R EDITION, S-77
&DDEND&,
N/
CODI CASE (b) APPLICAsLE EDITION OF SECTICN II UTILIZED FOR RDAIRS OR REF1&CIMENTS 19 Pd 6.
IDENTIFICATION OF COMPCNDfTS RkFAIRED OR REPLAND AND REFIACIMENT CCNPEENTS l
RDAIRED i
NAME OF MAME OF M& NUT &CTURER OTHER TEAR
- RDIACED,
'ST ED COMPONENT MANVFACTURER SERIAL NO.
IDENTIFICATION SUILT M
J=g,
.s RDuc-I l'l#2/C959 NN
'JpA-toot'#
lF9/ ALA 46t. l
$ ~ 3/45G NA 2PA -/M 4A 199/ @eb m_d_ 442 I
F-214 S/3 NA JPA-loe1A '/ff/
/ mod M
2-2}b 3/3 NA JPA-)d83A
/99/
$'w h2.j
- lN o
e c
u
(
j 7.
DESCRIPTION OF WORK M //, 9 M M
M,
/
8.
TESTS CONDUCTED: NTDROSTATIC D FMI12(ATIC D NOMIX1L OPERATING PAISSURE D OTMER D PRESSURE-N# esi TEST TEMP.
N#
'F NOTE:.$upplemental sheets.in form of lists, sketches, or drawings may be used, provided
(!) size is 8\\ in. I 11.12., (2) informat100 in ittas 1-thr00@ $ at this r# Port is 4 included on each sheet, and (3) ear.h sheet is numbered and'the number of sheets is recorded at the top of this farm.
A.-
ano-on
-asvaasp M/M/st FQRN HIS-2 (Seck)
A/PF- /1 N M />
g.
Rgxtaxs applie'ab'le Manufacturer's Data Reports to be Attached I
l I
carnncars or ccMP2,2&lus l
I w
1 i-A/e certify 3 hat the ' statements made la the report are correct and this I
Mraur conferne to the rules of the 135 Code, section II. -
1 I
repdir er replacement i
i 1
l l
Type caos symbol stamp N/A
,l l
l I
certificate of Authorisation no.
N/A Eg iration Data n/A l
l-31 ped db I/~-
Data
/s-tt 19 I
owner er owner's Desi nee, title l __
R. D. Gillespie - Manager. Central Support 1
l I
I l
. csannears or russavrcs zustscrzon 1
l 1, the undersiped, holding a valid commissian issued by-the National Board of * -
I l
l Beiler and Pressure Tessel laspectors and the state or Prwines of l
I
_ ARIANtas I
and employed by *mv11CRT MUTUA1. INSURANCE CO.
-of
.l NORVOOD. MASS.
I owner!s Rapert king the period h899 lasDected the oogehents described la this4 ar.
1 4-?n-91 to /d - #4 - 9'l I;
and state that to the best of my knowledge and belief,-the Owner has performed.
1 l
eneminattens and takaa corrective sensures described in this owner's Report la I
l accordance with the requirements of the ASMK code, Sec' tion E!.
I l
i l
i By siping this _ certificate neither the Inspector nor his employer makes any
_I warranty, empressed er implied, concerning the====inations and corrective measures-ll l
I de, scribed in this owner's Report.
Furthermore, neither the Inspector ner his _
I employer shall be liable in any manner for any personal injury er property damage _
~ l i
er a less of any kind arising from gr esenected with this inspection.
L l
I i
l 9.6. M S FACTORY MDTUAL SYSTEMS l
Commissions.
NB-9947, ARK-r133 "N" "I8' "A" l
I plaspector's sapature I
motional Seard, state, Province, and Endorsements !
J. O. Elliott I-Date O cng,., n 131
- l I
.l_
l_
t
i "f*'V*%'Q' W s
s r
p0 Red NPV 1 N CWITMCAff NOLDWis' DATA MEPORT POR NUCLEAR s vedPS OR VALYes.
a As Reguired tsy ese Proede&ene ed the ASAAE Code. Sestien 15. 06v.1
- t. Menv4ce,r,s W
- ^*rv Yaat Ma chi na Co.. Izula villa. EY f'seme 4A5 Mdress of N Certifke6e miser
. p. adanv%ce,ree so, Ark and as Faire r & 1.1ah t. Litt la to ek. A1 b
u1 One Euesellv1114. At 72801
~
g teese,en er w 8es*e e4 Aesonas 4 Pwme et VsNo _ Cat' Y' LIM
, pteennel intet Se 1"
h S.se 1"
GacN eones let Meded ha th) et Cev1 meets Moeder's set Ceneena Senestea Sertel Aeg.arehen id1 Droov6ad tft teert tel veer erType ses.
see see lesCiese Se peo toe 199 1 gig e.a ta
- 1. 2 ' i ' M E. A M ; M I_
a, cete 2-215' 14 s-48480. a6 1
1991 cm __ Cete F2L5M4 1991 5-46480..R6 1
Gg-f,,g es
~Cate 4-215934 1991
)
5-48400. R6 1
W c...
L.mo tA
=_inig w i
ina s se in III III (141 oret sesenseen ei serwee eer n es., ness essense
& 08099 CeHe#ene
$el
- F of VsNo ProcetW9 C3ees (1)
- 7. Ceed wrettaag ProsewJs480 se a terf.
E Wooewre Astewmag Pheose Mart feet MosensiSpes. Des.
Manwiessurer Aemerte les Ceemaee
._m
' ea.-1 amint v5e 004 a1105 Yoet
/
- see:temes sesow to sem er m enames er e, wave me, in enes proveeed in see is s.tr a t r. ci wannenen m meme 1. 2 eM $ en INe Does W is 6 en seen emegt. sad CR eeth ehest is owneered eed ensaker of sheses a rear **fett ettoo of #cs term u
v-e
~~
oosias asee e.
s
',,r,-
odesenal Spot. see, Mesweemaser flemerne Meng ges.
Id temwe cap 5erear 37 SA193 Crede 57 Tazas Solt 1
i
.e ouher Peres PA t A s
y te eAAto v.=
A1n vm
~
(ci, 4 mea nniyi l
l r
1N sei.
sei. Dese OsNesenesi emot oseense
- s. DeNresamens east CWITW CATI W C M We wesy shes the sneemmeans mese in she meest are eermet and met que casus, er essee, seneser== es me ndes l
- 1977 ceaserween et me Amet Cees ter seveneer Power meat C. cam seemen a, Dev L. Seawa 1/17/*1 4
anne.ne
_A-r '77
. Code Cees k Walsi j
h p Inn >
v
" " rv Yaet h Aidam f*A -
i, g,gnee
/
m Ceauessas sesseert v
ep e,e.,,,. afafa, uv
_ w,,,,.
our Asnes c seene et A enenessen me<
esse se C M W 40A h 00d 0F 8 W 1981 wm m4 assee passenenen en me m 8 pose ensevens sapevt IQese 1 enige en me a '
"J = vm wab, e.
tres f a= ase m g _ - - ; e.ggeg gy ggg _
17M1 pg gene, _ Ca11/9 fists g pee, sense enes,em es,eGed w til n i la '1' pg geese _ r - g."N Asg. h l
l US N M M N M N (M190475 0F SMW WWPelm001 L me endseeigned, heemns e osed commise6en leased by me Mesones esord of enter and Pvesewe veeses anspessess e
reini twea. v.
c.,
g Keetuekt e g
,,, ey e gan,ger e see.ed = - e, eesse..e med in.is ones noe
.n
=>
1 Jn M1 99
.end seese met te me test of nor kneededge and benet the N CerifAssen Heider has een-esmussed See poses, er estre, in essesdense sussi me AMIE coa Seemen 5, SF elpoing ede sagdeses, nester sie r nor his evgiover mehoe any esorroner, empressed er ingeod, eeneersdag me sesqmment deoermed a tMe Does h ne8mer the taeposest met No envieyer shoe te llette h any aer permeael y or w or e lees et say ted oneing hem er eennoceed wem mie insporten est 1 91. 11 I 4
dird.7' Ceeweseemene
'~t.
His
- %sn Ap=.Pm ea has 3:
w.a?,
A~
N
- &.. 't. f i h y
FORM NPV 1 N CERT)RCATE HOLDERS' DATA REPORT FOR NUCLEAR PUMPS OR VALVES *-
As Required by the Provisions of the ASME Code.' Section W. Div.1
- 1. Manufactured dy Henry Vogt Machine Co., Louisville, KY (Name and Address of N Certificate Holder)
- 2. Manufactured fo, Entercy Operations. Russellville. AR
<Name eaa aeorens os eu,cne.er e, o.ne,i
- 4. Pumo or Valve Gate
+
Nomanal inlet Site 1"
Outlet Site 1"
(mch)
(inch)
(a) Model No.. (b) N Certificate Holder's (c) Canadian Senes No.
Serial Registration (d) Drawing (f) Nat'l.
(g) Year or Type No.
No.
No.
(e) Class Bd. No.
Built Gate 1-216313 B-4 84 80, R.6 -
1 1991 n,
g_gg%
Gate 2-216313 B-4 5 4 80, R. 6 1
- (21 1991 ]
Cate 3-216313 B-48480. R.6 1
1991 y)
Cate 4-216313 B-4 84 80, R. 6 1
1991 g53 Cate 5-216313 B-48480, R. 6 1
1991 (6)
Gate 6-216313 B-4 84 80, R. 6 -
1 1991---
g3 Gate 7-216313 B-484 80, R. 6 1
1991 te)
Gate 8-216313 B-48480, R.6 1
1991
~
Gate 9-216313 B-4 84 80, R. 6 1
-1991 gg, (10) 5 serier oescripe on of serv <e for on.cn eau.oment was ces.gaeo:
600 6 Design Conditions psi
- F or Valve Pressure Class (1)
(Peesve,e)
(T empe<etwee;
- 7. Cold Working Pressure ps, at 100*F.
- 8. Pressure Retaining Pieces Mark No.
Material Spec. No.
Manufacturer Remarts tal Castings 6
l I
(bl Forgings Body CA-2 S A 105 V0GT t
Bonnet I
g CJ-4 S A 105 V0GT Y# 2 H-E SA taf Vc47 O, Y I
(1) For manuatly operated valves only.
- Supplementat smeets in farm of itsts. sketches or drawings may be used prov.ded (1) siae is 817" a It". f2).nformation in items 1. 2 and 5 on this Data Report is included on each sheet, and (3) each sheet is numbered and number of sneets is recorded at tcp of this form.
~
~
FORM NPV.1 (Back)
Mark No.
Material Spec. No.
Manufacturer Remarks (c) Botng l
Cap S crew B7 S A 19 3 Gr. B 7 Texas Bolt (d) Other Pa ts l
Gate l
WAG l
S A 182 F6a VOGT i ( G e t::. Oniv)
. ~
- 9. Hydrostatic test psi.
Desk Differential test pressure psi.
CERTIFICATE OF COMPLIANCE We certify that the statements made in this report are correct and that this pump. or valve, conforms to the rules of 1977 construction of the ASME Code for Nuclear Power Plant Components. Section Ill. Div. I, Edition Addenda Code Case No
~~~
Oate Sept. 27, 1991 S '77 sy_b A,, _M4 s og hg o Ma M ne Co.
Signed
~
j
- o. comvicate wem 947 N
1/6/93 Our ASME Certificate of Authorization No to use the symbol exp.res em toetel CERTIFICATION OF DESIGN Henry Vogt Machine Co.
Design information on file at.
Henry Vogt Machine Co.
Stress analysis feport (Class 1 only) on fde at Tanaka Design specifications certified by (1)
CA 17661 PE State p,g go.
A. Jouy Stress analysis cegfied by (1) 10416 PE State Reg. No.
(1) Signature not required. List name only.
CERTIFICATE OF SHOP INSPECTION
- 1. the undersigned. holding a valid commession issued by the National Board of Boiler and Prassure Vessel inapectors Cotn:::ercial Union Ins.Co.
and the State or Province of Kentucky and employed by of Bos ton, MA have inspected the pump. or valve described in this Data Report on Ju 2 8, 39
- 91. a nd state that to the best cf my knowieog e and belief, the N Certificate Holder has con-structed this pump. or vane. in accordance with the ASME Code. Section iti By signing this certeficate. neither the inspector nor his empioyer makes any warranty, empressed or implied. concerning the equipment described in this Data A port. Furthermore neither the inspector nor his employer shall be liab'e in any
- i manner for any personal inwy r pro p damage or a loss of anv kind arising from or connected with this inspectic r
f pt. 27,/
[j / 91 f
Kentuch M M IN2...N....
..-i.
c....
.,..,.~.,i n
C omni.s sie ns i
i.,i
- -. ~. - -.-
-~
3.JJ.
g
+
FORM NPV 1 N CERT 1RCATE HOLDERS' DATA REPORT FOR NUCLEAR PUMPS OR VALVES
- 1 i
As Required by the Provisions of the ASME Cade. Section Ill. Div.1 Henry Vogt Kachine. Co., Louisville, KY
- 1. Manufactured by (Name anc Address of N Certificate Hotcer)
- 2. Manufactured for En te rry Operati ons. Russellville. AR INome ena Accress of Puremeser or Owne< >
Gate Nominal inlet Site 1"
Outlet Site 1"
- 4. Pump or Va!ve (a) Model No. (b) N Certificate Holder's (c) Canadian Series No.
. Serial Registration (d) Drawing (f) Nat'l.
(g) Year or Type No.
No.
No.
(e) Class 8d. No.
Built B-48480, R.6 1
1991 Cate 1-216313 g33 B-45480, R. 6 1
Gate 2-216 313 1991 (2)
B-4 8 4 80. R. 6 1
(3)
Gate 3-216313 1991 B-4 84 80, R. 6 1
gi Gate 4-216313 1991 jpA-/caf 7 Cate 5-216313 1991 J B-4 84 80, R. 6 1
B-4 84 80, R. 6
- 1 1991 Gate 6-216313 is)
B-4 84 80, R. 6 1
1991 Cate 7-216313 93 B-4 84 80, R. 6 1
1991 Gate 8-216313 gg3 B-4 84 80, R. 6 1
Cate 9-216313 1991 gg3 (10) 5 ter e# coscrips.on of serv.co ser on.cn eau. omen.ss ces.gaeot 600 6 Design Concetions p s.
- F or Valve Pressure Class (1) tPressge,ej tiempo,siurej 7 Coto Working Peessure psi at 100'F.
8 Pressure Reta.ning Pieces Mark No Material Spec. No Manufacturer Remarts tal Castings (b) Forgmss Body C A-2 S A 105-V0GT Bonnet
_g CJ-4 S A 105 V0GT YF e R-5 SA saf Vc 47
\\fN i
(1) For manvalty operated valves only,
- Suppiemental sheets in form of lists sietenes or drawings may te usec prov cec (1) s.2e is 812 a 11. (2) enformation in.
items 1. 2 end 5 on this Data Report is included on each sheet. and (3) each sheet is riumbered and number of sheets as f eCorced at ICC of this forrrt.
+
~.
~
FO9M NPV 1 (Back) e Mark No Material Spec. No.
Manufacturer Remarks (c) Botting l
Cap Screw l
B7 S A 19 3 Gr. B 7 l Texas Bolt i
l (d) Other Parts l
Gate l
VOGT WAG t
S A 182 F6 a i (Ctem. Oniv)
,r -
22b 16 30 9 Hvoronatic irst ps.
Disk Ditferentiai iest pressv<r CERTIFICATE Of COMPUANCE we cernty inat the statements made in tnis report are correct and that this pump. or valve. conforms to the rules of 1977 construction of tne ASME Code for Nuclear Power Plant Components Secdon lit, Div. I., E dition Addenda Code Case No _
Oate Sept. 27, 1991 b
ioni M4Q[
g Hen ry Vogt Machine Co.
3,gn,o 947 N
1/6/93 Our ASME Certficate of Authoritation No to use the symbol e xperes m
menei CERTIFICADON OF DESIGN Henry Vogt Machine Co.
Design information on file at henry Vogt Machine Co.
Stress analysis report (Class 1 only) on f.te at aka Design scecifications certified by (1)
CA 17661 PE State p,g gy Guy A. Jolly Stress analysis cemfied by (1) 10416 PE State Aeg No (1) Signature not required List name only.
CERTIFICATE OF SHOP INSPECTION l, the undersigned. ho6 ding a valid commission issued by the Nationaf Board of Boiler end Pressure Vessel Inspectors Cot::mercial Union Ins. Co.
and the State or Province of Kentucky and employed by Boston, MA have inspected the pump or va ve, described in this Data Report on r
ef.
June 2 8, 39 91,and state thatio the best of my knowledge and belief, the N Certificate Holder ha s con.
structed this pump. on talve. in accordance with the ASME Code. Section til.
By signing this certificJte, neither the Inspector nor nas emp'cyer makes any warranty, empressed or emplied, concerning ae equipment descreed ir' this Data Aa ort Furthermore neither the inspector not his employer shall be liab?e in any minner for any pensena! engury r pro y damage or a loss of any kind arising from or connected with this inspects
[NJm-27, /
91 S pt.
f f
f
// N /
A Kentucky (19 75
~
)
4 &u Li> 'ls7Q f p
=
FORM NPV 1 N CERTIRCATE HOLDERS' DATA REPORT FOR NUCLEAR PUMPS OR VALVES
- As Required by the Provisions of the ASME Code. Section (11. Div.1 Henry Vogt Machine Co., Louisville, k~t
. Manufactu ed by r
(Name and Aodress of N Cefilfscate Holder)
- 2. Manufactu ed for Enterry Opera tions. Russellville. AR r
iN mo.no aoo,ess of purenaier or o.ne,i Arkansas Nucleat One, Russellville, AR 3 Location of installation 4Neme ano Aooressi 1"
1" Outlet Site Gate Nominal inlet Site
- 4. Pump or Vatve (a) Model No. (b) N Certificate Holder's (c) Canadian Senes No.
Serial Registration (d) Drawing (f) Nat'l.
(g) Year or Type No.
No.
No.
tel Class Bd No.
Built 1991 B-4 84 80, R. 6 1
Cate 1-216313 gy 1991 B-4 5450, R. 6 1
Gate 2-216313 (2) 1991 B-48480 R.6 1
(3)
Gate 3-216313 1991 B-4 84 80, R.6 1
g)
Cate 4-216313 1991 B-4 84 80, R. 6 1
,c3 Cate 5-216313 1991 ]
B-4 84 80, R.6 -
1 p
j,fy
___ Gate 6-216313 1991 B-4 84 80, R. 6 1
Gate 7-216313 (7) 1991 '
B-4 84 80, R. 6 1
Gate 8-216313 gg; 1991 B-4 84 80, R.6 1
Cate 9-216313 g33 (10) 5 see,et casce.pi on of serme ter on.cn eowoment was ces,gnedi 600
- F or Valve Pressure Class (1) 6 Design Conditions psi ip< es ve,e j tiemper ature
- 7. Cold Working Pressu e psi at 100'F.
r 8 Pressure Retaining Pieces Mark No Material Spec No Manufacturer Remarks (a) Casungs
_j (b) Forgings B ody CA-2 S A 105 V0GT Bennet CJ-4 S A 105 V0GT
- Y 0 0-5 SA t&T Vc L T" (1) For manually operated valves only.
- Supplemental sheets in form of hsts. sketches or drawings may be used provided (1) size is 8 1/2' = 11' (2) information en items 1,2 and 5 cn this Data Report is included on each sheet, and (3) each sheet is numbered and number of sheets is recordec at toc of this form.
~
FORM NPV 1 (Sich)
Mark No Material Spec. No Manufacturer Remarts l
(c) Botting Cap Screw B7 S A 19 3 Gr. B 7 Texas Bolt (d) Other Parts l
Cate l
WAC S A 162 F6a VOGT (Chem. Oniv) 9 Hvoroirtatic test ps.
D.sh Dif terential test pressum ps.
CERTIFICATE OF COMPUANCE We ceristy that the statements made in this report are correct and that this pump. or valve. Conforms to the tults of construction of the ASME Code for Nuclear Power Plant Components Section til. Div. l. Edition 1977 _.
S '77 Sept. 27, 1991 Addenda Code Case No Date sgh J;[s y Hem hoh$ P.ac.We Co.
Signed 9 t. 7 N
1/6/93 Our ASME Cenificate of Authorization No to use the symbol empires no (Devel CERTIFICATION Of DESIGN Henry Vogt Machine Co.
Design information on file at Henry Vogt Machine Co.
Stress analysis report (Class t onlyn on file at Design specifications certified by (1)
CA 17061 PE State _
p,g go, Guy A.
J olly 3,,,,,,
,,,,,,,,,,,4 gy g 3 3 10416 PE State Reg No.
(1) Signature not required List name only.
CEftTIFICATE OF SHOP INSPECTION 1, the undersigned, holding a valid commitsion issued by the National Board of Boiler and Pressure Vessel inspectors Commercial Union Ins.Co.
Kentucky and employed by and the State or Province of Boston, MA have inspected the pump. or valve, described in this Data Report on of June 28, 33_91. and state that to the be st of my knowleoge and belief,the N Certificate Holder has con-5 structed this pump. or valve. in accordance with the ASME Code. Section lit.
By signing this certificate. neither the Inspector nor nis empicyer makes any warranty, expressed or impi ed, concerning Fu thermore ne ther tne inspector nor his employer shall be liab'e in.=ny the ecuipment described in this Data R o rt r
manner for any peisenat iniu y r pro.r/y damage or a loss of anv kind arising from or connected with this inspects r
OS 2 7, /
91 Dpp t.~ A L E i _-__r - m. m sns
- "L"97 f
- 9 "
1 i
FORM N!s 2 U FINDIE !! - Mhl u TCET MTISD ENG 021 06/30/09 FORM NIS 2 OWNIt'S RDORT FOR RDAfts OR REPLACDerfs As Required by the Provisions of the AsMB Cads Secties II 1.
OWNER Apat/trTrne opremmrt. Inc.
D&2I
/d-/- M I
Name ut. s. mer 1st e. nestftiVI. AR. 72801 NEET
/
of
-/
Address 2.
PLANT Auriittit IrDeivAn our WIT two
- l Name 1
RT. 3. ROI 1370.103gri t yft t v, A3, 72301 78, # 6d8*/3 S//
Address Aepair Organisatian 70 Bo., Job No., etc.
3.
WORK PERFORMED ST AP&L/E5rrtW ops.. Tue.
TTFE 0005 5D308, St&RP m/A Name
&UD M IZATI M NO.
E/A RT. 3, Roz 1370, RUSSE 2.LVILLE, AR. 72801 Address EXPIRATION D&TE m/A IDrutITICAT10N or STstEn fAurhatuutt Abb SnANu (2Fe d-/9) 4.
v v
5.
(s) APPLICABLE CONSTRUCTION CODE IM7ZT 19 d EDIT!cN, 8-79'
- ADDDM, NA CODE CASE (b) APPLICA3La EDITICW of $3CTICN II UTILIED FOR RDAIRS 04 REPIACIMDffs 19 84 G.
IDDTTIFICATION OF COMPQNDf75 RkPA1RD OR RD1 ACID AMD RDIACIMDft COMPEDffS "II' RD&1 RID' CODE NAME OF NAMI 0F MANUFACTURER OMER TRAR
- REFIACED, D
COMPONDfT MANUTACTURER SERIAL NO.
IDDrf1FICATION BUILT M
,1=4
.s
,Due=D,,
h l
Y NA 2SV-f*0 W Mf/ &
$tb l\\
r j
lN i
L l
j.
Ni l.
u l
h b
H H
H h
T.
DE$CRIttION 07 UORKhi+4bWJtDMlYWi H[O b Mll2h MN V
8.
TEST 3 CONDUCTED: HTDROSTATIC D FMEtMATIC D NOMINAL OPERATING PRES 5URE D OTHER O PRES $URE NA-Dei TEST TEMP.
MF
'T Supplemental sheets in form of lists, sketches, or drawings may be used, provided
. NOTE:
4 (1) size is 3% in s 11.in..-(2) information in items 1 through 6 am this report.is -
included on each sheet, and (3) each sheet is numbered and the nuitber of abests is-
. recorded at. the top; of this farm.
4 A
t
....... =
- asvaan 021 06/30/89-Pc M E S-2 (teck).
s, nocuss N/4 Applicele Manufacturer's Data Reports to be Attached 3
L4 3
i I
l czanncars or conPL2auts l
l I
I ve certify that the
- statements made la the report are correct and this-Jhahb oonfoms to the rules of the ABE Code,Section II.
l l
l l
repai'r er replacement i
i I
I i
Type code symbol Stamp 3/A l
1 l
l l
Certificate ef Avtberisatlan No.
3/A Empiratian Date 3/A -
-l l
Siped
)d b e Me~ ~
Date
/o
't 2--
,19,1,, l I
owner er owner's Desis ee, Title l
R. D. Gillespie - Manager,-Central Support
]l -
l
~
l 1
czarrncars or zusancs zustscrza -
l 1
1 l-2, the undersiped, holding a valid commissian issued by the sational Seard of_
- I l -.
Boiler and Pressure Tessel !aspectors and-the State or Prwince of l
l-ARKANSAS 4
and egleyed by *AlrVRICHT MUTUA1. INSURANCE CO.
I
_NORV00D. MASS.
ei l*
l-Ownerts Report during the period have laspected the camponents descrees in this4 as.
4-20-91
'te
/d ~.70 - %f
.)
1 and state that to the best of my knowledge and belief,-the Owner has-performed 1
l emaninations and takaa corrective measures described la this owner's Report la
-l l-accordance with the rewirements of the AIM Code, ses' tion E!.
I l-
~l l'
By aiplag this certificate meither the taspecter mer his employer makee any l
1 warranty, azpressed or implied, concerning the-saaminations and corrective measures i
' l:
described in this owner's Report. Furthensore, neither the Zaspector mer his-l l
employer shall be liable in any manner for any personal injury or pro ll or a loss of any kind arising fra gr connected with this laspection.perty damage l
l 1
- 9. 6l [EM FACTORY MUTUA1 SYSTEMS l
l Commissions-NS-9947, ARK-I133 "N" *18' 'A" l
t (2nspector's sapature I._
National Board, State, Province, and todorsements l J. O Date. Elliott 4
den /o aa ag g I-I l
l
~
FORM NIS-2
&PPENDIE II - M&S &TOET REVISD-ING-021 06/30/09 FORM NIS 2 OWNER'S RDCET FOR RDatRs OR REFlacEMENTS As Required by the Provisiens of the ASME Coes Secties II-1.
OWNER Apat/trTrner opreartcura, fac.
9425
/d M l
Name nr. s. ser ist a. amettw,. Am. n:On smT
/
or
/
Addr...
2.
F1 ANT inringts weetrin our wgy two Name RT. 3. BOI 137C. RDStet t vit t v. Am. 72301 M,
dO880888 Address Repair Orgr.nisatisa F0 No., Jeb No., etc.
3.
WOM PERFORMED ST APat/Estreef ops.. tue.
TTFE C008 f!tSQL STAMP R/A Base
&UDCt12&TIWR W.
E/A Rt. 3. Box 137G, RUSSEI.LYTLLE. AR. 72801 Address EEPIRATION 0425 E/A 4.
IDENTITICAT!oN OF ST3TER d
(f0d#-b 5.
(a) APPLIcAsLE CONSTRUCTION CODE lerM ZIf19Jfd, BITION, OS-7Z-ADDEND &,
wA c0DE case (b) ArrtIcAsLE EDIT!cN or sIcT!cw II UTILIZZD FOR REFAIRS 08 REFIACINDffS 19 P6 6.
IDENTIrtcarroN or ccMroNINTS AkPAIRED OR REFIAcED AND REPLACEMENT COMPCNDf75 A"
RDAIRD OTHER TEAR REFIACEDh"S**
IIIO"II' I.
NAME OF NAME OF M&NUFACT m 1 "a0&*
g"=4 coMroNixr M&Nuriervat s m ar. No.
returtneAfroN sors.T ce l
O,um-
.x l 30*Aths C. E, k
Rn K
NA Je ep so " / 10 Yadtad YES l l\\
l lN l
i c
i Ni i:
l N
L 4
h i
n k
- l DtscR1rttoN or woRKJbnend P7$ubtAh ZTEt /w 0f-00?
1.
/
8.
TESTS c0NDUCTED: NTDROSTATIC D FMItMATIC D NOMINAL OPERATING PRESSURE D OTHER D PRES $URE A/4-Dei TEST TEMP.
NA
'T NOTE: Supplemental sheets.in form of lists, sketches, or dravings may be used, Provided (1) size is s% in. x 11 in., (2) information in items 1 through 6 on tMs report is -
-included on each sheet, and (3) each sheet is numbered and the maber of sheets is e recorded at the _ top, of this form.
n t
END-021 asvansa 06/M/89-Ptml 528-2 (Bask) _
anaax de Applicable Manufacturer's Data Reports to be Attached Y B ttb (L A A K - b.A 1A A A,
t.
I l-I czartncars or emertzases l
l l
i l
We ce,rtify that the ' statements made in the report are correct and thia l
l Aum4>
conforms to the rules of the 135 code,Section II.
l l
repait er replacement I
i 1
l l
Type code symbol stamp n/A I
l l
l l
Certificate of Autherisatian Be.
N/A Elpiretien Date w/A l
Siped b >YLM Data
/C - E L-
, 19 l
owner er owner's Desimee, yttle l_
R. D. Cfilespie - Manager, Central Support l
l I
I czarzncars or zussav2cs zustscrza I
l I
2 the undersiped, holding a valid commissias issued by the setional Board of
- I 1
seiler and Pressure vessel laspectors and the state or Province of l
I l
ARKANSAS and employed by *ARKVRTCRT MirrDA1. INSURANCE CO.
I NORVOOD. MASS.
af l
1-ownerts Report during the period have inspected the e p'to /d d aa Mats described 4-m-g1 l-and state that to-the best of my knowledge and belief, the Owner has. performed
,1 1
l examinations and taken corrective sensures described la this owner's Report in I
l accordance with the requirements of the '&sME_ Code, Sec' tion'II.-
1 l
l-I l
ty siping this certificate neither the Inspector nor his employer makes any L
i warranty, sapressed er implied, concerning the a==Ntions and corrective measures ll 1
described in this owner's Report. Furthermore neither the Inspector mer his l
I:
.esplayer shall be liable in say manner for any, personal injury or property desage l-or,a less-of any kind arising fra gr commected with this' inspection.
l l
~l FACTORY MUTUAL SYSTEMS -
l
- 9. O d./169 Commissions N3-9947, ARK-I!33 "N" "18 "A" '
l I
(Anspector's sipature National Seard, State, Province, and todorsements !l I
Ji 0. Elliott I
Date d @ o,1 r 19h I
1 l
I
-9 L
k FORM N!S 2
' &PPENDIE II - N&lE& TORY REVISD 7MM NIS.2 06051'8 Ap0RT F08 Rparts-04 RDL&CDIENTS As ap. dred by the Provisions of the &SNI Code Section II 1.
0WNER Apatierrrner opre AT10rt. IEC.
D435
/d 92 Name at. 3. 102 137 c. RestritVT"*. AR. 72801 SMIT
/
ef
/
address 2.
Pt.hNT nerin u weetrin arr tar!T Two name nr. 3. nor inc. nessettYttre. Am. ns01
.IO,*OC8F076 Address Repair Organiset.ian 70 Se., Job No., etc.
3.
WORK PERFORMED ST AF&L/EBrftef cps.. tue.
TTPE 0008 5120L St&RP m/A Name
&DTHotIZhTION NO.
3/A RT. 3. Rex 1370 RUSSEI. LYT 112 AR. 72801 Address EEPIR&TI M DETE n/A L
4.
IDENTITICATION OF ST37EN
-St/WR?tAbb>E'[4 o[JDo $ - f')
v y
5.
(a) APPLICABLE CONSTRUCTION CODE 3efJ"Z2'~
19 1 D IT! W,
S /J ADDEND &,
NA CODE C&KE (b) APPL!cAsLZ DITION OF SECTION E! UTILIZED FOR REPAIRS OR REPIACINDrfS 19 M 6.
IDDrtITICAT20N OF COMP 0NDffS ADAIRD 08 REPIACED AND RDIACEMENT COMPONENTS 9
AINI 4
NAME OF NAME OF NhMUTACTURER ONht' Sph! RID 0008 OTHER TEAR REF1 ACID COMPCNDff NAWTACTVRER SERIAL NO.
IDert1FICATION RUILT OR ST&MPED s
REPIACIMDrT
)
f 5l.24!88 Me 6W-5082 Off Yass*W Ylus N
l L
l I
i o
J xi l
\\
h -
-p L
i.
h
]
h 7.
DESCRIPTION of MORK Awin6&Ain4ldid.obe(DbYMbkb_JMbaba e
v 8.
n5Ts cocucTED: NTDRosTATIC D PMEUNATIC D NONINAL OPERATINO PRESSURE D OTHER D.
PRES 5URE NA
'esi TEST TEMP...pA
'T NOTE:' Supp!amental sheets.in fans of lists, sketches, or drawings may be used, provided
-(1) size is 8% in, a 11 in., (2)' information la items 1 through 6 ce this repert=is -
included on each sheit, and (3) each sheet is numbered and the nunber of sheets is recorded at the top. of this farm.
1
SNG-021 agvassa M/M/M PCQN RIs 3 (teck) 9.
RonAK8 N/A Applitable Manufacturer's Data Reports to be Attached t
4 l
l I
I czanncan or couriynets i
I I
I we certify that the ' statements made la the report are correct and this I
NAMb conferas ta the rules of the ASIS Code, Sectian II.
l.
I repait er replacement l
I I
l I
Type code symbol stamp m/A l
I I
I I
certificate of Autherisation us.
3/A Rupirstlen Date
- 5/A l
siped J
/I_
Date aab
, 19 I
Cwner er owner's Desionee, ritle I
R. D. Gillespie - Manager. Central Support-l l
+
l j
i I
. csanncan or zustancs zustserzau I
l I
2, the undersiped, holding a valid canniasian issued by the National-Beard of
- I l
l Boiler and Pressure vessel laspectors and the State er Proviate of t
l ARIA 3tAS and esplayed by *nxvRic1T MttrUAL INSimANCE CO.
of l
l NORVOOD. MASS.
1 owner!s Report during the peried hsTe iBEted W coepocents described 18 thiSa4 %
4-?o-91 to /4-##-92
.)
I and state that to the best of my knowledge and belief, the Owner has performed I
i esaminations and taken corrective measures described in this owner's Report la I
l accordance with the requirements of the hsME-Code,; See^ tion II. -
I 1
I I
ty siping this certificate neither the Inspector nor his employer makes any I
warranty, empressed er implied, concerning the ama=Ntions and corrective measures li -
I described in this owner's Report.
Furthermore, neither the Inspecter nor his l
l employer shall be liable in any =amar for any personal injury or property damage _
l I
er,a less of any kind arising from gr ceanected with this inspection.
l l
FACTORY MUTUAL SYSTDt3 l
- 9. O. [./4h Camaissions NB-9947 ARX-r133 "N" "I8'? "
l A
l l
(Jaspector's sapature National Seard, state, Province, and Endorsneents l 1
Dbe
- bem u 22 19,Li, I
i I
9
i FORM NIS-2
' &PPENDIE !! = Nh3R M W Y RETIsEn-RNo o21 M/30/89 FORM N!s 2 OWNER'8 REPoE FOR REP &fRS OR REPuCEMENTS As Required by the Provisions of the ASME Code Section El 1.
OWNER Apat/orTrner openations. ruc.
MER
/4 - #~ M Name RT. 3. ter 137 c Retrvt tTTtiv. AR.,,Zjigl SMIT
/
of
/
Address 2.
PLANT anrngts WDet win our WIT Two j
Name Itt. 3. BOI 1370 RUSItttYTttv. 11. 72801 E 8.
OC87.394V Address Repair Organisatian 70 No., Jeb No., etc.
3.
WORK PERFORMED BT APat/rserner on.. vue.
TTPE C005 81 2 0L ST&MP n/A same
&P!NotIZ&Utaf 30.
- t/A RT. 3, Box 1370, RUSSELLVII.I.E. AR. 72801 Address EIPIR& TION D&TE n/A I
4.
IDDf!!TICATION OF ST87EN
/d d 8 8 "
5.
(a) APPLICA31.2 CONSTRUCT!cN 0005 4 0
19d EDIT!Caf, /Ap. /4 Z ADDEND &,
NM CODE C&st (b) APPLICABLE EDIIICN OF SECTICH II trf!LIZED FOR REPAIRS 08 REFIACEMENTS 19 8d 6.
IDENTIFICATION OF COMPQNDfr$ REPAIRED OR REP! ACID AND RDL&C3 MENT COMPQNDITS 1
REP & IRED M&MWnI' HAME OF NAME OF M&WFACTURER OTHER TEAR REFIACID, "
COMPONDff M&WFACTURER SERIAL N0.
ISBNH FICATION BUILT 03 f4
=-
.s
-,mCE INr l
NA-NA
- fett-9-1-NS. /97/ U
$l
.l 1
l l.
'~
!N l
I i
l xi i
u j:
i N
n a
c i
i c
I 7.
DESCRIPTION OF WORK Y M
//1HJW1##2 dis k
/
't
/
/
/
l 8.
TESTS CONDUCTED: NTDROSTATIC D PMEWATIC D NOMIN&L CPER& TIM PRIESURI D' OTHER Q PRESSURE M4 Dai TEST TEMP.
N$
__'F NOTI. Supplemental sheets.in form of lists, sketches, or drsvings may be used, Provided (1) size is 8% in. a 11 in., (2) information-in items 1 through 6 on this report is -
L
' included on each sheet, and (3) each sheet is asambered and the manber of sheets-is
. recorded at the top of this top.
~
l
i
,ING-021 asvasse-06/30/09 FCEN NIS*2 (Seck) 9.
Annax$
Ad8
,511caLAe Manufacturer's Data Reports to be Attached 1
czanncars or courLIAma I
I i
I I
l We copify that the
- statements made in the report are correct and this l
I
.AfAtt/v conforme to the rules of the Aas code, Se tian II.
1 repast er replacement l
I i
I I
I Type Code symbel Stamp N/A I
1 l
I certificate of Autherisattaa No.
B/A Eg iratian Date w/A l
1 l
Siped d
O Mw Date
/O ~ E L
, 19 I
owner er Owner's Desisee, yttie l_
R. D. Gillespie - Manager. Central Support I
l_
i I
l carnnears er zussancs zustscrzan I
l l-l 2, the undersiped, holding a valid esamissian issued by the National Board'ef
- 1 l
Boiler and Pressure vessel Inspecters and the state er Frw1 ace of I
l-ARIANSAs and employed by *nrvnicar MirruAt twstntANCE CO.
i 1
MORVOOD. Mass, Of l
I owner!s. Report during the period have inspected the campements described in this4 as.
4-70-91
'to
/0 Md -94 I
and state that to the best et my knowleeps and belief, the Owner has performed
.I-
-I examinatiens and tahta corrective sensures described in this owner's Report-La 1
I l
accordance with the requirements of the ASME code, see' tion II.
.I l
I ty siping this certificAM neither the Ins l
.l warranty, expreased er implied, concerning the =pecter nor his employer makes any
=l
==Ntions= and corrective measures t 1
-described in this owner's Report.
a Furthermore, neither the Inspector mer his l
1 i
employer shall be liable in any manner for any personal injury or property damage
-1 er a less et any kind arising from gr connected with this laspection.
1 j
I
-l
- 9. h. [./ @
FACTORY MUTUAL SYSTDtS j
Comunissions NB-9947, ARK-I!33 "N" "I "A",
1
(/laspeeter's-31pature National Seard, State, Province, aad todorsesents !l I
J. O. E11toct i-Date o em :22 It h I
1 l
I
t FORM N!S-2
' &PPENDIE !! - MMID& TORT REVISD FORM NIS 2 068tD'S RD0ET FOR RD&fts OR RD14CIMElfr$
As Required by the Provisions of the ASME Code Section II 1.
OWNER AP&L/ ENTE 12Y OPr'affmrt. INC.
M2R
/8-Y-fM Name RT. 3. ter 157 c. testettvr"'. AR. 72801 SMIT
/
of
/
Address 2.
PLANT avran u wecteam our W827 Two Name RT. 3. BOI 137C. RUSIFf t Vfit t. A1. 72001 M. 0080 68d[
Address Repair Organisatian 70 No., Job No., etE '
3.
WORK PERFORMED ST AP&L/ENrvecT 071.. T1re TYPE C005 31390L STMIP n/A m-Name
&DTHORInTICII NO.
u/A RT. 3. Box 1370, RUSSELLVILLE, 11. 72801 Addr.ss IDrun0N at
.ii 4.
IDDTIIFICATION OF SYSTEN.NRid6 add > bf8dM-/4) 5.
(s) APPLICABLE CWSTRUCTICII CODE.Idin 192 EDITICIf, S-/f7f ADDEND &,
NA CODI CASE (b) APPLICABLE EDITICtf of SECTICN EI UTILIZED FOR RDA. IRS OR RIP!ACEMENTS 19 86 6.
IDDerITICATION OF CcNPounrrs uPAIup Ca ROL&cID AND ROIAcIxprr Cenpapits ASME
. REPAIRED NAME OF M&ME OF MANUT&CTURER OTHER.
TEAR RI,tACID, g
STAMFD COMPONENT MANVFACTURIA SERIAL N0..
IDENTIFICATICII BUILT M
y;;3 D,ue
.s h'W lW h
(> 7 NA 2SV-W 36
? '/990 $ m bid bl j\\
l l
i 1
- H a
l
\\
l h
l 0
N h
!l l
7.
DESCRIPTION OF WORK Mo M V w w//d M 2 d-
- NM EzI M,
u 8.
. TESTS CONDUCTED: HTDROSTATIC D PMEWATIC 0-NC8LIMAL CPn& TING PRESSURE D OTHER D PRI55URE NA osi.
TEST TEMP.
A/4
'F NOTI: suppIsmental sheets in form of lists, sketches, or drawings may be used, provided (1) size is sh in. x 11 in., (2) information in items 1 through 6 on this report.is -
included on each sheet, s.od (3) each sheet is ntaubered sad the maber of sheets is (recorded at the top. of this form.
~J ml~
1 u
asvaasp co-on 06/30/st FCEN E18 2 (teck) 9.
RIM 1AR$
8[/
l
/ Applicable Manufacturer's Data Reports to be Attached s
I l
I atanncars or courLzaNes l
I l
l we certify that the"ststements made in the report are correct and this l
l Are44v confetas to the rules of the Aas code,- sectian II.
l l
repair er replacement l
1 t
I l
l Type code symbol stamp m/A l
1 I
l Certificate of Autherisatian No.
M/A Empiratian Date N/A l-l signed
/[ /d m.-
Date
/ o -
- t- -
. It I
owner er owner's Desio6ee, fitle l
l R. D. Gille'spie - Manager, Central Support l
t i
I I
. carr!F2chTE OF IMEIIVIc5 ZMEPSCTION l
1 l
1 2, the undersiped, holding a valid commissian issued by the National Board of
- l l
Beller and Pressure Yessel Inspectors and the State er Proriace of l
1 ARRANtAS and employed by *nxvRicHT MirrtfAI. INSURANCE CO.
of
~
l NORWOOD. MASS.
have laspected the scoponents described la m
i owner!s Report during the peried A-?o-91 to
/#-16-PJ
,1 I
and state that to the best of my knowledge and belief, the Owner has performed I
-I examinations and taken corrective measures described in this owner's Report in-I accordance with the re pirements of the AsME code, section-II.
-l l-l l
I-By siping this certificate neither the taspector mor his empicyer sales any.
warranty, empressed or laylied, concerning the examinations and corrective measures ll-I I
described in this owner's Report. Furthermore, neither the Inspector nor his
'l-
-i esployer shall be liable in any manner for any personal injury or pro 1
er a less of any kind arising from gr ceanected with this inspection.perty danege -
I
-l l
FACTORY MUTU/1 SYSTEMS
-l
_l
- 9. 6. dM Commissions ws-9947, ARK-r133 "N" "IP "A" l
i 4nspector's -sipature National Board, state, Province, and Endorsements l o
I J. O. Illiott_ L & u.2 2 I
I Dato c/c 19 g 1-1 I
t l.
u l
b
}
m..._-_
i
~
-FORM NIS-2 APPENDIE !!
- M&lS&TOET RITISD ENG 021 M/30/89 FORM N!s.2 040tn's RDot? FOR RDalts OR REPL&CDerTS 1
As Required by the Provisions of the AsME CoosSection II 1.
0WNER AML/ENmcf OPr* Affort. Tuc.
8425
/d-f- M Name RT. 3. nor 137 c. Retrettvf"*. Am. 72801 SIERT
/
of
/
Address-2.
PLANT anriittil NDet'At DEI INIT Two Name RT. 3. ROI 1370. RUS$FtLYTffT. A1. 72901 M. Od8803 FC Address nepair Organisatian 70 Se., Jeb Wo., etc.
3.
WORK PERFORMED ST AP&L/EstERCT ops.. Inc._ TTFE CODE EDSQL ST&MF m/A Base AUINORIZATICE h.
E/A RT. 3. Box 137C, RUSSELLVILLE, AB. 72801 Address IIFIR& TION D&TE n/A 4.
IDorrIFICATION OF SY37ER ddxt3fldadmaL
(/NdB-45) 5.
(a) APPLICABLE CONSTRUCTION CODE f
19 7/ EDITION, S-78 ADDEND &,
A/#
CODE CASE.
(b) APPLICABLE EDITION OF SECTION EI UTILIZED FOR REPAIRS OR REPLACEMENTS 19 &/a 6.
IDENTIFICATION OF COMPONDrTS SkPURED OR REPLACED AMD REFL&CEMINT COMPEDffS AINI RDAIRED "IU" CODE -
L NAME OF MAME OF-MA NFACTURER OTHER TEAR RIP 1&CID COMPONENT MANVFACTURER SERIAL NO.
IDOff!FICATION WILT M
f4
=-
RDuce.fr
.s 1,f" etb.,
idef-
'l u
i l 6tk.
14%nw l J %7f No l26 V-+'H0-2 _ '/FW Ausk Uit l l
?
l l
!X i
l j
x!
u 1
i i
N u
o u
n 9
1 1
~
i 7.
DESCRIPTION OF MORE A1)*+ M N % w ntlb b w U b lbfAls DM/ob.
l V
8.
11375 CONDUCTED: NTDROSTATIC D FNIWIATIC 0 -
. WCMDIAL OFDATIM PRESSURE O.
OTHER O PRIs5URE NA psi TEST TEMP, A/A
'T NOTE: supplemental sheets ;in form of lists,- sketches, or drawings may be used, provided (I) size is 8% 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 sheets is
, recorded at the top of this_ form.
L4
asvansa spo-cal-06/30/a9 FOM 515=2 (Back) 9..
nasass WK epplicable Manufacturer's Data Reports to be Attached I
l I
csartricars or ccecrLIAutz l
1 I
I We corpfy that the
- statements made in the report are correct and thia l
I ArAm*
conferns to the rules of the ABS code,Section XI.
l l
repair'er replacement l
1 l
l l
l Type code symbol stamp N/A l
1 l
l Certificate of Avtberisatian us.
M/A Eg iratian Date N/A l
1
'siped 10O
/[e_,a
, Data n-tt 19 l
owner er owner's Desi nee, title l
l
~. D. Gillespie - Manager, Central Support l
R 1
l l
1
. carnnears or Inssevzcz zustscrzan 1
1 I
I I, the undersiped, holding a valid commissian issued by the Natiemal Board of
- l l
Boiler and Pressure Yessel laspectors and the state er. Province of l
1 ARIANSAS and employed by *nxWRIGHT MITTUAI. INSITRANCY CO.
of l*
I I
NOWOOD. MASS.
have laspected the semponents des:ribed la this:4 as.
l l
ownerts Report during the period 4-?o-91 to
/818-f4
.l 1
and stato that-to the best-of my. knowledge and belief, the Ovner hae periormed l
L I
esaminations and taken corrective measures described in this owner's Report in l
i
-l accordance with the requirements of the AIMS code, Sec' tion II.
l 1
-l l
ty siping this certificate neither the taspector nor his.emplorer nakes any:.
warranty, empressed or implied, concerning the an=N ions and corrective asasures ll l
t I
described in this-owner's Report. Furthermore, neither the Inspector nor his -
l I
esployer_ shall be liable in any manner for any personal injury or-property damage' l
l-or a less of any kind arising from gr esenected with this inspection.
l l
FACTORY MtrrDAL SYSTDtS l
l
$ O. [,l/69 commissions NB-9947, ARK-I!33 "N" "18' "A" l
l (taspector's sipature sational soard, state, Province, and sadorsements l I
J.-0. Elliotb e h a I
I Date 199.1.
I-l-
.i l.
FORM NIS 2
'&PPENDIE !! = M&lS&TOET REVISD FORM NIS=2 Ot8tER'S REPORT FOR RD&Its OR REP!&mMErrs As Required by the Provisions of the ASME Code Section II 2.
CWNER Apat/rwTrnef openAttorn. TEc.
MIR
/0-f-f/
Name RT. 3.102 117 C. RU5fft t VT1. AR. 72001 SMIT
/
of
/
Addren 2.
PLANT anr o t in En ct rAn oirt r!T Two W
Nam 8 RT. 3. BOI 137C. RUllet t Vit t e. AR. 72001 18, dC8M8M Address Repair Organisation 70 No., Job No., etc.
3.
WORK PERFORMED ST AP&t/rsetscT opt.. Tue.
TTFE C006 STISCL St&MP R/A Name EUTHORIZATION B0.
E/A RT. 3. Box 1370, RUSSELLVILLE. AR. 72801 i
address IIPIRATION MN E/A 4.
IDENTIFIC& TION OF ST37EE YAldatz b>b b hFo8-/h v
v l
5.
(a) u?LICABL2 CONSTRUCTION CODE luI8 191 EDITION, W-7#
- ADDENDA, NA CODE CASE-l (b) APPLICASLE EDITION OF SECTION II UTILIZED FOR REPAIR $ 01 RDIACIMErfS 19 86 6.
IDENTITIC& TION OF COMPONENTS AD& IRED OR REFL&CID AND REFLamMErf COMPCDZENTS ASME R&TIONLI' CODE NAME OF NAME OF M& NUT &C WRER OTHER TEAR RE i
ST&WED j
COMPONENT MANUT&CfmtER SERI&I,30.
IDerTIFICATICW SUII.T OR
=.
.-2
,7 opg,
.s LkH wllb IA-8 94f' NA 2.T%~ $0 lfW da/nd
$11 i
J krtkwl/
SA-N 7 NA 2S% ~ /0
'/974! ltafamet*/
IN c
- x<
i N
c o
o n
L j
e
-7.
DESCRIPTION OF WORK h-8M[ a440M MMd
/
/
8.
TESTS CONDUCTED: NTDROSTATIC D PNEWi& TIC D NOMIN&L OPER& TIM PRES $URI o CTHER O PRESSURE N#- Dei TEST TEMP.
N4
'F
' NOTE: Supplemental sheets la form of lists, sketches, or dravlags may be used, provided (1) size is e% in m 11 in., (2) information in itses 1 through 6 em this report is -
-included on each sheet, and (3) each sheet is, numbered and the-tnaaber of sheets is
( recorded at the top of this fam.
e 1
' - ' ~
" ' ' ' ~ ' ' ' ~
~
~~"'~ ~
h021 m &&ED
- l#/#
FONT NIs 2 (teck)
A p tr-/l 27M_f s.
manaus W11caMe Manufacturer's Data Seports to be Attached g
-g i
czannem or ccMPLtants 1
1 1
I We certify t the' statements made la the report are correct and this l
l A1A senferns to the rules of the ARE Code,Section II..
I I
rep 61r er replacennat 1
i I
l 1
type Code Symbol step N/A l
t l
__ l l
Certificate af Authorisatian No.
N/A Empiratism Date w/A l
signed [d[
r/d_,
Date u-2s
, 19 I
owner er owner's Designee, yttle l_
R. D. Gillespie - Manager Central Support Ij i
1 l
carnnCm or zussancs Instscyzou l
l.
l 2, the undersiped, holding a valid commtission issued by the Natissal neard of '
l'
=
i
'l Seiler and Pressure Tessel laspectors and the State or Prerinee of 1
ARF # tAS-l I
and suployed by *nrvntent MUTut InstntANCE CO.
nowoon. MASS.
of l
I ownerfs Report during the period bsTo inspected the compements described la this.4 as.
4-?o-o to
/#-Jo-9I
- l and state that to the best of my knowledge and belief. -the Owner has performed
,1 1-emaninations and tahan corrective sensures described in this owner's Report in l
I i
accordance with the requiraeonts of the ASME Code, Sec' tion s!.
I l
1 l
ty siping this certificate neither the Inspector nor his esplayer makes any 1
varranty, espressed or lay 11ed, concerning the a===Mtions and corrective measures ll I
described in this owner's Report. Furthermore, neither, the Ins employer shall be liable in any manner for any personal injury.pector mer his l
l 1
or a less of any kind arising from gr eennected with this inspection.perty damage
-l or pro l
l h.& [.//M FACTORY MUTT!AL SYSTEMS t
l Commissicas
-l 1 -(Jaspector's $1pature W3-9947. ARK-I!33 "M" "1" "A" I
Nationa15eard, State, Province, and Endorsements l J. O. Elliott I
Date dc h :;t.
19 1 I
1 l
e I
_ ~ - _.--_ -.
i C m RECTED Cort #
I
'CTRICTED CERTIFIcJ.7E OT Alfr50RIZJ.TIO!I 1%PIRATIDil DfTE l
f 0101 NI'V.111 MfAC1 t'ltl.ils' H tTT lll.I'UllY I Olt NLCt.1;4tl l'l3f t's 011 \\ Al.) L5.,1 S*I ~ 6 0 t
L p
As llequired 1,3 61., l'en i.io....' ike \\4ti; C..Je it.i.
- fr J4 86f w._._ _ _ - - - _._ ~
Bocivoll P.anuf acturirg Covpony Pe 0, Pos.$.%, %1g.yr. 4Th,.".;s 2tn.sL]S t(p, 9,,,, y- - ft.5gq3 ',
i i
- s. u. t
..<,4 t,,__
....e u.
in-.
Itechtel Itreer Ccrporatios Ik Q,.Iox 39552_0sLTWnetsa.Mifm1, et,1t h,3,,,_fff,q. g tg.cg
- 2. w..
- m... d t., -
i n -.... a u.....
Att.enses Pcrser and I.icht (bopeny I'e_0. Jox.I'59,.Ib.ptpMvi)1ta.st)Jna tJ_72001 ifait n.r:bar ?so
- 3.,- se e _
Artenso.c !N: lear Ontf p
tee.<i..etrsene 1n d ano,J 2 &T.9:8 7tLh'l 4.
b JA867 nru JACy(,,,,,,,,,,
'%* S. r..r., v.t.. th ietr... ;..121)_,_1,"D.M71 F31671 Velve s Serial ihr: ers O
L f-1 Rockve11 l'onufacturins Company Assembly fot INnber B357-1
. i i...e................ e.,... 6.......... a..
g h,
D David !!. Thorneou y
(.pt>,..ia: N... P") 7 3 1 8.,c y. A p,, p,,,a g M'
.;- ;p C
v.
y00.,
- m. Nedea.1 Deu.f %.'
.,s M " * *.,
. 2,21 0_
,_,_ p,3 _
' h
( t>e.ir c.aJ;.i....
e e.....,
1 o.... i o
7, 16, e m... ii.i.t.. i s.. c.....< d..... J. t..i.is...,.,r li' *
- id' AWi C a'h '= ' t ie a Ill C l * * *. -
g
{,.
y
[
6.t n..
,_.I. '/O _ *
, A.'Jr..ia ().,, DOCCCher )l,,J), P *, g,, _,,,,Jon?
7 j
E.
e...,6.
s u.i.,.i s,...e4..
u <
u.o n..
[
t oi r...b.
O!fN'~ I,f[GN-1 Consolidated lie at E'
I filveIIic3o f
-~.
N
~
Q'd
. ~., _..... ; -.
0
[ * }M_si,,,(dk6
- r ms.m.
h
.I O_l b. h.,-. h 0. - ~
ENIEb W*1*98*.131..- IM.8.F.fgr,g_
--U _...Miin't ~' Anet _eny._I4ai, lum
=--
_ h 9
3 w._....
y 3
- -4
+k.i.
f.yo h['f 9
I-
]
&i;Q-.ww x_= = ---
o.
l'0IDI NPWI O,.ek)
/,
...n.i s.e....
q t i s.i i.
9
\\
~_
Heat _ tag F b _
... pi o l.e. r....
.s11iK-T-31f2 carpenter
$j DhtC7ttra SFA.3 913316 Teledyne l'.cKay Eest 1213C Sdd_nueT_
b
=
Iy g
E 1{
_4
....,e..
- .. yJ
- s. u, J,....i e e s. __$_1.0_0
-._._._ r. i.
CLitTil~lCNI10\\ (11' lil31GN Sult ur 0,*>r. in.C: e.T.e..x.a.s...
h Co-cony i
y
.n i s.
f,.....a t.: e...B.ockvel_1_.l.u..n_u.' a c.t.ur_n. g_ _. _. J..__
...._ 1.1.1.pnuf gciur_ig coneny,_Ggi4Lr,gri,ncp,_lexo.c_105 i
- i ne..
0 O
sue.....i,.;. n s...a f.it.. Jo.CD:
__ g i, p.,,,,,,, s,.,,7c yp,,,,,, u.,.,Q
'W\\
ns.is.pe c ific.iie......iivie J t i- ). it. Ic onnrd,.ir. _ __ g si,,,,,,,,,,,3,,,,,Te x eg g,,,,y,,,J M M
cavid H. 'inerneou sue.....i,si..eren eeniinJ t.,
( 1) Sis a *i aa' " s="* J I i'i a a
- e 'al.
t
.Jf C
!Q@
t. e e na, o..
ii., si ni.
e ais ei. iJe.., ii.is n poei ee c onee s.
,/
/ /,,
.. /.*?
I
_ 5 5neJ yochu311 Ng._ C[ppj:ny, p, hp
.t.-
n.it /' M '_*/ C.,7.C I
<w...n..
II*3b7 e.pi,,,_Jonutry 11, 193 y,
ce n;t.. e.I A,it.is.ii.. x. _
7
- g. *'.
ycy CEllT lt'lC.\\11'. Ol' 5110!' IN $l'CCTION m'
i, te i,.Je. ired, beidies e i.ti.i c eiimi..i.a i...eJ br the Nealeal Desed *I l'aile' ead Pe**. te W. s ee****o.
si ne.it e..ni< e et._... 'T02 D P -
. J esirleyeJ br.IAL**'f*CD8 l'uluel Coevo
.t.
. M U.03oye.,fil'.ngip,,, 0f1 k... i.. p. e.,a 6,,,p,; p,,,,.. J,,,,;g, g ;. u. n.,,
..J/., ike
./.-
th a t so the bepe of saw naceleJse.nd i.cliel..he stanuf steeste R epan en..... d.~M. -,,1rmiet ia se c ewJ ac e aaJ stait nh abe art ecable fekstetiva s et AWL CoJ c. %ec tiva 111.
v.. e v s oveJ th s < *i".*f.c as. n< nt er el.e latti.*ine noe l.it c a.rl n t' d e * *at * *an't. e s per sseJ et implieJ. e poc l
0" a
i l tt ia.nt in g i.c e qui.i at Je w obe.1 i.i ebu Daia i< eren, i vol.ennoer, ne n;.i s it.c la tre8 **' **' h's e*<rlore' p,.i g,.ie.g it... e n iii d i. insp seiere.
f.*
J4 mage t e e less of say Lin 1 meisisig le..is os cent.ecicJ t
i S'
sn.nnee (o,.ag pg eseast se rve, or re.ye se)
J t
d~c20-
- i,2p n.,e y
TcE.8_S91 I
J
.d-c.n,,,s..i...
(m u.a.: i....e. si.i.. r e..iu e 4 p._)
' ti. ri M
y
%at T his f a = (l')f) is ete.ineue 1,.= i.e AS.tk. Hg g, afin $<., pre T ed. N.Y.16011 riini.e in V.S. A. (?/t in 1
hh'&
E');Z Nd,';ik
%A m L:#2Z LN[M % %-g QQ } g [
N
(
ToRM HIs.2 D FEND!E !! = M&ND& TORT MTISED 06/30/R9 ING 021 FORM N18*2 CHKER'S REPOU FOR REPATRS OR REPLACENDf75 As Required by the Provisions of the AIME Code section El 1.
OWNER Ayst/twinct orn1T10WI. TEC.
DATE _ /8" 7-II Name mt. 3. vn 137 c. resrrttnttr. u. neot surf
/
er
/
Address 2.
PLA.VT nri.xsts rDetne our tafIT Tvo Name
~
RT. 3.10I 1370. RUssrttVit t r.11. 72:o1-50.
60 # 7f4 3.2
&&iress Repair Orgeaiut.ian PO M., Job No., etc.
3.
WORK FERT0MID IT AP&t/ntnct opt.. Tve.
TTFE C00f'. STMDCL STAMP M/A name AUTHORIZ1710lf NO.
1/1 RT. 3, Box 1370, RUSSELtvitLE. A1. 72801 A&iress EIPIRETICIf DATE v/A Y456 ae (.7EFB-9) 4.
IDENTITICATION OF ST3 tdt 5.
(a) APPLICABLE CONSTRUCTION CODE I1 M. I 19 W EDITICIf,
.f-/fM
- ADDENDA, J S/ 6 CODE CLSE (b) AFFLICABLE EDITION OF !!CTION EI ITTILIZID FOR M711R$ 08 REFLACIMDftS 19 PS 6.
IDENTITICATION OF CQKPORDft1 RE?i2 RED OR RIFLACED AND REPLACIXDff COMPCEDITS REP 11 RED N "
I e
NAME OF NAMI 0F MANUTACTURER OTHER TEAR REPM CED STAMPED COMPOND(I KANVTACTURER SE11AL Wo.
IDerTIFICATI0tt WILT OR a.
,Mrac=xDer J",,;>
.s l
I 1
u M*M/
l l
l /0
1%ya# wb'm l AN-M2 up R V- /0s2 M 7(J Oe da w ex H <//L l llax I
{
i 1
j N j
i n
1 i
i I
i N
1 1
DISCR!? TION OF WORK M,Mbtob.) Mob 2'L.
7.
u 8.
TEST 5 CCHDUCTED: HYDROSTATIC 0 FMEUKATIC D WOMIX1L 0FruTDfG PMS$URE)(
OTHER o PRIsscu _ #0 o psi T1st u xP.
Se,/ 5' _'F HOTE: supplemental sheets in fons of lists, sketches, or dravings may be used, provided (1) site is sh in. x 11 in., (2) inforsatico in items 1 inrough 6 co this report.is -
included on each sheet, and (3) each sheet is runbered ssd the tramber of sheets is
. recorded at the top, of this icmn.
- L _ - _ ____--_-___-___-_-_____-________--____--____-___--__________-____-_
... o. -.
asvasso Dio 021 04/30/99 Poss K15 2 (Back) 9.
xtxxxF.s A//4 Applicable Manufacturer's Data Reports to be Attached Acllwab24dM [Y6' 3'28 9V i4 U.754 M W Ktw M-p u
v fl/g Pl ?3'y).
I i
i canIF2c m oF ccMrLIAncs 1
I l
l We certify that the ' statements made in the report are correct and this i
I M /Au&rmn#
conforme to the ntles of the ARE Code, $+ction II.
1 I
4epair 1st replacement 1
1 1
l l
l Type code symbol stamp N/A l
I l
I certificate of Authorization Ilo.
y/A Empiration Date w/A l
sigrad N h
_ L/t, =
Data
- / /- 9
,19f,2-l I
owner or ovoer's Destgoes, yitle l
l_
R. D. Gillespie - Manaver. Central Support l
l 1
. --cm o, --c. -,cno.
I l
l I, the undersigrad, holding a valid e-hsino issued by the National Board of
- I l
soiler and Pressurt Yessel Inspectors and the state er Frwince of l
AM.AMAS and employed by *AMVRfCHT WTUAL INStrPANCE CO.
of ~ lI I
NORu00D. MASS.
hatt inspected the coupcoents described in thigg at+
l ownerts Report Artag the period 4-?o-91 to
/d-#0 - 9A
.I l
and state that to the best of my kncvledge and belief, the ovner has performed l
I examinations and talan correctin mearures described in this owner's Report in l
I accordance with the reedrements of the AsME code, section n.
1 I
l I
sy signing this certificate neither the Inspector nor his employer makes any varranty, empressed or implied, concerning the naaminations and corrective measures li I
I described in this owner's Report. Furtherisere, neither the Inspector por his 1
I employer shall be liable im any manner for any personal injury or property damage 1
I or a loss of any kind arising from gr connected with this inspection.
I i
FACTORY HUTUAL SYSTDiS l
l
- 9. O. E M Ccomissions M-994 7. ARK-T133 "N" "1 'M '
l l
paspector'ssignature National soard, state, Province, and Endorsements l Date
- 11/9 19 9.1
,1 1
FORM NIS 2
&PFIND!I!! = MhlEMOET RETISD ENG 021 06/30/89 F0DI If!S 2 Ot8tn'8 RD0tf FOR RDAIRS OR REFuCEMDffs As Required by the Frevisions of the AsHE Code sectian II 1.
owNu Apat/Extene openittern. rue.
8425
/4-//- 94 Name nr. 2. ner ist a, ressrtteru.E. AR. neat sMarf
/
et
/
Address i
2.
PuMT intants wuct ein our tal!T two Name JM 808 ~/8fd 9 RT. 3.101 137c.103 set t yTt t v. Am. 72801 Address hepair Organisatian 70 No., Jna,3 etc.
3.
WORK PERFORMED ST AFat/rztene ops.. w.
TTPE 0005 513908 STnMP BfA same
&PDICAIET!W M.
E/A RT. 3, les 137G, RUS$t1177113, AB. 72801 Address EIPIRATICII DME n/A 4.
1DDCTIT1 CAT 10N OF STSTEli
$A W M1L Y
{ACCA-Sh 5.
(a) APP!.ICABLE CONSTRUCT!Cet CODE OM 5 19 D 172018, J~ 79 ADDENS&,
A/A CODE CASE I
(b) APPL!cuLE DITICIf 0F EICT! Cat II trTILIZED FOR RDMRS 08 REPuCENDffs 19 86 l
6.
IDENT1T3 CAT 20N OF COMPONDff$ RDMAD OR REFT &CID MED REFuCEMDIT CWEPEDffS RDAIRED N& Wh!'
e NAME OF M&ME OF MufvFACTURER OntER TEAR REFu CED,'
ST D
COMPONDff MANVT&CTURES SE11&L NO.
IDDrTIFICATIC0f WILT OR
=.
=,ua,iDrr Ja4
.s Y
Y A
NA
.1514 S00/- ). /98/ lbwEld 8'M.
>L I
i
.I l
N l
l
\\
j
]
u u
p 1
ll 7.
DESCRIPTION OF WORK 8MfM/M *MtW//40 N WM/>MWlad, i
8.
71175 CONDUCTED: NTDA0$7& TIC D FMEWATIC D DOMIMkL OPERATIM PM55URE D l
OTHER D FM55UM NA-psi TEST TEMP.
N#
-'F NOTE: supplemental sheets in form of lists,. sistehes, or drawings may be used, provided (1) sise'is 8% la. s 11 in., (2) inforsation in items 1 through 6 on this report.is.
included on each sheet, and (3) each sheet is numbered and the staber of sheets is
. recorded at the top, of this fois..
. l-.
. =
= -
asvaaED xm-021 06/30/st FCIDI Es 2 (Seck) 9.
RDn3It Al A Applicable Manuf acturer's Data Report.s to be Attached
~
I l
I crutncus oF ococrLIAmer l
I 1
i We certify that the
- statements made in the report are carrect and this l
l At/rea conforms to the rules ef the EIS Code, Section KI.
l l
repair 'or replacement i
I I
l I
i Type code symbol stasy w/A l
l 8
I certificate of Authorizatico No.
y/A tupiration Date N/A l
1 Sipwd
/\\b[+
MA Data
/* -7 L
, 19 I
ovner or owner's Desirmee, Title l
l R. D. Gillespie - Hanager. Central Support l
1 I
I
. czutncut oF Det*NICI Dt1?scy1CII l
t I
l 2, the un6ersigned, holding a valid cometissian issued by the National Soard of
- l l
Boiler and Pressure Yessel Inspectors and the State or Prwhee of l
1
_ ARIAN1A3 and employed by *DXVRfCHT NUTUAL INSURANCE CO.
of l
l NORWOOD. MASS.
have inspected the components described in this.'4.m I
ovnerts Report during the period 4-?o-91 to
/4 -## '- 92
.I l
and state that to the best of my knowledge and belief, the Ovner has performed l
l examinations and tale.n corrective sensures described in this owner's Report in l
l accordance with the requirements of the AsMr code, sec'tlen II.
l I
I l
87 signi.ng this certificato neither the Inspector nor his employer makes any varranty, azpressed or implied, coocerning the azastbations and corrective measures ll l
t I
described in this owner's Repert. Furthermore, neither the Inspector nor his l
l amployer shall be liable in any==r for any personal injury or property desage I
I or a loss of any kind arising from gr connected with this inspection.
l l
FACTORY HUTUAL SYSTD(S l
l l
- 9. O [.fteD Commissions N3-9947. ARX-T133 "N" "1" "A" l
l l
6 inspector's signature Natlocal Soard, state, Province, and Endorsements l I
I J. O l
1 Date_.Elliotber@
.?,1 1991.
l 1
l a
l l
\\
l
l l
l FORM N!5 2
' APPENDIE II - MLMD& TORT REVISED ENG 021 06/30/89 FotM KIS 2 OWNER'S RDORT FOR RDAIR$ OR REPLACIXDfTS As Required by the Provisions of the AsME Code section El 1.
OWNER AP&L/mncf 0FEMT10ert. IEC.
D&TE
/8 -/8 ~ [2 Name RT. 3., 30f 137 C. RUSft11TR11. AR. 72801 SPEET
/
ef
[
Address 2.
PLANT D rivtM WDCitit ONE WIT Two Nhme RT. 3.101 1370.1DSIM LYTt t 7 11. 72801 18, 0878 94 Address Repair Organia.atian Fo 50., Job Wo., etc.
3.
WORK itRFORMED ST AP&t/tyrney oys., rue.
TTFE C005 87 203,ST&MF M/A Name LUDORIZATION 30.
v/A RT. 3. Rex 137G RUSSELLVTLI.E. A1. 72801 Address EEFIRATION DLTE m/A 4.
!DENTIFICATION OF ST37EM b >>#f;
/
W
(/
5.
(a) APPLICA3LE CONSTRUOTI0tt C00EduI $ 192 EDITION,
.f-9/
ADDDfD&,
NA CODE CASE I
(b) APPLICABLE EDITION OF SICTION KI trT1LIZED FOR REFATRS OR REFLACIXDfr$ 19 PS 6.
IDENTIFICATION CT C0KPONDf75 REPAIRID OR REPLACED AMD RDIACEMDrf COMFWDffs REFAIRED "AI' CODE e
NAME OF NAME OF KINUFACTURER OTMER TEAR REF! ACED STAMPED COMPONDff MANVTACTURER
$1111!,30.
IDDfr1FICATION BUILT OR a.
==CExDer Ja;>
V
/M JSt/-504/l,
/9t/ thei14 " A//b E
jN j
i lN
~~l l
N l
l Ni 3
l c
u
- 7.
DESCRlFTION OF MORK Alt #Ntt's WMwN1/ th2bbridfjinl AO, V
8.
TESTS CONDUCTED: HTDROSTATIC D FMEVMATIC O WCetIMAL CPERATING PRE 15URE O OTHER O PRESSURE NM Dei TEST TIMF.
w/;
'T NOTE: Supplamental sheets.in fors of lists, a14tthes, or drtvings may be use6, Provided (1) size is 3% in. x 11 in., (2) information in items 1 through 6 en this report.is -
included on each sheet, and (3) each sheet is numbered and the ausber of sheets is
. recorded at the top, of this fam.
- __x-
1 suo. cal asness 06/30/se 70 M E15 3 (Besk) 9.
RDGAKS N/A-I
/ Applicable Manufacturer's Data Reports to be Attached 4
I I
l l
czmncm or cceerumcz I
I 1
I we certify that the ' statements made la the report ero correct and this I
i osoferas to the rules of the ASE Code,Section II.
l l
repair er replacessat I
i 1
i I
Type code symbol stasy n/a I
I 1
l Certificate of Authorisa No.
M/A Egitaties Date N/A li l
Siped e
e--
Date
/o - 2%
, 13 l
Owner er Owner's Desianes, title l_
R. D. Gillespie - Manager, Central Support I
-1 I
1 l-
. camnem or zussums zustserzon I
I 1, the undersiped, bolding e-valid esamissias issued the National Seard of
- 1 1
1 Beiler and Pressurin vessel Inspectors and the state er ARKANSAS of
-I l
l and employed by *ntVRICHT MUTUAL INSURANCE CO.
NoltWOOD. MASE.
Of d**
l Ownerts Report during the period bete insDested the @ats described la this4
- 1es a-m-91 to /d-16-91 l
and state that to the best of ary knowledge and belief, the Owner has performed'
,1 I
l enesinattens and taken corrective measures described in this owner's Report ia -
l l
eccordance with the re wirements of the ASME Code, Sec' tion II.
l l
I I
4 ty siping this certificate neither the Inspector mer his employer makes any I
i described in this ownsr's Repert. warranty, sapressed or laplied, concerning the na I.
Purtheroere, asither the Inspestar nor his I
i
- esplever shall be-liable in any manner for any personal injury or pro I
I
-er a ness of any kind arising from gr esamected with this inspectica.perty damage _-
1 i
- 9. C. d6 FACTORY MUTUAL SYSTDt3 I
Camaissions ys.9947. - ARK-r133 "N" "18' h
I 1
'l
-(taspecterf s sapature National Beerd, state, Province, and todorsements lI-
- ! ow % m i
~
1,3
-.l 1
-. - - -. - ~..-
FORM N!5 2
' APPEND!I !!. unmaTgg7 33715D ENo.c2l M/30/89 FORM NIs=2 OWNER'S RDORT FOR RDatt$ OR RDIACEMENTS a
as Required by the Provisions of the ASME Code Section II 2.
OWNER AFat/rwTner Gren*Trors. Inc.
D&TE
/d -/#- f/
name nr. 3. nor 137 ci testettvin v. AR. 72801 SIERT
/
of I
address 2.
PLANT atraitgit NDet'At DET WIT Two N8me g
- 17. 3. BOI 1370. RD11Ff t ytt t e. Am. 72801 M 608805/2 Address Aepair organisatiaa 70 No., Job No., etc.
j 3.
WORK PERFORMED ST AF&L/Eyrtte? ops.. ne.
TTPR C002 ST Bot. STRMP R/A Base
&UTHORIS TIM W.
M/A RT. 3, lex 1370,_ RUSSELLVILLE, AB. 72801 I
address RD IA&TI M DETE n/A 4.
IDENTITICATION OF SYSTEM ha#6
(/80 #- /)
5.
(a) APPLICABL2 CONSTRUCT!ast CODE let TIC19,J,Z,DITIN, S-7f ADDIND&,
N#
CODE CASE (b) APPLICA3LE ED1720N OF SECTICet II UT!!.1 ZED FOR RDAIRS OR REP!.ACEMDfTS 19 86 4
6.
IDENTIFICATION OF COMPCNDffS EkPAIRD OR REF1 ACID AND REFLACEMDrf COMPCDsDffS E
RDAIRD "II' CODE NAME OF MAME OF MANUT&CTURER O!MER TEAR
- RDIACID, STADD COMPONDiT MAWTACTURER sat 111, 30.
IDE3rTIFICAT!cN WII.T OR yg,
.m
,7
.s L
/[
NM 2SV-S8 W - 7 /9 90 fd/at&
V1b lN l
l lN i
j i
N l
l N
L l
e n
a u
3
, T.
DESCRltTION OF MORK bMN4NWt1Nll1A'-)ddbbwlblabM/dio -
V 8.
TESTS CONDUCTED: NTDRo$fATIC D PNEWATIC D NOMINAL OPERATIM PAZ55URE D OTMER O FRESSURE M
Dei TEST TEMP.
N# -
__ F NOTI: supplemental sheets in form of. lists, sketches, or drawings may be used, prwided (1) site is 8% in.
11 in., (2)-information in items 1 through 6 as this rePert.is -
included on each sheet, and (3) each sheet is numbered and the number of sheets is a recorded at the_ top of this farm.
Y.. -. -.
- -.... ~.. -...
--... ~ -
..... =.
- aavlass FCM Es 2 (Besk) 9.
RDERA$
X//4 Applicable Manufacturer's Data Reports to be Attached
+
=
1 i
I czanncus or omrtzancs 1
I 1
i I
we e9rtify that the'statsesats neds in the report are corroet and thia l
i Avv4 conferns to the rules of the ARE code,Section II.
l l
repair er replacement l
1 1
I l
1 Type code srubel stasp m/A l
1 l
l Certificate of Aubrisatian us.
M/A Impiratian Date w/A l
1 signed
/b b
d Data
/o - 2 t
. 19 I
owner er owner's Desimee, fitle l_
l R. D. Gillespie - Hanager Central Support l
1 I
i
. czanncus or zustancs rastscyzan l
1 I
I, W undersiped, holding a valid caenissian issued by the sational seard of
- l I
seiler and Pressure vessel Inspectors and the state or Frwince of i
l l
Amts tAs and espiered by *mVMCRT WTUAL INSURANCE CO.
Of l
1 NORVOOD. MASS.
have insDected the SeapoOGBts described la th1844 ase l
ownerta tapert eating the peried 6-20 to
/# Vd-71
,1 I
and atato that to the best ef my knowledge and bellef, the Ovner hae periermed l
I entainattens and taken corrective sensures descrhd in this owner's Report la l
I accordance with-the requirements of the ASME Code, see' ties II.
l l
l l
l l
ty siping this certificate neither the taspector mer his employer makes any :
warranty, empressed or implied,-concerning the saaminations and corrective measures ll l
-l i
i described in this owner's Report. Furthermore, neither the Inspector nor his.
l-I employer shall be liable la any manner for any personal injury or property damage i
l or a less of any kind crising from gr comaected with this inspection.
l l
FACTO R HUTUAL SYST ms l
l
- 9. Cf,.14&
Commissions NB 9947 ARK-M33 "N" "18' "A
l l
l Claspector's sapature National leerd, State, Province,- and todorsements l I-J. O l
Date. ElliottdeUh.2.1 19 1 l
1 I
.i i
___m F0M N!s-2 AFFINDIE !! - IEND&f0NT RET!ss F01st NIS 2 040tER'S 200RF Pet REFatts OR RDIACEMDrrs As Required by the Provisions of the AsNE Cads Secties II 1.
OWNER DAL/DrTE157 OPERATICEli _INCt._ 3425
/8-/d-92 Name RT.1. 301 th7 Si RUlffttTT. A1. 72801 BERT
/
of
/
Address 2.
PLANT Ant w un unetvis our tu!T _ two Name RT. 3. 101 137Ci RDiltitYTttv. A1. 72801 18, 8088d7 ff C9
/p/5) 1 Address Repair Organisatian 70 No., Jeb No., etc.
3.
WOM PERF0MID IT AP&L/Esttaaf ops.i Inc._ TfPR 0008 STISQL ST&MP n/A same
&PDIORISTICII 30.
n/A RT. 3, Sex 1370, RUSSELLVILLE. AB. 72801 Address E D IRATION natt n/A 4.
!DENTITICATION OF SYSTEN 224#4t40 AwR $
/Nt'8-/.r) 4 5.
(a) AFPLICASM CONSTRUCTICH CODE o
19 DITION, S-/f79 ADDEND &,
NA-CODE CASE (b) APPLICAsu DIT!cW OF SECTION E! trt1LIEED FOR RDAIRS 08 REF1ACENDrFS 19M 6.
IDENTIFICATION OF COMP 0NDf?$ Ri:P&2MD OR REF1 ACID AND REF1ACEMDr! CCNEPC9sDffS RDAIRD NAMI 0F MAME OF MANUT1CTURER OTHER TEAR EDIACED,'
0"II' 30 IO D
COMPONENT MANVTACTVRER SERIAL NO.-
IDENTIFICAT!0N BUILT OR f4 a.
Nr
.s f
S'l NN-2 SV-SS55 ~A /990 ulAnd
'f))L '
lW$ lN Ibef&
l 77 e
isr-s,iss-a irez
!\\
l l N l
l N
n j
u blN f Af & dad >MlNabd>m
. T.
DESCRltfl0N OF MORK Luff-DIS
- 8.. TESTS Co@UCTED: NTDROSTATIC D FNEW GTIC D WCMIM1L OPERATING PRESSUM D OTHER D FussURE
- A psi Tts? TEMP.
N#
_F NOTE: supplemental sheets.ia form of lists, sketches, or dravings may be used, Provided (1) size is #4 in. s 11 in., (2) information in items 1 through 6 en this report.is +
included on each-sheet, and (3) each sheet is asabered and-the number of sheets is irecorded at the top of this form.
l- $
..----.. a-..-. -.--.
asvasse i
20 021 M/M/M FCM N13 2 (tech) 9.
REMERK$
NFF-/ Rb Applicable Manufacturer's beta leperts to be Attached 4
I i
I carrtncars or courtlaats l
l 1
I We certify that th "statensats made in the report are correct and thia l
l Nr(vInuu?"
conforms to the rules of the Ass Code,Section II.
l I
repait er replacement l
1 l
l I
I
.?ype cede symbol step N/A l
l I
certificate of Authorizatian No.
M/A Empiratian Date N/A l
i siped
/d [
WO Date
/d-t6
, 19 l
owner er owner's Desimee, titla l
l R. D. Cillespie - Manager, Central Support l
l l
. czattnckts or Dessav2c3 InstscTIm i
I i
1, the undersiped, holding a valid commission issued by the National Board of
- l l
hiler and Prossure Yessel !aspecters and the 5 tate or Prwince of l
l I
- ARIA 31A3 and employed by *nyv11Crr MirreAL INstmANCE CO.
of NORVOOD. MASS.
have tassected the camponents described La m
i owner!s Report king the period 4-?o-91 ts
/ d - #d - %T
,l l
and state that to the best of my knowledge and belief, the Owner has performed l
I examinations and taken corrective sensures described in this owner's Report in l
I accordance with the requirements of the AsME code,Section II.
l 1
l l
By signing this certificate neither the Inspecter nor his employer makes any l-I warranty, empressed or implied, concerning the asaminations and eerrective measures i l
described in this owner's Report. Furthermore, neither the Inspector nor his l
1 esployer shall be liable la any manner for any personal injury or property damage -
l l
er a less of any kind arising fran gr connected with this laspecties.
I l
FACTORY MITTUAL sTSTEMS
-l l
t d 6.H.S Commissions WB-9947. ARX-r133 "N" "18' 1',
l I
I sational Seard, state, Province, and todorsements l l
(/ nspector's sapature x.o nu~
uw
,,.a.
l l
l
FORM NPV 1 CERTIFICATE HOLDERS' DATA REPORT FOR NUCLEAR PUMPS OR VALVES
- As Required by the Provisions of the ASME Code. Section lit. Div.1
- 1. Menutectu<ed end eertified t>y Target Rock Corp.: 1966E Broadhollow Rd1 E. Farniingdale, NY 1173 5 in.m..no.ao,...e Nc. w m Ho6o.,3 Entergy Operations Inc.; Russellville, Arkansas 72801
- 2. Menutectured io, in.m..no.oo.... v eu ch.., w o-n.,i Arkansas Nuclear One; Russellville, Arkansas 72801
- 3. Loc i.on ot initenet.on en m..no sao.easn 8 0 E--001 91L-001 A
N/A
- 4. Modei No.. ser.es No., or Typ Dramno p,
ggy 1977 5 1979 1
N/A 5 AsME code section lii.
-~
E dition Aeoence o.t.
C1.se Coo. Can. eso.
Va1ve I
l
- 6. Pump or valve Norninal inlet size OutW1 sire -
i.a i i.n.
SA-182 T316L SA 479 316 SA-564 GR 630 SA 479 316 Bonne,t Disk
- 7. Maienei. sody Indicator Tube tal (bi (ci (d) del C e r1 Nat'l Body Bonnet Disk Indicator Holder's Boa d Serial Senal Serial Tube SenatNo No No.
No.
No.
5eria1 No.
75 N/A 5770 3514 2049 4099
~~
~
76 N/A
$ 7'6 3 3584 2043 4143 77 N/A 5771 3770 1965 4057
~
78 HlA 5766 3552 2014 4193 i v-56 ff
.7 79 N7A 5764 3631 1963 412 D 80 N/A 5782 3549 2010 4187 8]
N/A 5783 3775 19I)0 4072
~
82 N/A
$759 3640 2047 4178 83 N/A 5760 3510 2001 4105 84 N/A i 5781 3T60 2004 4233
~
N/A N/A N/A N/A N/A N/A O
6 *
- y y
s.w.m.nw inv4.on.r v. vo.m on.u. imwi a d. nai m., i us.o me..o.a in ia.. e w. u. in into,m.io,.n
. i ei,oosn 4 on
- c.2 e.oon
.-ciuo.o on..cu~.i. i>>..:n in..i nume...a.* ema., e v.....e.,a.o.ow io, e is.
10 Ett in.s to,m tEocc37 m, t otanee t cm t** o.s, tut. Asut. 345 g 47tn si h.
yo,s. N y 10017
FORM NPV 1 (b:ck)
Mir. Serial No.
f
~
B Remads _
2500 700 N/A
- 9. Design conditions e,
,,,%,,,,,,,,g,,
treessures ftempeeennel 2
- 10. Cold worbng preswe -
pal et 100*r 6W Id it. HydrostetH: test
- psi Temp.
- F Disk differential test pressure psi CERTIFICATION OF DESIGN 4557 1.arry Young Prof. Eng. state Arkansa s n,7 g,,
Des.pn St.ecification cert fed by NY 056047 Steven Karidas p,,,, g ng,,,,,,
Reg.No.
Design meport certif ed by CERTIFICATE OF SHOP COMPLIANCE We certdy that the statements mede in this report are correct and that this pump or volve conforms to the rules for constructen of the ASME Code. Section ilt.
I2*l2"92 N Certificate of Authonrotion No
[mpires _
6b Target Rock Corporation Signed...
Date Name W certificate Hosoeet E. DajesfgitatM eeCtor, Q.A.
4
\\
CERTIFICATE OF SHOP 1NSPECTION 1, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure V sIins]etorsap*
U"U A #
U U" U"*
NOW YUfh and employed by the State or Province of 58*
have lnspected the purnp or velve, described in this Date Report on
- hoston _ N 19ffund state that to the best of my knowledge and beleef, the N Certificate Holder has of.
t
[
constructed this pump. or valve, in accordance with the ASME Code, Section lit.
By signing this certificate, neither the Inspector nor his employer makes any warranty, supressed of implied. concern ng the equigeens desenbod in this Data Report. Furthermore, neither the inspector not his employer shall be liable in any manner for any personalinjury or roperty damage of a loss of any kind arising 8vom or connected with this inspection.
4M
- i gt.
oste
/
N.Y. STATE COMMISSION NO.2288
[/I' br+ --
- _.J_r3/ ommissu,nso Commissioned IN PENN., OH10 & CONN.
m.ci st, iu.namomentsi state, e.. and ue i on.mtori
(
II) For maavany operated salves only.
l
FORM N18-2
&PPEND!I !!
- Nhm &TONT RETI5O ENG 021 06/30/M FORM NIS.I Ol8tIR'S RDORT FOR RDatRs OR RDL&CIMENTS 4
as Required be the Previsions of the AsME Code Section II 1.
OWNER AML/twTruer opre Auers. Tse.
BME
/d -/# ~ f/
Name l
mr. s. nor 137 a. mestvityr"*. Am. 72801 spuBT
/
of
/
address 2.
PLANT ARIANIAI NDeteAn our WIT Name RT. 3.101 137c Rettet t Ytt e r. AR. 72801
- 78. #86886 79 [ b(r M-sp/5)
Address Repa&r Organisatama 70 50., Jeb No., etc.
i 3.
WOM PDIORNED BT AP&L/EETE12Y flPLi IErL.
?!PI 000R S1 208. STEMP J same
&PIMORIS TIM NO.
E/A RT. 3, les 1370, RUSSELLYTLLE. AR. 72801 Address IIPIR&T!QN BMW E/A 4.
2DD(72TICAT!0N OF 8781D8 A/$td48 bbNff-/d
+
5.
(a) APPLICA3!.I CONSTRUCT!QN CODE 9 2 5171W, J-/f7 9 ADDEND &,
NA CODE CASE (b) APPL!cAALE D1730N OF $3CT!QN II FTIL12ED FOR RDMRS OR RIMAGNENT119 84 6.
IDDff!FICATION OF COMP 0NDf712IPi1RD OR REMACED &MD RD1ACEMDrF CCMPCNDf75 RDAIRD
""IU"II' OMER ft&R REPIACED,'
0008 e
NAME OF NAME OF NhWF&CTURER
'==
ConPOND<T M& w r&Civ= 2 Eun m.
ro Nnneann an?
=
=.
=,L&CE=Nr.1=4
.s O
$l NA YS V-Cl 33 -/. 1990 W
$ltb
-Y 7b Nk J.tV-n E3-l AU M l w d
$ llt) l l
V l Ns l
L l
N y
c o
e 1
T.
DE5CRIPTION 07 MORK Ati Aul.Al/$vd 9-A1lRabbAM PL.AluHf fJ~ O/S.
p 8.
TESTS CCefDUCTED: HYDROST& TIC D PNEUMATIC C WOMIM&L OPERAT1M FRE55VRE D OTHER D PRESSURE NA Lti TEST TEMP.-
w#
_' F NOTE: supplemental abeets.in form of lists, sketches,.a-drawings may be used, provided (3) sine-is e% in. s 11 in., (2) information in items 1 tarough 6 en this report.is.
-included on each sheet, and (3) each sheet is mmbered and:the number of sheets is
. recorded at the_- top, of thisitors.
t-4 l
i
...e.w=
- asvassa 2 021 06/30/89 FOM N18 3 (tesk) i NFr-/ 6/d2/$6 -
9.
manAaxs Applicable Manufacturer's Data Reports to be Attached l
l 4
l l
I czartr2cus or cenrtrames 1
i I
i I
We rtify t the ' statements made la the report are correct and this l
1
/mts eenferus to the rules of the Aas Code,Section II.
l I
repair er replacessat l
l l
l
^
l l
TYPE code spbel stamp 3/A l
q j
u l
certificate of Autherisa me.
M/A Espirettan Date n/A ll l
siped IA k a /d. m' Data
/0 -2 B 19 i
i
~
owner er owner's Desimee, fitle 1
i l
R. D. Gillespie - Manager Central Support l
l l
l czuftricus or Instav2cs Instscrzen 1
I I
I I, the undersiped, holding a valid esamissian issued by the National Board of
- i-l Boiler and Pressure Tessel Inspectors and the State or Freriace of l
l
_ ARKANtAS and esplayed by *HRVRICRT MUTUAL INSURANCE CO.
of I
l NORWOOD. MASS.
b8?e insDetted %&S SGEpensats describe 4 la th184.h I
ovner!s Report ouring the peried a-?o-91 to M -/0-f/
ll l
and state that to the best of my knowledge and belief, the Owner has performed l
l emaninatiens and takas corteetive neasuree deMribed in this Ovner8s Sepert in l
l eccordance with the requirements of the AsME Code, Sec' tion II.
l I
l I
ty siplag this certificate neither the Easpector mer his esplorer nakes any verranty, aspressed er laylied, concerning the asaminations and eerrective measur I
l described in this 0wner's Report. Furthermore, neither the taspector nor his l
l amplerer shall be liable la any manner for any personal lajury or pro er a less of any kind arising from gr esemeeted with this inspettian.perty densge-t i
l l
FACTORY MUTUAL SYSTDi$
l l
( L'h d./ A B -
Commissiens NS-9947. ARK-I!33 "M" "18' "A "
l l
$nspector'ssignature National Seard, State, Province, and Indorsements l Date
/ C ' 'M 19M
.I l
81 w
h an.
--i--t'-----m -------w+em--a8 rr---w ta
===s eeurn-n.,a-r.--,
m,@ io ereey some e r,.t1-v ge
-,mW 59-
--+.c
.+w4ww-+mi+y,<-f
--i--wwg.m 7-,,ynv,
--vw,my
FORM NPV 1 CERTIFICATE HOLDERS' DATA REPORT FOR NUCLEAR PUMPS OR VALVES
- As Required by the Provisions of the ASME Code. Section 111, Div.1 Target Rock Corp.
1966E Broadhollow Rd E. Farrningdale. NY 11735
- 1. Manuf actured end cottified by inem..no eoe.. 8 N c.. sew. Hino.r Entergy Operations Inc.: Russellville. Arkansas 7?JE
- 2. Menutectured io, an m. ano so#... e ru,c.., e, own.,i n
Arkansas Nuclear One Russellville, Arkansas 728vl 3 tocation of enstettetion in m. eno.oo,esii
[ Model No. $.rie. No., or Type 80E-001 91L-001 A
N/A Dr ewing n,,,
cny I977 S I979 I
N/A
- 6. ASME Code section ttt Ano.noe om ci..
c.o. ces. no.
toaan Y8IVU I
I 6 Pump or volve Nominal en6et size Outlet size am.
in.
SA-182 F316L g,nn,,SA-479 316 n,,,SA-564 CR 630 SA 479 316
- 7. Metenet Body Indicator Tube 14)
(b)
(c)
(d)
(el Cert.
Nat'l Cody Bonnet Desk Indicator Holder's Boefd
$enel Serial Serial Tube Senal No No.
No, No.
No.
Seria1 No.
75 N/A 5770 3514 2049 4099
- t. fsff - /
76 N/A 5763 ~ '
3584 2043 4143J d
77 N/A 5771 3770 1965 4057 78 N/A 5766 3552 2014 4193 79 N/A 5764 3631 1963 4124 80
~
N/A 5782 3549 2010 4187 N/A 5783 3775 1960 4072 81
~
N/A 5759 3640 2047 4178 82 83 N/A 5760 3510 2001 4105 84 N/A i 5781 3560 2004 4233 N/A N/A N/A N/A N/A N/A 6
44 4
supcemem.i.niu,G.on.n n. ivm e 61.. it.ics.. o, e...nos m., b. neo o.o..o.o m w.
a w i t, inform.i.on a n.m. t m%gn a on
- m. on newt,s.ncivo.a on..:n is.i. tai..:n iv.i. et..o ano n nomt < v iw.ti..co,s.oann.ionortn e m 56/6bi Thi 108m ([000371 fr.y b. Ctiamed from 19 Orce, cent, ASME. 345 E 4 7tn $t, New Yo,.. N Y 100i7
FORM NPV.1 (back)
Mfr. Senal No.
2
- 8. Remar6:
)
2500 MO
- 9. Design condet6one.
p,j or or vetve pressure class lit u.e.wei ei.mc.,ewei 4372 10 Cud wor 66ng pressure pel et too'r AmM e nt
- 11. Hydrostatic test -
pal Temp.
,F Disk d<fferentiel test pressure psi 1
CERTIFICATION OF OESIGN 4557 Larry Young Prof. Eng state =Arka nsa s g,, go,1 Design Speutestion cervf ed by NY Steven Karidas p,,,,gng,,,,,,
neg No.
Design Report comfied by CERTIFICATE OF SHOP COMPLIANCE We certif y that the statements made in ttvs report are correct arid that this pump or watve conforms to the rules for construction of the ASME Code, Sectum bl.
7 N Comficate of Authoritation No taperes fi. [fl2#MIT M-Maf,-)
Target i<ock Corporation signed y,,,,
p,,,
E. Ba jede,gn:lHeec t or. Q. A.
(N Certificate Holde<i n
\\
CERTIFICATE OF SHOP INSPECTION I, the undersigned, hold'ng e valid con. mission issued by the National Board of Boiler and Pressure Vgn on qctors apo.
s I ins Commercia ns.
New York and employed by the State or Province of.
855 have inspected the pump. or volve, desenbed in this Date Report on of DOSE 0" N _' 1991end state that to the best of my kriowledge and behef, the N Ceruficate Holder has constructed ttus pump, or volve, in accordance with the ASMt Code, Section lit.
By signing th.s cartrficata, neither the inspector rior his employer makes any wartanty, empressed or implied, concerning the egulpment desenbed in this Date Report. Furthermore, nehher the inspector tine his employer shall be liable in any manner f or any personellnjury or roperty damage or a loss of any bind arising from of connected with this inspection.
SN
-1
- Det,
/
N.Y. STATE COMMISSION NO. 2288
..pA&gE';ff& [-
_ ' MI.*/ ommissionaALSO COMMISSIONED IN Pf.NN. OHIO & CON
/'
(Net 18d.. and. endorsements) siete, hev. end N.J Onepectort Y.
tu romewiv cc aied v.ses oniy.
~_
FORM N!s 2 DFEND!I !!
- 3RISkf0ET RETISD Foget wts.1 OletER'S RD0RT FOR RDatts OR REF14CEMNTS as Rettuired by the Previelens of the &DB CodsSection II 1.
0WNER Apal./tirfreef opreaff art. TMC.
MIB
/d-://~f/
Name RT. Si tot 117 S RDifvityrn e. AR. 72801 NEET
/
Of
/
Address 2.
PLANT Aurinus unct rAn our WEIT Two Name RT. 3.101 137C RDilet t yft t v. A1. 72001 18e 60MO 7fd/df f.F-4#/F)
Address Repaar Organisataan 70 Be., Jeb Wo., etc.
3.
W3K PERFORMED BT APat/tsr2RST SPs.. Inc....
TTFE 0008 STISCE, ST&MF m/A 4
Name
&UTHORIZhTI M NO.
n/A RT. 3, los 137G, ROSSELLTT113. ARs 72801 Address IIFIRATI M DhTE n/A
_A1]M&Y
[.YNCA-/5) 4.
1 DENT 1TICAT10N OF SYSTDt 5.
(s) APPLICA3LE CONSTRUCT!0N CODE _ DIII 19g DIT!W, 8-/f 7S~ &DDEND&,.
NA CODI CASE (b) APPL 1cASLE DIT20W OF SECTION II UHL12ED FOR REFAIR$ OR RD14 CEMENTS 19 N 6.
2DENTIT! CATION OF COMPONDff8 3D&1RD OR REFLACED AND RDIACEMENT COMPCNDffS e
AINI RDAIRD "IO II III"II' CODE 4
NAME OF N&MI 0F luMUF1CTURER OTHER TEAR REFIACED O
COMPONDif MANUFACTURER SRIAI, 50.
IDerf!FICATION WILT OR REFIACEMENT l
s
)
A' 4
t 89 [
~ NM 293-f89
/973 $1Abad,
- Afil, l
9)-5]SC/1 NM 293-/89 MfY
&JeY lb I
W l N I
h I
If H
I!
n 4
7 DESCR1FT10N OF NORK fill~ AubJtlAbnHA%Al
,MNP92-AB)3
- 8.. 71575 CONDUCTED: NTDROSTATIC D FMIWATIC D' WQK! Mkt, OPERATIM PRESSVRE D OTHER D-F11580R3 N4 osi TEST TEMP.
N#
'_F NOTE: supplementsi sheet.in fora ef lista, skatches, or erevings met be use4, previded I
-(1) sine _is 8\\ in. a 11 in., (2) information in items 1 through 6 en this report,is +-
included on' each sheet, sad (3) each sheet is enaberee sad the snaber of sheets is
. recorded at the top, of this farm.
-whpe.=e-erm_mma___ma--
...eo.
arvaass suo.on M/M/es Font NI5*2 (Seek)
~
9.
AsMAAA3 88P-/
applicable Manufaeturer's Deta Reperta to be &ttached e
i I
l I
carnncats or courL ames l
1 1
i We certify jhat the ' statements made in the report are correct and this l
l
_/vz/u muur conforms to the rules of the nas code,Section II.
l 1
repair er replacement i
I l
i l
l Type code symbol stamp N/A l
I l
l Certificate of Autherisatico M/A Rapirstlen Dete M/A l
Siped
[
d
. # +,
Data
/d -W
,193 1 l
'0wner er owner's Desi me6, title l
l __
R. D. Gillespie - Manager. Central Supporc l
1 l
l
. czannears or nesszncs Inspsenom I
i i
i I, the tadersiped, heldlag a valid esamissian issued by the National seard of
- l l
Soiler and Pressure vessel Inspectors and the state or Prwince of I
l
_- ARIANtAS and emplepd by *nrV11CET MUTM1. IN5 HANCE CO.
of 1
I wotwooD. MASS.
b8?e inspected the eenpaneAts described la thlS4 Me I
owner!s Report daring the period a-?o-91 to /# 40- PE
,1 l
and state that to the best of my knowledge and belief, the Owner has performed l
1 examinattens and takaa corrective measures described in this owner's Report la
-l I
accordance with the requirements of the ASME code, sec' tion II.
I I
I l
By siping this certificate neither the Inspector nor his esplefer makes any-varranty, sapressed er implied, concerning the asaminations and corrective measures ll l
l described in this owner's Report. Furthermore, neither the Inspector nor his -
l 1
employer aball be liable in any manner for any personal injury or property danap l
I or a less of any kind arising from gr esenected with this inspection.
l i
FACTORY MUTUA!. SYSTDiS l
l l
- 9. A <'JASdP Canissions NB-9947. ARK-T133 "N" "18' k".
l L
l faspector'ssipature National seerd, state, Province, and Endorsements I l
J. O i
Date. Elliote I
/ o/g i ag M i
.l-I e,
t
.. ~
g.
,e.s,..v,
a..ge og g
.y
.g.
..,.... s. a.....n ri.,.v.. s.u c,s.
Ein d.,i.,
uy:
... r -r..
ix...,....
.. ~....
FORM 'NPV.1. N.CERTIF1CATE; HOI.DMATA~ REPORT,F.OR' NUCLEAWPUMPS OH VAWIge '
FAu. I' ', '.....
'I
As Required tIy'th's Provisloetsjof the AS'ME Cod's. Shtlon in, Div.1
,[,' l'
. = -
= - -.
Henry Vogt MachinL %3euf sv111e. F.Y C
- 1. Men fectured by w
4 the ne ano Aoorses of N certivecate e.oicer, Arkansas Pc'ver & L1Rht _ Co., Little Rock. AR
- 2. Menufactu ed for r
i%eme em Ana,ne e eww w.
s 3 Locateen of enstallation _Arkansa.s Nuclear One. Russellville. AR inieme eaa Aooreni 4 Pump or Velve CAle V41YP
, Nominet inlM Site 1"
Outlet Site 1"
(inch)
(ench)
(s) Model No. (b) N Certificate Holder's (c) Ceredsen Senes No Ser1a1 Regirroteon (d) Dreeng (f) Net *l.
(g) Ye er (f) ~
or Type No.
No No.
(el C1ess Od. No.
8vitt 1984 B-49832 1
l '"
Gate 284-215017 (y
1984 B-49832 1
Cate 290-215017 Y
(2) thru (3
313-215017 O
g3 (See Attached Sheet)
,J8$-/ff (5,
%' M/~ off FC / Y v-tsi e' '
(7)
(8)
O 191 (10) g 5
4e.
c,ew.ps.oa e' e=ce to ece eaw.pment.. cas,gneci n
1500
'F or Velve Pressure Class _
(1)
O
- 6. Des'gn Concitions ps4 iriewei if w,,c s owse 7 Cold Worbng 8'vessu<e VOQ rsi et 100'F Pressu e Rete 6.ng P.eces 8
r i
i M anuf acturer Remarks Mars No Matenal Spec No 1
i (al Cast >ngs
}
I i
I i
l l
. b ;-===mu
=..
- -.---.-==.
= = = = = - -
(b) Forging s JQ$L RJ_630A SA_182 F316 i
Vogt EEnet Rhe02A SA 182 F316 Vogt R1853 SA 182 F31,6
___ Vogt t
__.1 I
1 t
1 - --
._=:-=
===:--:---===-1---
(16 f or manually op*rsted vaives only.
- Suwementat $ beets in fo<m of I.s1s. steiches ce eramngs emsy tie used o'evided til site is 81f2" 11*.1;) niorrnat cn in ite<rs 1,2 anc 5 on th.s Cata Repon is included en each sheet, and (3) es:n sheet is nw nbe<ed end number of AStets r
is seco*ded et top of th s form
_w-ni1HyyQrye; a
. _ ~ _ -.. - - - _ _. - _ _ _ _ - _ _
.e.uSE..
4a@ygn.v.2n ws.w
- renu mp.cu.q.),.c,g. 7.m.. m_yag.t,s. y'-
vcj
..w.gg,g,rgg a n m.:
. g, g g.,,,,
c.,nsyg(,giyists i.ai t.g,p,g;g. g a
...;c.
fel B_ oft 6ng
~ ' " ' " ' ^ ~
Cay Screw
- s
- HTC SA 564, Gr. 630 Vogt (Condition 11 1150)
- O ~
Iel Other Parts
~
w,-
Gate 115N SA 564, Gr. 630 Vogt C
(Condition H 1075)
V
- e. e 49
.e
- 9. Hydecwtstic test bk. rei.
Disk Detferential test pressues pel.
g CERT 1MCATE Of COMPUANCE
'g We ceridy that the statements made ett this seport are c.7treet and that this pump. or valve, conforms to the rules of construelson of the ASME Code for Nuclear Power Plant Components Section 111. Div. l.. Edet.on 1970 Moenca Su= er, '75
. Code Case No
. Date November 2 7, 1984 HenryYgt Machine Co.
y h jdggj ggs,e o cemm,i. co,o Ove ASME Cen f.cate of Authoresshon No.
W N
1/6/87 to use the symbol espires em to.ies CERTIFICAVION Of DESIGN l
On.gn.nformahon on fa, et __
Henry Vogt Machine Co.
Stron oneWs report (Class 1 ontyt on file et lienry VoSt Machine Co.
Des,gn spect. cat ons cert.f.ed by(11 M.rry D. Young.
4557 Stress analysis certif.ed by (1)
R. S. Pe try PE State Kentucky p,, u,_ _ _
$360
~
til S<gnatvre not reovired List name only.
CERT 1FICATE OF SHOP INSPECTION
- 1. the unders gned, hold rsg a valid commission issued by the Nationat Board of Boder and Pressure Yessel inspectors and the state or Province ot Tenneslee and emptcyed by_C.omercial Union Ins.Co.
of Besisn. MA have inspected the pump. or vafve, described in t'nis Data Report on Avril 16. _ _ _19 84
.a nd state thauc the best of my knowtedge and bol;ef.the N Certif'cate Holder has con.
structed th.s pump or valve,in accordance with the ASME Code. Section ftt.
By 4+gning this cemficate, ne6ther the insoector not h.s employer makes any warranty, espressed or impfied. concerrnng the ocu orment described in thes Data Report Furthermore, neither the inspector not h:s employer sFall be ristde in e tv j manner for a personalinjury or property damage or a loss of anY k'f d arts.n9 'om or Connected with this en$0ecisore l
I
'#PC.b_9r 2p_ _ tg 3, Cate Add /dd.
_/'L,
<x d 4
- N Comm<ss.ons.
4ennessee #22M e.,.no.t e..o ca. si... e,e,...r. e a 1
-ew m
.,m,--<w--
^
yogg pgs.2 DFENDIX !! - MutMTOKY REVIS D 20 021 06/30/89 FORM wis 2 CWMn's BIPORT FOR RDAIRS OR REPLACEMEN!1 As Eag. tired by the Provistor.s of the AIME Code section D 1.
0wNu iP&t/ExTner orERAffort. Inc.
MN
/d~/4-94 Name RT. 3. sof 137 c. tUlftLLY111E. AR. 72101 SMIT
/
of
/
Address 2.
PLANT tirusis weet m Orr tatIT Two Nhee Rt. 3. 101 13 7C. 1D S SM i VIf f T. 11. 72801_ 88,'968<907ff(/U9.7-4#/5)
A6 dress Repair organizatico to no., Job Mo., etc.
3.
voRK PnFORMED BT AP&t/ENTUCT OPE.. tee.
TTFE CCCC ETMDOL STMP M/A Rame AUTHORIu TICIf M.
M/A RT. 3. Box 1370,1055ELLVT11E.11. 72801 Address E2PIRAT!aN DATE N/A 4.
IDENTITICATIC44 0F ST5 TEM
/dt!/td
/W 4kP(#N t'8 -/J) 5.
(a) APPLICA3LE CONSDUCTICJ CODE fod 19 ff/ DITION, J-/FYT
- ADDENDA, NA CCDI CASE I
(b) APPLICA3LE EDITICW 0F $1CT1001 XI UTILIZID FOR R1713.5 OR RITLACIMENTS 19 85 6.
IDENTITICATION OF C0KPONDf71 AIFAIRD 04 REPLACID AND RE?uCIXDrf CCMXEEWT5 EEPAIRD NAME OF HAME OF MANUTACTURER OTHER TEAR REPD CED ST D
COMPONEXT MANVFAC1VRER SnuL 30.
IDENTIFICAT!cel MILT OR J"A
=.
.DuC==7 s
JY
// /-2/SC/ Y NA
,785-S700 _ /9/$kMktob 4/2b cut'
!!!-2/SC/7 NN
'293-S780 1199 3 lwwl d!/b
.V i
u i
x.
j i
N, 1
l 1.
DESCRIFt10H OF MORK hl $Af_AMbH.lV)?)ff Ab M Af&lff9,Y- $$/5 8.
TESTS CONDUCTED: NTDROSTATIC D FMEUKATIC D WOMIXAL 0FDATIM PRIS5VRE D OTMER O PRI55URE _
NA-psi TEST TEMP.
- A
_F NOTE: SuppleMatal sheets in form of lists, skstches, or draVings may be gged, provi6ed (1) site is 8% in. x 11 in., (2) infornstion in iteas 1 through 5 cc this report.is -
included on each sheet, and (3) each sheet is numbered sad the number of sheets is
. recorded at..he top,of this form.
}
\\
asvaass sno. cal 06/30/s3 F0 5 N18=2 (tesk)
NPr-/ fl Y tb '
s.
nxnnnx3 applicable Manufacturer's Data Reports to be Attached i
i czanncars or carLzancs I
I l
I ve certify tpt the 'statensats made la the report are correct and this l-I
__ AMAunnatt conferas to the rules of the ASIE code, section II.
l l
repair er replacement l
1 H
I H
I type code Symbol Stag n/a H
l f
I certificate of Autherise us.
3/A Empiration Data n/A l
l Siped 1
Data /C-2 V
,191h I
owner er owner's Designee, title l
1.
R. D. Gillespie - Manager. ' Central Support l
l 1
csannears or Inssw!cs InstsenM i
i I
l i
1, the undersiped, bolding a valid comunissian issued the Battenal Board of
- H I
Boiler and Pressure Vessel Inspectors and the State er of H
I
_ ARRA3tAS and egleyed by *AetvRICHT MUTUAL IN$tTRANCE CO.
of J
i l
NORVOOD. MASS.
hETs insDetted the tempebeats describe 4 la th1M 2e*
I ownerts Report daring the period a-? o to
/8 /v-ET
.l t
and state that to the best of my knowledge and belief, the owner has performed l_
l I
examinattens and taken corrective sensures described la this owner's Report la l
I accordance with the requirements of the ASME cede, see' tion II.
-l I
l 1
ty siping this certificate neither the Inspector ner his employer sakes any i
I warranty, sapressed or implied, concerning _the asaminettene and corrective nearures i I
described in this owner's Report. Furthermore, neither the taspector nor his l
1 emplorer shall be liable la any manner for any personal injury or pro l-or a lares of say kind arising from gr ecanected with this inspecties.perty damage
.I factory mrTUAL SYSTD($
-l
-l l
l 9.G.2,/& G commissions-Ws.9947 AAK-r133 "n" "18'"A "
g i
pnspector's Sipature petional Board, State,-Province, and Endorsements l Dbe.Elliott
/ d /,;z9 19 9A o
.I l
1
FORM NIS.2
&FFEXD!I !! - M&MD& TORT WI5G guo.021 06/30/st FORM If!s.2 OWMD'8 REPORT FOR m1IR$ 04 NCEMMS As Required by the Provisions of the AsME Code section II 1.
OWNER AP&t/DrfncT opt 11710W1. IEc.
RN
/o+ 94 Name RT. 3. MI 137 C. turrLivillR. it. 72801 SMIT
/
of
[
Address 2.
PLA)G tirnsts wecita Ort WIT Two Name RT. 3. BOI 1370. 1031rtlVTfTY. 11. 72001 dl), O(1880 7 9S(2CF 9,1-6/>/J)
A&iress Repair Orge.nisatico 70 No., Jie No., etc.
3.
WORK PERFORMID BT AP&t/ENTm*f opt.. YYf*.
TTFE C005 51190L ST&MF N/A name EUDtMLIZATICII 100.
X/A RT. 3, Box 1370,10$$tLLVII.tI, A1. 7201 Address EXPIRATICII RH v/1 1DDatilckT10N OF STSTEM hAJEWAAP hp (efHC8~/5) 4.
y'
/
y 5.
(a) Af?LICA3LI CCNSTRUCT200f CODE S tN N 19f f,,, D ITICIt, 8- / 9 7S~ ADDENDA, AW CODE CASE I
(b) APPLIC15L1 DITION OF SIC'!!0el XI UTILIZID FOR REPAIRS 08 REFIACIMDf7819 88 6.
3DDCIFICAT!0N OF CcKPONDfT$ RI?AIRD OR REFLACE AND RI?LhCIMDff CMPWDf73 REPAIRD NAME OF NAME OF KANUFACTURER i
OTHER RAR REFIACED COMPONDC MANVTACTURER STR11L WO.
=-
,R=C=De !"A
.s O
I f
psy-2!sett AIA 525-570/
1983 $ct/Mrd dhL lo
/ T8-//SC/1 NP l283 -S 70/
'!9/3 lMtald 8th l
L
!N' I
u 1
U 1.
DtsCR1tT10N OF \\CKK Ath0hb Aubttb%_AfbMAhl)1ht Alv lu'92-Ad/5,
/
/
8.
71575 CONDUCTED: NTDR0571 TIC D FMIUMATIC D WOMIX1L 0FIRATIJfG PM55VRE D OTHER D PRISSURI NS Dsi TEST TIMF.
- A
'T NOTE: supplemental sheets in form of lists, sketches, or drawings ma7 be used, provided I
(1) sise is W in. x 11 in., (2) informatice in items 1 through 6 on this report is -
intluded on each sheet, and (3) each sheet is mmbered a.nd the mmber of she-sts is
. recorded at the top of this fop.
J
asvaass m e-cat 06/M/st PcM N18*3 (task)
A/Pr-/ M -
s.
annans Applicable Manuteeturer's Deta Asperts to be &ttached
\\
I l
I czartncus or conrumes l
l
(
l We certify that the ' statements made in the report are correct and this l
AMAmnt4f eenferse to the rules of the Aas cade, section II.
1 i
I regir er replacessat l
l 1
1 i
i Type code symbol stasy n/a 1
i L
l Certifieste of Autherisatias m/A Empiratian Date n/A l
Signed d.
/Iw Date
/d - L V - y '2 ~, gg_ g i
owner er Owner's Designee, Title l
l_
- t. D. Gillespie - Manager, Central Support l
l-
_I l
. cserinCUE OF INSERVICI DEPSCf105 l
1 i
i I, the indersiped, holding a valid commissian issued by the Natiemal Seard of
- l l
De11er and Pressure Yessel laspectors and the state or Province of l
l ARIANSAS and eglered by *AstVRICHT MUTUAI. INSURANCE CO.
of l
nowooD MASS.
h8Ts lassected the SOEpeOsate descr2ed La thtSM AS.
I ownerts Report Aring the period a-20-91 to /4-E ~FI'
,l l
and stata that to the best of my Imewledge and belief, the Owner has perferned l
I exaalaations and takaa terrective measures described is this owner's Report la l
I accordance with the requirements of the AsME Code, Sec' tion II.
l I
l I
ty siping this certificate neither the Inspector nor his espleyer makes any 1
-I varranty, sapreased er laylied, eoneeraing the ama=inatiens and corroetive asasurea l i
described in this owner's Report. Furthermore, neither the Inspector mer his L
i employer aball be liable la any namner for any personal injury or pro '
i or a less of any kind aristag from gr esanected with this laspecties.perty damage l
l l
FACTORY MUTUAL S1ISTIMS-l l
9.C. 81/M Cennissions W3-9947, ARK-M 33 "N" "18 'k ".
l l-gaspector's sapature Wetiamal Seard, State, Province, and tadersements l I
J. O. Elliott I
l Date
/4/49 19 1 1
1 l
4 i
l
b.*.h l k
b.A
?
mmotome neronnon wcuum:
we vasemw'
< a m.
rw wv.Em e
p.;
, ' #e
.. As R.eirvitW @ $ Pr6viel6ns M,t6s Asher. C5de, Sectioitet, DM 1M'-.??-.'.W,9':':.h. ". "
.~c
- .gq,y.
Henry Vogt. Mat. hine Co., louisvillei1CYM U.h lh. ;,
%,,d (Name ano Aodress of N Cdcbto tbleer) Littia Rock, 'AR
~v r' ax Arkansas Power gt
.g,.
- 2. Manufectured fe, it.r. ae w o,
- 3. Loc.,tm oinnceumon A ans as e ar e,
sellville, AR aN Yve
, g,',nin,i gni,, g;,,
3/4" g,,gi,,
3/4"-
- 4. Pumo or veve -
forcN
- (incN (el Model No.. (D) N Cerifficate Holder's ic) Canodlan R*0 ettetton (d) Drew 4ng (f) Net *L 101 Yo8f l
Series No.
Serial CC -
of Type No.
No.
Peo.
(el Ctese 8d.No..
8witt 1983 B-49832 1
(1)
Cate 152-215017 thru o
(21 161-213017 g3 (See*Attsc.hed Sheet)
,fgS'- g70/
o p;
ON /SA *d/Se/Y (s)
(6) m m
(s)
- O (9)
(10) m 5.
itw oe.cnpe>oa o secace for.* wen e wie ses ga.c) r O
1500 g33 C) 6 Design Conditions psi T of VsNo Pressure Class 3600 pu,, ion.p,
- 7. Cold Worting Pressure
- 8. Pressure Betaining Pieces Mark No, Meterial Spec. No.
Manufacturer Romeeks (a) C4:1mos 1
(b) Forgings Body R4611A SA 182 F316 Vogt i
Bonnet R3928A S A 182 F316 Vogt R4608A SA 16Z FJ1b Vogt
=
_ _ _ _ _ - = = =. = =. = - - -
(1) For menvally oc.ersted vehree onty.
- $wpplemental sheets in form of lists. sketches or drswings may te used provided (1) s;te is 81/2' a 11*, (2)information in items 1. 2 and 5 on this Dets Report is included on each sheet, and (3) each sheet is numbered and number of shefts is tecorded at top of this form.
Enesuchmanniemeninhasmammmaamewaun i -r m -i 4
e-4.
-o~~-
,- i.
- 9. 4 r..
w.,
-a rg
>S. ^* % ". Mort No. F
- M if,W! Met'edeISM No P"IN d,6 M M'a M e~r.sfrp p p t gjy, g,geg g
~ -
oe -
+ -. p.. t iw...
t.
ff.
. Cop Screv HPJ' SA $64 Gr. _630 Vogt_
A (Condition H 1150)
- ,s r.
w-141 Other Ports
~
Gate
- O liS G 5A bbT, Gr. bJU Vogt
~'
(Condition H 10B)
-i V
.1 4
<O
't 5[Y6
~
- p. Hyrenemw ten
- ret, oisk oit#,rentie teet s.
sure.,
r.1, s
C CUITinCATE Of COMPUANCE O
we cemfy that the statements made in this report are correct and that this pump, of valve conforms to the rulee of 1974 C
construction of the ASME Code for Nuclaar Power Plant Components. Sectien ut. Div. I., Edition _
S tu=e r ' 75
, Code Case No.
Dete - Decceber 8,1983
~~~
udence d a,, J d u d ca...
Hen ry Vogt Machine Co.
sy _
5,gned s
t c.,in..
ie.,,
Our ASME CMf cate of Authorization No to use the symbol e spiree
<=>
so )
CDITinCAT10N Of DESIGN Henry Vogt Machine Co.
Oman informat.on on file at _
Benn V gt Machine Co.
Stress enotysis report (Cises 1 onty) on file et W g D. Yo mg Owgn speo6 cst a cert 44 by (11 A ans as 4557 PE Stste g,g ya.
R. S. Perry Stress enstysrs cefti6ed by (1) 5380 PE Stsw _Jentucky p,, go.
(1) Sagne'ure not required. List name onty.
CfJtTinCATE OF SHOP IMPECTION I, the undersagned. holding a valid cornmisaic*i issued by the National Board of Bober and Pressure vocael Inspectore Cot:::aercial Union Ins.Co.
end the State or Provmco of _. Kentucky and employed by of.
E08t0Ds NA have inspected the pump, or vatve, described 6n this Date Report on De eer.b e r 8, 3 g,,8,,,3. end st ate thet to tha best of my knowf Hg e a od belief, the N Ce rtificate Holder has con-l structed this pump, or valve. in accordance with the ASME Code, Section Ill.
Dy syning this certificate, neither the taspector not his employer makes any warranty orpressed or implied, concerning the equipmeet desortbed in this Cate Report. Furthermore, neither the inspector not his empfoyer shall be liable in er'Y petty damage or a loss of any kind arising from or cc.anected with this inspection.
reanner for any rsonal inj or
__ 1 l'entucky #1 Date
_Idt Comm;ss;ons i
Z[w 4.ctori th en 60. State. P.ov and suo I u-.==+--
a
__.7_-.
.m...
t FOM N!s 2
'&PPEND!I !!
- MhMhkTONT 33735D FORM r!s 3 OnstIR's RD0tf FOR RD&Its OR REP!ACDerTS As-Required by the Previsions of the Asus Code sectica II j
l 1-1.
OWNER APat/ENTrnef OPrnA71 Ms. IBC.
94E5
/8-/8 - Pd Name nr. s. nor tsy e. ness,tter". Am. neot me T
/
et
/
-Address L
2.
PLANT ADValtt it WDet PAS ONE WIT Two Nee RT. 3. 101 13 70. RDj 3Ff f YT1 f T, AR, 72801
((, d8888 7 9f(/ fp f)- gp/f)
Address Repair Organisation 70 No., Job No., iG.*
- i 3.
WORK PERFORMED ST AF&13Ezrtst f ops.. tue.
TTPI COM 51330L STREP E/A same AIFDIDRIEkTION NO.
E/A RT. 3. Box 1370, RUSSELLVILLI. AR. 72801 Address EDIRATION DhTE n/A i
4.
2DENTIFICATION OF STSTEM AZ)4MB AD h NoR-/SY U
!. (/
5.
(a) APPLICARM CONSTRUCTION CODE _.[12N7ZI' 19g IDITIN, S-/f75~
&DDEND&,
NA CODE CASR I
(b) APPLICA3M EDITION OF SECTION II IFY1LIZED FOR RDAIRS 08 RIP!ACIMDffs 19 P4 6.
IDENTIFICATION OF COMPONDfTS Rh AIRD OR REP! ACID AND REP!ACIMENT ComtalDffs NhTION&I'
' RD& IRED
- EUOI NAME OF MAME OF NhMUFACTURER O!MER TE&R RIPEACEn 4
I E
COMPONDft MANUTACTURER SERIAL NO.-
IDENTIFICATION SET 11.T tR
=-
J=,,=,
.s RDi&eD.,r AA ai
/47 NA
/8S-/0 +'2 M 73 A
' 1/1L A
N o-Asset 7' NA JBs-/es7 irt3 Astbud b
i i
M l
i 4
l l
Ni L
1 l
u 4
c T.
DESCRit?!ON 07 MORK ANY.nl/lAf/b &AflOl L eP 92-fe/Y 8.
TESTS CONDUCTED: HTDROSTATIC D PNEWATIC D If0 MIX 1L 0PERATING PRESSURE D OTHER O PR2ssuns NA-esi TEST TEMP.
NA
_'F
' NOTE: Supplemental sheets in form of lists, akstches, or drawings may be used, provided-
-(1) size is 8% in. x 11 in., (2) information-in itens 1 through 6 ce this report is
- included on each sheet, and (3) each sheet is tambered and the number of sheets is
- . recorded at: the top, of this farm.
4
- A.
sm-021 asyl&ED 06/w/st ross KIs-2 (sock) s nosnxs NPV-/ OYR b Applicable Manufacturer's Data Reports to be Attached t
~
g I
exnIrtem or ccNrt.Iams
-g I
1 I
% esrtify that h statesents ma6e in the report are correct and this I
A1/tl' htt/g/
conforms to the rules of the AsaK Code Section II.
t l
l repiit or replacement l
l i
i l
I Type code symbol stamp w/A I
I I
I I
Certificateofauthorisationp.
y/A E3piration Data N/A l
l
/13 ApC
, toni si,ed use os i
o nor er owner's Desiones, Titis l_
R. D. Gillespie - Manager, Central Support Ij i
1 I
cxrrrrtem or Insxn2cr Ixsnerzou I
I I
2, the usdersiped, holding a valid commission issued by the htional Board of
- I i
l soiler and Pressura Yessel Inspectors and the stats or Province of i
Atra sAs I
i and employed by *DWRIGHT MUTUAL INStfPMCI Co, si
~l N0?V00D, MASS.
I ovnarts Esport during the period h8?e insDetted & Compooents descrhd la this4 m 4-?o-o to
/4 -Jo-95 l
and state that to the best of my knowledge and belief, the Ovner has performed
,1 I
l extainations and taken correctin measurer, descrhd la this owner's Report in I
l accordance with the requirements of the AsME Code, Sec' tion II.
l I
1 l
Ry siping this certificate neither the Inspector nor his employer makes any l
warranty, ampressed or implied, coocerning the azaminations and correctin measures ll I
described in this owner's Raport. Furthensors, neither the Inspector nor his l
l esployer shall be liable in any manner for any personal injury or property desage l
or t loss of any kins arising from gr connected with this inspection.
i l
l
- 9. O,6)L.R FACTORY MDTUAL SYSTDiS I
l Commissions NB-9947, ARK-f133 "N" "18'"A "
l l
(/ Inspector's sipature National soard, stata, Province, and Endorsements !l Dais * *lli **
/o/.a 9 2,31,
,1-I
hi, l.
ew~
j gyy r2wyrgyr.wwv.ttw,swew.=+=tve_M F y J~g Mew m...
k#
.h g b
k
f
.!b ih.d6 hM1.,,
I w/_
'. $y <y;8;<.E"
~/i?dFORM'NPY.rN;CtMTECATE'ItOLDDtr-DATA-REPORT.FOR;NUCt. EAR l dWi;OMWAL.. ]W.W Jr.,
5
, e 'Cfi--
......... As Mehulted by the Priwiejonsid tdASME Cd SlactfodlO D.
.3=
YOEC ' Machine Co., Louisv11.le,' 'KY A; E'D*7 Njk
- 1. Menufectured W
(%sme ano Aodress of N CertiNt cIto bioer:., Litt1'e Rodk,'AR-Arkansas Fever & I g t
'l
- 2. Manufsetured fo, o..mo k% aassesEe eve w or ownerkussellville, AR Ar ans as uclear one, 1 w% eiwenetu _
atY TNe
. Nominat tniet Site Outlet' Site G Pump or Vehre OncN Oncre (a) Model No.. (b) N Certificate Holder's (c) Cettedien Series No.
Serial Registret6on.
(d) Drsng (f) Nat'l.
(g) Year No.
No.
No.
(el C1.s.
Bd.No..
Bullt CC --
or Type 1983 B-49832 1
152-215017 n)
Cate O"
e m
161-215017 (See Attached Sheet) gg$ - //J e/J 01 o
gi SW /48 ~ o7150/ Y ts)
Y (6) y m
(8)
- O (9)
(10) m 5.
taw oestnpt on of ww.ca tw m w :... o gneat O
1500
_ p3 V or Vehre Pressure class psi C 6 Design Conditions d empereng (Propurel 3600
- p. e, iocer,
- 7. Cold Working Pressure
- 8. Pressure Retaining Pieces Manufacturef Romerks Matefiel Spec. No.
Mark No.
(a)Castngs I
(b) Forgings Body SA 182 F316 Vogt Rt.611A Bonnet R3928A SA 18Z F316 Vogt R4608A SA 162 Ulb vogt (1) For manually opersted veMs onty.
- Supplementat sheets in form of lists, sketches or drawings may te i. sed orovided (1) size is 81/2 x 11, (2)information items 1. 2 and 5 on this Data Report is included on exh sheet, and (3) each sheet is numberea and number of sheets is recorded at top of this form.
.o.
~u
. ce re.m s.
vmng. sy.., w
.. n.s.., w.;..... ~...nW M w a.s.
{,b,S'J". Mort No'fM!N 4.(i&?iMMS6edTEid.d 6,@@'*Ef@ter $@ 339$h7yM
.I.3 7
......... u.m i,..g i
~
-...~
.... - ~.
..,r..
(c) sosting n
g.
- A'/ ~
Cap Screv
.Vogt f
(Condition H 1150) e..
b, os ~
Idi other Perto Cate et) nc sA db4 Gr. b.w vogt (Cond.ition H 1075)
T 4
5T00 O'sk Cifferentief test prowure pol.
e
- 9. Hveartstic toit pai.
O CERTIRCATE OF COMPUANCE We cenity that the statements made in this report are correct and that this pump, or volve, conforms to the rules of O
1974 constmetion of the ASME Code for Nuclear Power Plant Components Section lit. D<v. l EditionDecember 8, 1983 C
Su=er ' 75
, coe, c,,, so, p,,,
Addenda b,,.m) [%g aames Henrv Vogt Machine Co.
g J
s;gned _
2/10/84 su cemnw. o o eers n
947 N
symbol expires to use the Our ASME Certificate of Authordstion No.
c.=t
<=>
CDmRCATION OF DESIGN Henry Vogt Machine Co.
Devon infortnat>on on file at Henry Vogc Machine Co.
Strova enaNsis report (Close 1 onty) on fire et Larry D. Young Des.gn speofieraons certir.ed by (1) ansas 4557 PE State Reg. No.
R. S. Perry Strus anayss certified by (1) 5380 Kentucky p,, go, M State (1) 5.gnature not required. List name only.
CDmRCATE.OF SHOP INSPECTION
- 1. the undersegned, holding a valid commission issued by the National Board of Boller and Pressure Vesset inspectorsCot::me Kentucky
- and employed by and the Sate or Province o, Boston, MA have inspected the pump. or vatve, described in this Data Report on of.
83. a nd state thet to the best of my knowiedge a nd belief.the N Certificate Hold er has con-Dececher 8, 39 structed this pump, or volve. In accordance with the ASME Code. Section lit.
Dy s4 ming this certificate. neither the Inspector nor his employer makes any warrenry, expressed or implied, concomin the equipment deso6 bed in this Data Report. Furthermore, neither the inspector nor his employer shall be liable in any perty damage or a loss of any kind arising from or connected with this inspection.
manner for any rsonal ini or Dececher.
39,
Kentucky #1 4' / a Commissions (N tt'l 8d. Steve. P.ov smi No.1 a
V (msb.cror) t
.~.
-.. ~.
-~
~ ~ ~ -
mes r-
..-_ _. ~. _ - _
FORM N!5 2 AFFINDIX !!
- IE 2 & TORT RIVISD ING 021 06/30/09 FORM Nts.2 06051'8 RDorf Pot Rohtts OR kp14CIMErrs As Required by the Frwisions of the ASME Code sectAan E 1.
OWNER Apat/EwTner openinors. Inc.
RTE
/4-# - f4 Name RT.1. Ref 117 C. RUSfftLYTH v. AR. 72901 SIRIT
/
of
/
Address 2.
PLANT Anrivsts weetran err tar!T Two Name RT. 3. 101 137c. RussrttVTtte. AR. 72801 10, OON/f/8 Address kepair organisatian F0 No., Job No., etc.
3.
WORK PERFORMED ST AP&t/Estraer ops.. Tve.
TTFE C005 57390L STnMP N/A same
&DTNotI S TION B0.
n/A RT. 3, Rex 1370, RUS$11LVILLE, 42. 72001 Address EIFIAATION R TE m/A 4.
IDENTITICATION OF SYSTEN MV4W(14 (JR8-N) i v
y 5.
(a) APPLICA3G CONSTRUCT!CN C00g juI-fff
19 E DITION, 9-77 ADDEND &,
Nd CODI CASE I
(b) ArrticAsu EDITION OF SECT 2Cet E UTILIED FOR REPMRS OR REPLACIMorts 19 8d 6.
IDENT!ricATION OF COMP 0NDfr$ RDMRD OR REFuCD AND REFIACIMENT CCHFCEENTS ASME NAME OF NAME OF MANUFACTURER OTHER TEAR
,\\
CODE i
COMPONENT-MANUTACTVRSR SIMAL NO.
IDerTIFICAT!cN WILT ON D
=-
g=4
.s
. D u C
,r Y
l$$k l
3 A4 Osy-sof&
199/ badn6 A/Ms l I
I 4
lN L
j l
N j
t
\\
h
]
p y
1 p
[
7.
DF5CRIPTION OF WORK A W 4% d WWuv//d/9/12/F ua/4/abwl#',,
v s.
TrsTs coWDUCTID: NTDROSTATIC D FMEUMATIC D NOMINAL OPERATI M PRISSURr O orxrR o PR255URE NA Dei TEST TENF.
p
- F NOTI: Supplemental sheets in form of lista, sketches, or drevings may be used, prwided (1) size is e% in. m 11 in., (2) information in items 1 through 6 on this report.is included on each sheet, and (3) each sheet is nud>ered and the rumber of sheets is
. recorded at the -top of this form.
(
. - -.~ ~
. - - - - -. -.. -.. -.. -... ~
...... =
- ENO-021 asvassa' 06/M/89
(
FCM N13-2 (back) m 9.
REMARK 8 N/A
' applicable Manufacturer's Data Aprts te be Attached l
l i
i^
1
~
4 l
I czanncats se courL1aats i
I i
1 I
We certify that the "statensats ande in the report are correct and thia l
i i
stMadv couderas to the rules of the AaB code, Sectian II.
l I
repait er replacement t
i I
I 1
I type code stubel stamp n/a l
l l
.I I
certificate of Autherisatlan'Wo.
3/a Empiratisa Date n/A l
l Signed
/d [
//w Date
/ 0 ~1 L -
19 I
Owner er owner's Desinee, title l
l
- s. D. Gillespie - Manager. Central Support l
l 1
l l
. czarrncars or zussans zustscrzem l
1 2, the edersigv.4, holding a valid commissian-issued by the National Seard of
- l i
l
{
l l
Seiler and Pressure Vessel laspectors and the State er Prwinee of
- 'l.
I ARIANSAS and eeployed by *nrvntent wrnt instmANCE CO.
of l
I nowooD. MASS.
I ownerts Report during the period have taspected the compements described in thise.4 w.
a-20 91 te
/4 -#6 -f/
,l f
I and state that to the best of my knowledge and belief, the Owner has performed I
l
- examinatians and taken corrective esasures described in this owner's Report in I
accordance with the requirements of the AsME Code, Sec'tian E!.
1 1
I I
- ty siping this certificate neither the faspector mer his agleyer makes-any i
i verranty, espressed or implied, conceralag the esaminattens and eerrective measures l1 I
described in this owner's Report. Furthermore, neither the Inspector mer his.
l l.
employer shal?. be liable in any manner for any personal injury or pro er a less of any kind-arising from gr esenected with this laspectiae.perty damage I
-l l
FACTORY MUTUAL SYSTEMS l.
1
- 3..C. [.faQ -
Commissions NB-9947. ARK-r133 "N" "18' "A" l
l j
j 01aspectar's 31pature Battenal Seard, State, Province, and Endorsements l I
J. O l
Dete. E111oced c.'GLe-, a;t 1991 i
l l
l*
I 4
u
~
FORM N!5-2 APPENDIX !!
- NAND& TORT MVISED INo.021 06/10/81 FORM xts 2 CWWER's RI?OR FOR MPAIM OR RIFIACEMENTS As Required by the Provisions of the AsME Code 5+ctico XI 1.
0 WHIR APst/DeTncy cPERAT10W1. IEC.
D&S M "M" 9N Nhme RT. 3.10T 137 C. IVSfYLLTI112. AR. 72801 SMIT
/
sf
/
Addrass 2.
PLANT AM1143 A3 FUCT Me Off IBIIT Tvo Name RT. 3. BOI 137C. RUS$t1LVTit t. A1. 72801.
10, OOUPNI Address E*ptir organisation P0 No., Job Wo., etc.
3.
WORR PERFORMID RT AP&t/tyrncy oys.. Tve.
TTFE CODE STMDOL ST1MP M/A name
&UTHORISTICtf NO.
1/1 RT. 3, Box 1370, RUSSELLVII.I.E. AR. 72801 Address EX?IRATICII DLTE n/A 4.
IDEurtrtCinOH OF SYSTIM O VM (2//8f-/)
5.
(4) APPLICABLE CONSTRUCTIQlf CODE MeM ItC19 7/ EDITIC0l, 8-75
- ADDENDA, NA CODE CASE (b) APPLICASLE EDITIC84 of $1CTION II URLIZED FOR R171I15 CR RE71.ACEMDris 19 M 6.
IDENTITICATION OF CCEroNDrr5 REPAIRID OR RIFIACID AND RIFLhCIMDff COMPCNDfTS REP 11 RID "U "
E NAME OF NAME OF MANUTICTUM1 0THER TEAR REFLACID N
COMPONENT MANUTACTURIR SIRIAL NO.
IDDf71FICATI00f SUILT OR 4=A
=.
=rtic=x=fT s
av t i AV6 2 N&
26 V-1V8/-/
/fr'/ h uYA
//14 N
l I
L L"
l lN j
c e
j c
i N!
s c
l 1
\\i u
i i
4 k
n 7.
DESCRIPTION OF WORK ME#MVINMbW/Ild r2I#
2WNI//AI AWN,
~
8.
TESTS CCHDUCTED: HYDROSTATIC 0 FXIVKATIC D WOMIX1L CPIR&TDeG PRESSURE O OTHER O PRIssURI NA esi T137 TEMP.
N&
_F NOTI: supplemntal sheets in form of lists, sketches, or dravings may be used, provided (1) site is th in. x 11 in., (2) informatico in itects 1 through 6 en this report.12 included on each sheet, and (3) each sheet is numbered and the number of sheets is
. recorded at the top of this farm.
I
_ - - -.. - - - ~ -
..... =
- asvaass
.ENG 021 N/30/89 FORK E18 2 (Seck) 9.
REMhkK$
N/M
/ Applicable Manufacturst's Data Reports to be Attached i
i l
I cazriticart or courLIancs l
1 l
1 We certify that the' statements made in the report are correct and this l
l AcM/h conforms to the rules of the has code, section II.
l l
repair'or replacessat 1
I l
1 l
l Type Code symbol stamp s/A l
1 l
l Certifieste of Authorisation No.
3/A Impiratian Date 3/A l.
I Siped bL 4//m Date vo - t '-
, 19 l
owner er owner's Desimee, Title l
R. D. Gillespie - Manager, Central Support l-I l
l CERf!FICLTE OF INEIR71CE INSPECTICE l
1 l
l 2, the undersiped, holding a valid commissian issued by the National Board of
- l-l Beiler and pressure Vessel Inspectors and the State er Prwince of-l
_ l
_ AREA 35As and employed by *nRVRICHT MUTUAL INSURANCE CO.
af l
l MORVOOD. MASS.
have inspected the semponents described la thisit4 m.
I ownerts Report Aaring the period 4 H
_ to - /d -3 42
,1 I
and state that to the best of my knowledge and belief, the Owner has performed l
I examinations and takaa corrective measures described in this owner's Report la l
I accordance with the-reg 11rements of the ASMI Code, Sec' tion II.
l 1
l 1
By siping this certificate neither the Inspector nor his employer sakes any varranty, empressed or laplied, concerning the awaminations and corrective measures ll l
l described in this owner's Report. Furthermore, neither the Inspector nor his l
l employer shall be liable in any manner for any personal injury or pro l
or a less of any. kind arising from gr comoected with this inspection.perty damage l
l l
FACTORY MUTUAL SYSTEMS l
l
$. O. - dJfM Commissions N3-9947, ARK-T133 "N" "I" "A" l
l 6taspector's sipature National Board, State, Province, and Endorsements -l-I J. O. Elliote I
l Date Ce2 Eau a2 19 h l
]
3 l
m._-.
l
~
' FCM W!5-2 APPENDIE !! = M&Nhkf0ET 33y2333 FORM NIS.I OMR'S RDORT PCR RDAIRs OR REFlacINDff$
As Required by the Provisions of the AsME Code Section E!
/8 // fd 1.
OWNER Apat/trrney openaTrout. rue.
~ -
Name RT. 3. ser 137 c. RUsfrittret'. AB. 72801 Sm?
/
of
/
Address 2.
PLANT Anran ts NUctrin est M
Two N'**
RT. 3. 101 137c. nossrttVfffT. 11. 72801 3d, 0088/2/ 7 Address Repair Organisatian 70 No., Job Wo., etc.
3.
WORK PER10MID ST Apat/tserner ops.. Tuc.
T!Pt CODE 51 2 0L St3NP R/A Name
&P!MRIZATION N0.
3/A RT. 3. Box 137G, RUSSELLVII.LE. AR. 72801 Address EDIR& TION hk2E n/A 4.
IDENTIFICATION OF ST3TER St/Ru16 b >>
1Ad[J#d8-Md i
V V
5.
(a) U PLIC13LE CONSTRUCTION CODE S M TIC 19 E EDITION, J-79 ADDEND &,
N#
CODI CASE (b) APPLIcAsLE EDITIm 0F SECTION II FTILIZED FOR RDAIRS OR RDIACENDffS 19 84 6.
IctNTIFICATroH OF COMPCNDff$ EkPAIRED OR RDIACID AMD REFIACEMENT COMP 5ENT RDAIRED ONLI' NAME OF MAME OF NhWUFACTURER OTHER TEAR REPIACED a
COMPONENT MANVTACTURER SERIAL M.
!DENTIFICATION BUILT E
=.
.Dae,=,
sg, l
5 AM
,7 S p - C e f Y
/98/ 20tadtd>
N ix l
l
!N i
L l
l N!
l l
l.
U h
h h
b DESCRIPTION OF 1CRK Ile M # Afrw //1 4 3e M 8 I I m / b 4t b W l 6, 7.
V 8.
TESTS CONDUCTED: NTDROSTATIC D PMEUMATIC D.
NOMIXhL CPERATIM PRZS5URE O OTHER O PAISSURE NA Dei TEST TEMP.
wA
'T NOTE: supplemental sheets in form of lists, sketches, or dravings may be used, provided (1) size is th in. x 11 in., (2) information in items I through 6 on this report.is -
in:Iuded on each sheet, and (3) each sheet is nu6bered and the manber of sheets is recorded at the top of this form.
w a
+*sme mmw=--v--Mv w 1y m
ee m.
e w
W-
m m_..
~
g o. cal asvaass
/38/8' PcAN Els 2-(Seck) no u ns n/n
/ Applicable Manufacturer's Data Reports to be Attached l
czartncars or ccecrizases l
l i
1 We ce I
I AfAw+rtify that the ' statements made la the report are correct and this l
l conferas to the rules of the As3 Code,Section II.
l I
repait er replacessat I
1 I
l l
Type code symbol stamp w/A 1
1 i
I certificate of Autherisatino N/A supiratien Date M/A 1
1 I
siped 2
/Ib,<=
Date
/c-7 L-
, 19,2 5 I
owner er owner's Designee ~, titla l_
R. D. Gillespie - Manager, Central Support I
i I
1
~l-
-l
. czartricm or zustav2c zustscTrom 1-l I, the undersiped, holding a valid commissimo issued by the National Board of
- l I
I Seiler and Pressure Vessel !aspectors and the State er Prwince of'
.l l-ARKAstAs and esplayed by *nmicBT MUTUAL IN5tmANCE CO.
of I*
I nowoOD. MASS.
1 Owner!s Report Aving the period have inspected the compements described in thisi.4 as. -
4-?o-91 to
/d ~#6 -92
-1 and state that to the best of my knowledge and belief, the Owner has performed -
1 I
1 examinations and tahan corrective measures described in this owner's Report in-1
-l-accordance with the requirements of the ASME code, socition II.
4 I
l l-I By siping this certificate neither the taspector ner his employer makes any.
I I
warranty, empressed er lay 11ed, concerning the_ saaminations and corrective asasures 1
-l described in this owner's Report. Furthermore, neither the _laspector nor his _
l-I employer shall be liable in any manner for any personal injury or property damage I
1-er a less of any kind arising from gr commected with this inspection.
- 1
-l l
3 i O. [ M FACTORY MUTUAL SYSTEMS
- l-Commiseions NB 9947,1 ARK.r133 "N" "I8'"A"
- l (Inspector's sapature
- l i
I National Seard, state, Province, and Indorsements I J. O. Elliote 1
Date 29,ra a.:t av g 5
.I i
4 l
4 5
t
FORM NIS-2
' &PPENDIE !! - MMEDATON!
3371gED FORM N15 2 OWEER'S RDORT FOR RD&1RS OR REPLACEMDrts As Required by the Frevisions of the AstlE Code Section II 1
-1.
0WNER Ant /rwTrnav openitiers. Inc.
MIE M-//- 94 Naas RT. 3. ter 137 c. Regrettfr"*. AR. 72801 EMET
/
of
/
Address 2.
PLANT atraitqtt WDet win oEt WIT Two Name 88.*OO886887 RT. 3. ROI 137C.1011rt t YTt t v. 11. 72001 Address Repair Organisation 70 30., Job No., etc.
3.
WORK PERFORMD ST 4ML/tstEncf on.. TEc _ TTPE 0008 STISQL STMIP E/A l
Naas i
&UTHORIZ& TION 90.
E/A RT. 3, Box 137G, RUSSELLYTLLE. AR. 72801 Address EDIR& TION D&N n/A IDDTIITICATION OF SYSTEN Mb
[48d8-8) 4.
5.
(a) APPLICABLE CONSTRUCTION CODE 19M EDITim, )P-/f#2 ADDEND &,
NA CODE Cast l
(b) APPLICABLE EDITICN OF SECTICN II UTILIZED-FOR RDAIRS OR REFLACEMENTS 19 86 6.
IDENTIFICATION OF COMPONDTS REPAIRED OR RDL&CID MED RDL&CEMDrf CMPCNENTS l
ASME RDAIRD{
CODE "Ib REF1&CED e
NAME OF N&ME OF NhMUT&CTURER ODEIR TE&R E
COMPONENT MANVTACTURER SERIAL NO.
IDEarf1FICATICW SUILT 08 l
,R=><=imera
.s YL I
A NA MV-SB35-f IH3 bnUd Abb N
i l
l\\
l l
N:
l l
N u
n i
c k
1 7.
DESCRIPTION OF WORK M D i d 8
1#w d M M.
8.
TESTS CONDUCTED: NTDR05fATIC D PNEWATIC D WOMIN&L OPERATI m PRESSURE O OTHEA D PRE 55URE NA' psi TEST TEMP.
N#
'T-NOTE: supplemental sheets.in form of lists, sketches, or drawings may be used, provided (1) size-is e 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 sheets is
. recorded at the top;of-this farm.
N~
asvasso ENO-021 M/30/M Foss Nis 2 (Back) 9.
ROGAK$
NM
' Applicable Manufaeturar's Deta Reperts to be Attached I
^
1 I
I czanncm or carl 2 Ants 1
1 l
l We certify that the ' statements made la the report are correct and this
-l I
Aceh conforms to the rules of the has Code,Section II.
l l
repair'er replacement l
1 I
l l
l Type code symbol stamp w/A l
I I
I certificate of Autherisatlan y/A Empiratian Data n/A i
)
siped
/
Ad
/b Data
/c - 7 '
, 19
.I owner er owner's Desime's, title l
l R. D. Gillespie - Manager Central Support l
l l
l
. czannem or Inszunts Instscrza 1
I l
i 1, the meersiped, holding a valid commissian issued by the National Board of
- l
-I kilar and Pressurs Yessel Inspectors and the State er Prwince of l
I
_ AArs1AS -
and employed by *mwRIGHT MIMAL INSITRANCE CO.
of l=*
I notwoon. MASS.
have inspected the components described in this:4 as.
I owner!s Aspart Atring the period 4-?o-91 to
- -#6 - 91 1
I and state that to the best of my knowledge and belief, the Owner has-performed l
I examinations and tahan corrective measures described in this owner's Report in l
l accordance with the requirements of the ASME code,'Sec' tion II.
l l
I I
ty siping this certificate neith1r the Ins i
warranty, expressed or isplied, concerning the =pector nor his emplorer nahes any I
===tnations and corrective measures'l I
described in thir. Owner's Report. Furthermore, neither the Inspector nor his l
1 employer shall be liable in any manner for any personal lajury or property desage i
l or a less of any kind arising from gr connected with this inspection.
l l
FACTORY MUTUAL SYSTEMS l
1 9.. O' [ll,C Commissions WB-9947, ARK-1133 "N" "18'"A" l
I Gaspector's sipature
- Detional seard, state, Province, and Endorsements l l
go.Elliottg j
i I
x
?
0
FORM N!s-2
' APPENDIX II - N1MD& TORT R372 SED f
ING 021 06/30/49 FotM NIs.2 OWND'S RIFORT FOR REPAtts OR REFIACDENTS As Required by the Provisions of the AsME Code section II 1.
0WNER Atst/DrrncT ornAT10ws. Inc.
DLTE
/d - M-95 usee RT. 3. tor 137 c. testtuvitt'. AR. 72801 sm
/
of
/
Address 2.
PLANT nrEntt 1rUtten Our IRf!T Two Name
- n. 3.101 iste. lessrttvrtir n. 72:01_ IA 60P&//4 9 Address Repair Organisat.Lon Fo No., Job Mo., etc.
3.
WORK PERFORMID IT AP&L/DFrmir 0P2.. Tve.
TTFE CODE STt90L ST1MF N/A name EUDR**.IZAT100f NO.
1/1 RT. 3. Box 1370, 10$$ELLVILLE A1. 72801 Address EIFIRATICII DLTE n/A IDENTITICATIcm 0F sTSTEx AuM/24p]mauS[#GdB-70) 4.
5.
(a) A.PPLICARLI CCESTRUCTICII CODE 19g EDITICIf, JP-74
- ADDENDA, NN CODE CLSE (b) APPLICABLE EDITICet OF SECTIOtt II ITTILIZED FOR RIFAIRS OR REPL&CIMDffs 19.D4 6.
IDENTIFICATION OF CCKPORDrts IEPAIRED CA REPLACID AND RIFLACIXDff COMPWDfts E
REPAIRED
- II'
- I NAME OF NAME OF MANUTACTURIA CDtER TEAR REF14CED
==
52==
Conrox m
- riC m za smu.
0.
tecnnnCinon m tT OR R2FlAC"XDff 0
)
rk lW? IkM -4 /8 N pp 28s./2A1 197V Aeu<did 411s l l\\
j L
i l
r lN l
u u
l l
N!
c l
c l
\\i i
i
'i l
n i
T.
DESCR1FTION OF MOKK AwtM %_Amr$didNulh rHlldhrb M lb, 8.
TESTS CCHDUCTED: HYDRC$7ATIC D F 2VKATIC D WOMIX1L OFIRATIM FRISSURE O CTMER 0 PRIsscKI NA psi TEST TEMP.
NA
_' F HOTE: Supplemental sheets in fors of lists, sketches, or drtvings may be used, provi6ed (1) size is 8\\ in. x 11 in., (2) information in items 1 through 5 cc this rrport.is -
included on each sheet, and (3) each sheet is owbered and the manber of sheets is
. recorded at the top. of this fans.
i
asvisED moo-cal w/m/es FCM N1s=2 (Seek) 9.
ROGARs Nb
' Applicable Manufacturer's Data Reports to be Attached e
l L
=-
I czarIncm or costrLinum l
l l
1 we certify that the' statements ande in the report are correct and this l
l conferns to the rules of the nas code, sectica II.
l 1
repair er replacement l
1 l
l I
Type code ayubel stamp n/a l
1 I
I certificate of Authorisatise 3/A Empiration Data W/A l
siped b/A
/d l Data
/o-ia_-7 % gg_g i
owner er owner's Desime', Tith
-l e
l R. D. Gillespie - Manager, Central Support
{
l 1
I
. c anncm or zustana zustscrton l
I I
i 1, the adsrsiped, holding a valid casumissian issued by the sational Seard of
- l 1
Boiler and Pressure Yessel taspectors and the State er Prwince of l
l AREstas -
and employed by *nrvntCET MUTUAL INSURANCE CO.
Of i
140RV00D. MASS.
have inspected the capats described la an.
I ownerts Report during the period 4-20-91 to M -#d-fl
,1 I
and state that to the best of my knowledge and belief, the Owner has perferned l
l emaninstions and tahan corrective sensures described in this owner's Report in l
I accordance with the regairements of ths AstR Code, Seition II.
l 1
l l
By signing this certificato neither the laspector nor his emplerer makes any warranty, espressed or implied, concerning the===iutions and corrective measures ll t
1 described in this owner's Report. Furtherners, neither the taspector ner his l
1 employer shall be liable in any manner for any personal injury or property damage l
I er a less of any klad arising from gr connected with this inspection.
l l
FACTORY MUTUAL SYSTEMS l
-I
- 9. O. 2,RM Commissions WB-9947. ARK-r133 "N" "18' 'k" l
l Gaspector's sipature National Seard, state, province,.and Endorsements l I
J. O. Elliott I
l Date
% gas 4 A 19M l.
.I I
- TOM N!s-2
&PPENDIE II - MhlE&TOET REVISED sNO-021 06/30/e9-PORM NIS I Ot0EER'S RDORT FOR RD&TRS OR REP 1ACIMElrFS As Required by the Previsions of the ASME Ceds section II 1.
OWNER Ant /rwTrney ominmen. rue.
MIR
/8-/J-f/
Name
- 37. 3. nor 137 c. Regrettvf'". AR. 72801 SIBIT
/
of
/
Address-2.
PLANT inrin n wDet*** our WIT Two Name RT. 3. nor 137c. RDsset t yrttv Am. 72001 I 8, 6CP&//Y/
address Repair Organisatian 70 No., Job No., etc.
3.
WORA PERTORMED RT Ant /rsrrner on.. rue.
TTPE CODE 5120L STAMP R/A Bane
&UTHORIZh71W NO.
n/A RT. 3. Box 1370, RUSSELLYTLLE, AR. 72801 Address IIPIRAT!W MTE n/A 4.
IDENTITICATION 09 SYSTER A122nal l bh> >$46 [2e28-13) r v
5.
(a) APPLIC13LE CONSTRUCTION C005 4/S6 19 d EDIT!W,_lp 15E ADDEND &,
NA CCDI CASE I
(b) APPLICA3LE EDITIcel 0F SECTICII II UTILIZED P08 RDAIRS OR REP 1& CEMENTS 19 FS 6.
IDENTITICATION OF COMPONDrtS AkP&IRD OR REP 1 ACID &llD REP!ACEMENT COMPQNEN RDAIRD NAME OF MAME OF MANUF&CTURER M&I' CODE OTHER TEAR REPIACID D
COMPONDrf MANUTACTURER SERIAL N0.
IDENTIFICATION BUILT OR fA' m
R=ia<==Nr O
AlAL-NN A608-13-H1 ' /9il _$ nib /
6
!\\"
l l
l\\
l l
l
\\!
l 4
h
-4 0
0 7.
DE$CR11110N Of MOM 1AAAtl11tttsstad"M.
/EALR 92-Mff -
/
Ff S.
TESTS CONDUCTED: NYDROSTATIC 0 File 1MATIC D.
HOMINAL OPERATING PRESSURE O CTHER Q PatssURE N#- nei TEST TEMP.
'F NOTE: Supplemental & beets.in form of lists, sketches, or dravings may be used, provided (1) size is 4% la. m 11 in.,- (2) information in items 1 through 6 en this report.is.
included on each sheet, and (3) each sheet is numbered and the number of sheets is
. recorded et the top of this 19
.L
. ~
co cal arvaass 06/30/es
)
PCM 518 2 (Seek)
- 9. -
RDGAR$
N/#
/npplicable Manufacturer's Data Reporta to be Attached 1
i i
t 1
I I
csar2ncut or carl 2amm 1
1 l-I we certify that the
- statements made in t*N report are correct and this l
l A/Au2>
conferas to the rules of the ARE Code,Section II.
I l
repaif or replasmaat I
l 1
-l l
Type code sfebel stamp m/A
-l-1 l
1 I
certificate of autherisatian Be.
M/A E g iratian Date R/A l.
Siped b,J Date._. /0 - 2 t_
tg l
-ovaar er ovaar's Desi see, Title l_
R. D. Gillespie - Manager. Central Support 1
l 1
I 8
csanncus or zustana zustsence 1
1 1
l 1, the undersiped, holding a valid commissian issued by_ the Natlanal Beard of
- l l
Soiler and Pressure vessel laspectors and the state or Province of _
l l
AuAssas and eglepd by *mvmient NUTUAL InstmANCE CO.
ef 1*
-I BOWOOD. MASS.
h4To insDetted the Campenents described in thisW l-
-Ownerts asport during the peried 4-70-91 to
/d -So -91
,I m.~
.I and State that_ to the best of my knowledge and belief, the_ Owner has-performed-
-l I:
easainations and taken correetive asasurea described in this owner's Sepert in
_l l
-accordance with the requirements of the AsME code, Sec' tion II.-
l i
i i
l-ty siping this certificate neither the Inspector mer his employer nahes any 1
verranty, empressed or implied, concerning the esaminations and corrective measures ll~
_l described in thie owner's Report.
Furthermore.:neither the Inspector mer his l
.. l -
esyl shall be liable in any manner for any personal'ia or property damage l_
i or a s of any kind arising from gr connected with this tica.-
'I l
-l-9.'O. [/AD FACTORY MUTUAL SYSTDis -
l commissions its-9947, An-n33 "u" "18' "A*
l l
42nspector's sipature-I National Board,- state, province, and sadorsements !
'J. O. Elliott I
.1-Date o c h,.7JL 19 1 I
-1 1
i e-e m
..-.-r,-
=
..-n w-
l oRM NIS-2 APPEND 11 II = NUtDATORY kITI$tD FORM wis 2 OWNER'S REPORT FOR REPAIRS OR RIP 1ACIXDffs As Required by the Provisions of the AIME Code Sectice II 1.
OWNER __AP&t/DfTncY OPERATIONS. INC.
/d~/Y-94 name ef
[
_71 3. SOY 137 C. M3ft11YT111. AR. 72801 SMIT Address 2.
PLANT DJ_txsAs yoCinn 01I EREIT Two Name RT. 3. 101 137C. RUS$ttlVTttI. 11. 72801 18, OO88/.Y/d A6 dress Repair organisation 70 No., Job Mo., etc.
3.
WORK PERF0MID BT AP&t/tyrner otr.. Tve.
TTFE C005 STMBOL STAMP W/A Ease M inTICIt 30.
W/A RT. 3. Sex 137G,10$$t117ILI.E AR. 72801 Address EIPIRATICII MTE n/A M _ /a /I Id2 b 'z d [ # F C 8 - d 4.
IDDCIF1 CATION OF SYSTER i
v y
5.
(a) AFFLICABLE CONSTRUCTI0tt CODE
[N 19 77 DITICat, S-/977
- ADDENDA, NA CODE CASE (b) APPLICA3LE EDITION OF SECTION II UTIL12ZD FOR REPAIX.5 CR RIFLACIXDf7519 P4 6.
IDDrtIFICATION OF COMPORDC$ IIPAIRED OR REFLLCID AND REFLkCINDtf CCMPONDCS REPAIRED I
NIXZ OF NAXE OF MANUTACTURER OTHER TEAR REFLACID COMPONINT MANUTACTUR11
$11!1L 30.
IDOf71TICATIC01 BUILT OR
,PA
.mie -r
.s 4
l NR fSit-Se.ff
/98/
$sub
$24 l'%d l'M wr@4,Jb l
o m,- rw lx j
l c
u l
c l
N!
L i
L L
l l
N k
1 I
n u.
k l
DLS*$ Ytwd AMbtttd>1ht/ul N k T.
DESCRITTION OF MORK
/
/
8.
TESTS CONDUCTED: HYDROSTATIC D PMEUKATIC D NCMIX1L OFI3ATING FRISSURI O CTHIR O PAISSURI NM Dsi TIST TIMP.
N# __'F NOTE:
Supplemental sheets in form of lists, sistches, or d. ravings ma7 be used, provikd (1) sise is 8h in. x 11 in., (2) informatice in items 1 through 5 co 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.
i
.... -.. - - ~.~ _.--.. -.. -.. - - -. - - -..- -
- -.. ~.
nsvan NG-021 06/M/89 FCIgl Itts 2-(taek) s.
ntnnans A/PW / db$it/td>
- Applicable Manufacturer's Data Soports to be Attached
- ^
~
I l
I czanncar Or cenPLlancs 1
1 I
I un certify that the ' statements made La the report are correct and this l
l
_Avr/vM conforme to the rules of the ham Cade,Section II.
l l
repdir er replacement i
I I
l l
, Type code symbol stamp N/A l
1 I
l Certificate of Autherisatiaa M/A Empiratian Date 3/A l
Siped
.- l Date
< /o - 2 2-p
, 19 l
4 owner er owner's Desi nee, aitle l
.l E. D. Gillespie - Manager, Central Support l
\\
l l
. csannears or Instancs zustscum 1-1 l
l I, the nedersigned, holding a valid caustissian issued by the National Board of
- l
.I-Boiler m3 Preasure Toasel laspectors al4the State'er Prwinee of l.
I ARKANSAS and employal by *AMVRICHT MUTITAL INStmANCE Co.
of J
I metwooD. MASS.
b8?S in5Detted the cesponeRLs described La th; as.
1 ownerts Report during the peried a '!0-91 to
/4,To - F1
,l 1
and stata that to the best of my knowl6dge and belief, the Owner has performed l
_I examinations and taken corrective measures described in this owner's Report in l
l accordaece with the requirements of the ASMI Code,Section II.
l I
I l
er siping this certificate neither the Inspector nor his employer makes any -
varranty, aspreased'or implie4,- conceraing the esaminations and carroctive asasures ll l
l described in this owner's Report. Furthernere, neither the Inspector ser his l
1 employer shall be liable in any manner for any personal lajury or pro i
er a less of any kind arising from gr connected with this laspection.perty damage 1
I J
FACTORY MUTUAL SYSTEMS l
I S 0; M Commissions ~ WB-9947. ARK-T133 "N" "I 'A*.
l l
anspectar's sipature National Seard, state, Province, and Endorsements I I
J. o. Elliot*
I I
Date o c h.2 A itLA I
I l
)
m %rver-av -...
'. %* 6,,
7 Poned frV.1 N CWtTMCAft N DATA h POR NUCLEAR Pue#8 OR VALysse As Aeguired by tie Peee4elens ed the AStitt Code. Sessies all. 08v.1 1966r nrnadhallnv RA. Em farminadmin, Ny
'Parn*t ant k enen_.
t Wred by INeme end Addeves et 66 Certitk. ele Messers vnwar L t4nht t*n.
g m oor _ A rka n n a n
.as aseeme Pweener #r 0=aare Ar ansas Nuclear one, Units 1
- f. 2, Russellville, ARK a
a won ot wm.oa la
< w Aee 1"
o,,,, s, valve u,m,
, w s.
4 % orvow _
imcN s.=As tal Modes See, all 98 Certio6ceae e.eeeer's (c) Cenes ea Sease he sortes map aressen tal Dre=aag 40 Net's tel veer N
erYy,e
- tee, he he selCnees 64 Dee Sv e 85T-002 2
1985 81P 5, 6 Q1 as 2M-502,9 m g3 tsi es (7) as tot
~
fiel SAFETY INJECTIONS SYSTEM s
- * - a e., -a.e e
-.,e.e. e erme maw :
1500
,y 1950 140 y,, y,,,, p,,,,,,, c w,
c t Dew eadoene e
no i, 3000
,,, my, 7.Conswert.as %
O
~~ ~
uere he samenes spec. on weauteceweer nome,t.
tel C_-
g-etw Body ASME SA IS2r 316L Ideal Forge O
._ T..ctai e$eens sa form ed 6.see, saunches er apressenge may be used proveed (1) ease as S-14* a 1)*, Qi LJv =- :
7 em aeree 1. 2 end I en iPee Dene Aeport to inesweed en each ehest, and Of eech sheet le W and enamber of sheets es reenreos at eep of aus Sern TMs torne M oey be seensand hwan Wie Creer Dem., Aasst,344 E. 4te et,, see, y,,g, eg.y. toot 7 itM
_=. -_
pcued NPV 1 feesW A*awt*
Warwiscour*
useene seu. too s
~
po,g p.e lc) Sea.ng r=
w om., re.
ASME SA 479 SS 316 Universal Cyc1cos Bonnet
?
Ind. Tube ASME SA 479 SS 316 Universal Cyg1cos Main Disc ASME SA 564 GR 630 35 17-4PH Univer sal Cvelops 1100 pai.
4 5 0 0 - pel. Den o n c a w isc p+=s.we g. e.,. =: i CERTMCATE OF CotWUANCE
~
~ e, mi ~ -e ~ - D...ep.,,,e c.,,-. and - ~
. e.,es.o. m,y..,
coaem.cte et sNs A&Mt Code kr Nucleet Poww Pters Componerus sece.en m. Dw. t Edeen
- Does l
Sumer 1979
. Code Cow %
g __ k // M M
/[
m Tarce Rock corocration
- 5. pied 1947 104 Abrgt o, g nageru,9,,g 3 oo, Aust Asmc,n
.c,n Ne m
masse CWITFtCATION OF DESIGN g % en m g _
Target Rock cornarat4nn twom se repen ecues 1 eneyt en me m.
vacry n Ynung g m e,ges g (gg 45$7 AR meg. k pg goes.
sows e ce<dedwtil Pt sense.
Ase h m
m na ro
,od um nome easy.
w CWIT1FtCATE OF SHOP INSP9CT10N
. sne w.ee,,n d % e,e4 4 cocemos.en leewed by she Neoonei Seerd et Se.aer sad Prosev e
one ~ sw or ero > ace o, _ New York Boston, Mass he.,e inepecwd m pome, w vWwe. Gescrit,od an shee Dese As et **
g
/"d /2r u _pl. nd oe u a u se w w 2 2 :. : ena i,e w. e u c.ec.e New. hee-es,w.ad e W. e, vos. in acco,dence m one Asur ce44. suten m.
g e = in,s.d.eeac-n.ae ey e.,a.a. v. c,w.ceae, n
= ine cee< re, m ea,ioy menee say.encey. + :
the ogwemeen ducedied as the Dete Aeport Fvetnermore, nesther the Inopecnot not W envioyw shes tue tieWe an any ne.n,,ry
,,,,eny dems,e < i.ee et say 6 ad one.ae
- m. conneceed e ime me co.a.
mena, se, any./2p" Af, NEW YORK STATE COMMISSON to.2280
//
)MMi ee.44f # M com,n,- sao cows.ss@@N % ONo 4 genn, _
6 one.-,-..
e.
I g
1
-1 FORM N!s 2 APPENDIE !! = MME&TOIT REVISED' j
-t.No 021 06/30/09 P0an wIs 1 ONNER's 200a7 70s mIPAIas on REFLACsamTs i
As Required by the Provisions of the &BME Ceds Secties II 1.
0WNER Ant /rwTrner oPrearians. Inc.
D625
/8- /5' 7A man.
tr.1. ter 137 c. RUstettvi"*. AR. 72001 SMIT
/
ef
/
Address 2.
PLANT inriitsts rect ein our WIT Two Name
- 17. 3. nox 137c. tessrtt vittr. Am. 72001 58, #8087f88[
j Address Repair organisatian 70 me., Job Mo., etc.
I 3.
WORK PERFORMED BT AML/Estraef ops.. Twe.
TTPS C008 ST390L STARP M/A L
Eass l
&UDetIZhfical NO.
n/A l
Rt. 3, Box 1370, RUSSELI.YTilt. AR. 72801 Address EIPIRETICW D&TE n/A IDDrIIFICATION CP 3787EM b@Ib4*C h588- #)
4.
5.
(a) APPLICA31.E CONSTRUCTION CODE juITC 19 7/ BITIC3f, 8-/975 ADDEND &,
t
/S7V CODE CASE (b) APPLICABLE EDITION OF SECTION II UTIuZED POR REPAIRS OR RIFIACIMENTS 19 84 6.
IDDITIFICATION OF COMPONDf75 2IPURED OR REFuCID AMD REFuCIMENT COMPC8sDifs 15"*
aIPuaB'
" II"II' i
NAME OF MAME OF MDfUT&CTURER OfMER TEAR
- REPLACED, O
COMPONDif MANUTAC"NR1R SERIAL WO.
IDeft1FICATION BUILT OR
- gag,
-,uC fT
.s 4
DHb.2 lce - e <> V NA-
,.7PSt^- M S V. M19 Aut$vid AbL lNsa o rd-l V
l I 8 / ' }s.
l bM W) de - Oe6 &
NA
,JP R - M 5 9' 197f b !laumteb $ 4G l I ' 4 <t M.
I V
l Ni l
1 l
Ni h
n u
k i
7.
DESCRIPf!0N OF WORK RIMI//JNtb
,24d4.L 2 8.
TESTS CONDUCTED: HTDRO$7ATIC D PMEWATIC O-WOMIX1LCPERATINGPRESSUREX CTHER O PRIssURE
/ded psi TEST TEMP.
SyG~
__'T NOTE: supplemntal sheets ia form of lists, sketches, or drawings may be used, provided (1) site is s% in s 11 in., (2) in. formation in items 1 through 6 on this report.is -
included on each sheet, and (3) each sheet is,mambered and the manber of sheets is j
. recorded at the top of this form.
l i
! b
. ~.
i szvasso 0 0-021 N/30/st FCes N1s 2 (Back) ntnuts WP NPV-l h&ahZ$intahakAmdh.juic s.
Applicable nanufteturer's Data Reports te4e Attached v
- Ah **s$/k/Yv]> $ ul-432 Ale lMtltO UMAu sk$t08 y
l4 J A A n n A f k h M w t W b b cb btAt' Atw Wx/>$$
4 Anl$ /1< McN484a6 lb/Ja/AA kl Y AklL t
/u
(
I crnirIctrs or conn.IAmes 1
i i
l Vejartifypt the ' statements made in the report ars correct and this l
l A/dEWI/#/M
_ conforms to the rulee of the ARE Code, Sectico II.
l I
rep 41r or replacement l
I i
l I
I type code symbol stamp N/A l
1 I
i l
Certificate of Authoriza No.
y/A Expiration Date w/A l
l Signed A A
k < Ib._
Data
/ /, 19 9 l
' cvner or owner's Desicoes, Title
~~~ l l
R. D. Gillespie - Manager, Central Support l
l l
CERTIrtcitt or DesuvIct IxsFscTION l
1 1
I I, the underaiqped, bolding a valid commis inn issued by the National Board of
- l 1
loiler and Pressure Yessel Inspectors and the state or Provines of l
l
_-AtIA31t3 and employed by *orvRIGHt_ MtrTUAL INSITPAFCE Co.
of l
I NORV00D. MASS.
havs inspected the compcoents described in thisul &
I ownerf s Esport Aring the period 4-20-o1 to _ /4.74-f'-7
,1 I
and stata that to the best of my knowledge and belief, the Cvner has performed l
I examinations and taken correctivs measures described in this owner's Report in l
l accordance with the requirements of the ARE Code, sec' tion II.
I l
l I
sy signing this certificate neither the Inspector nor his employer makes any l
l varranty, expressed or implied, coreerning the azaminatices and corrective measures !
I described in this Cvner's Report..urthensore, neither the Inspector nor his l
l employer shall be liable in any manner for any persocal injury or property damage i
I or a less of any kind arising from gr econected with this inspection.
I I
FACTORY HUTUAL STSTEMS l
l 9 O. [.//uh Ccamissices NB-9 94 7. ARX-Il 33 "N" "I8' h".
l l [/ Inspector's signature Naticcal Board, State, Province, and sodorsements j Date
//[9 1992 I
l 4
' APPENDIX II - M&MDATOEf tr715m FORM HI5-2 ING 021 04/30/89 FotM NI$ 2 CWNER'S RDORT FOR RDitts OR REFuCEMDf75 As Raquired by the Prwisions of the 13ME Code Section El 1.
OWNER APst/mnci ePERitters. Inc.
DLTE
/d -/7-94 Naast RT. 3. MT 137 C. RUf frLLYT111. AR. 72801 SMIT
/
of
/
Address 2.
PLA)TI 11rEEAR FUtttn Off DETT Tvo Name i
RT. 3. BOI 137c. RUssrt t vitt r. 11. 72801 20!OO 87 928d Address Repair organisatian 70 50., Job No., etc.
3.
WORK PERFORMID ST A?st/tsmcf OPr.. Tve.
TTPE CODE ST20L STAMP M/A Name AUTHORIZATI M NO.
1/1 RT. 3. Rex 1370, RUSSELLVII.LE, A1. 72801 Address EXPIRATION D&TE y/A YOIbv (JTEBB-2) 4.
IDENTITICATICH 0F ST3TER 5.
(a) APPLICABLE CCHSTRUCTION CODE MM. N 19 7/ DIT15, 8-/973
- ADDENDA,
/57 /
CODE Cast (b) APPLICA3LZ EDITICN of $3CTION II UTILIZID FOR RIPLIRS OR RDLhCIMENT$ 19 PS 6.
IDENTIFICATION OF C0KPCNDf75 RIPAIRED OR RIFLACID AND RIFL&CEMINT COMPCEINTS 3D11 RID
- HAMI 0F NAMI 0F MAN 7FACTURIA CTHER YEAR
- REFLACID, aka 8nna COMP 0xort MuurictmR salu.
0.
reafirICureN wit?
Da g=4
=.
-Fac= - T
.s l
I&"
i I Nrso rs -
,1 i
d d
I, W14 l l 6a_
1 DM P
\\ ne -00e /
L NA 12P1V-/ 002 197 9 A2r.'Aud '
)
e-e 3 Nb P57-/06 2 l/979 tVtAl!v)>~1*
l-
,i i
i j x!
L l
l
'N 1
l h
h j
i 7.
DisCRIPTIoK OF MORK l$skbu/A m h & $ 2Asd v' Y M lA 1
i
/
/
8.
TZ575 CCWDUCTID: HTDROSTATIC D FN12ATIC D WOMIX1L OFIRATING PRIS3URI,A OTHIR O FRZ55URI
/d PS~~D11 TEST TEMP.
N O,*F NOTE: Supplemental sheets in form of lists, sketches, or dravings may be used, provided (1) size is *\\ in. x 11 in., (2) informatice in items 1 through G co this report is -
int.luded on eneb sheet, and (3) each sheet is numbered and the c:aniser of sheets is
. recorded at the top.of this fc.rs.
J J
arvassD sm-021 04/30/as room ns 2 (nack) fd--AlPr-/ $/mabbiauWa83fferafD Aetakp s.
ntnns Applicable Manuf44turer's Data Reports te#be Attached v
A J4 h l S u L Y4 a b A r h
W/11
')))
l 7_
}
2 A tt a A l A' h m t/f W A el12n t @.A J 4 b d &
M L /~a /
4 AliN f)2katt()
fxdJt Y M Y s
'y
/
v 1
I l
cannetts or coMM.IAms l
1 1
I WeAertify t)at the ' statements made in the report tre correct and this l
l A1AlW>>m/M-conforms to the rules of the AsM Code,Section II.
l l
repdir or replacement i
i l
l I
l Type Code Symbol Stamp W/A l
1 I
l Certificate of Authoriza No.
y/A Rapitation Date N/A l
l Signed k
/ //m,~.- -
Data M- ?
, 19 l
Ovner or Owner's Desicoes, Title l
l R. D. Gillespie - Manager, Central Support l
l I
c1rnFICATE OF DtEI2VICI IXIPSCUCN l
1 1
I I, the undersiped, holding a valid commissico issued by the National Board of
- l l
Soller and Pressure Yass41 Inspectors and the state er Frerince of l
I
_ ARIA 21As and employed by *AnVRIGHT MUTUAL INSURANCE Co.
of l
I NOP900D. MASS.
have insnected the compocents described in thisd '.*
1 ovnarts Report Aring the period 4-20-H to Ad <10 -9#
.I I
and state that to the best of my knowledge and belief, the Cvner has performed i
I examinations and taken corrective measures described in this owner's Esport in l
l accordance with the requirements of the A5ME Code, Sec' tion H.
l l
l I
Ay signing this certificate neither the Inspector nor his employer males any warranty, azpressed or implied, coocorning the azaminations and corrective nearares ll l
l described in this owner's Report. Furthermore, neither the Inspector nor his l
l employer shall be liable in any manner for any personal injur7 or property damage ' l I
or a loss of any kind arising from gr econected with this inspection.
t l
FACTORT MUTUAL SYSTDiS l
1 9 C. 6 % 99-commissicas WB-9947. ARK-I133 "N" "I8' l
I (Anspector's signature sational soard, state, trcnrince, and Emersements l l
case ' " " **
///9 is 9 A.
,i i
\\
~
FOM NIS-2 APPIMDIX !! - MutD&TOET REVISD ING-021 06/30/81 FORM NII 2 00(It'S REPORT FOR RDatts OR REFL&CIMDfTS As Required by the Provisions of the 15ME Code Sectico II 1.
0WHER AP&L/DrTnCT OPnATIONI. INC.
D&TE
/8 -/7
'M Name RT. 3. 10T 137 C. 10$ft11YTit'. AR. 72801 SPEIT
/
of
/
Address 2.
PLANT iM_iMSAS NUCT ht OMI 1 RETT Two Name RT. 3. BOI 1370 RUS $n.tVTt t f. A1. 72301_ 18. # dO87f834 Addreaa Etpair organisetien PQ No., Job No., etc.
3.
WORK PEPJORMID IT Aynt/nrrncT oys.. nc.
TTF1 0008 STMDOL STnMF M/A Name AUDOR.IIATICN No.
1/1 RT. 3, Box 1370, RUSSELLVT11E, A1. 72801 Address EXPIRATION D&TE M/1 4.
IDonIFICATION OF ETSTzM f/4t$r lIa
- E BB - / )
5.
(a) APPLICA1LE CCHSTRUCTION CODE ZIU 19 7/ EDITICat, 8-/975
- ADDENDA,
/ S'7 4/
CODE Cast (b) APPLICA3LI DITICai OP IICTION EI UTILIZED FOR REPLIRS CR REFLACEMDCS 19 <P6 6.
IDD.'TIFICATION OF COMPONDf75 RIP 11 RID OR RDLACE AND RIFLACIMDff CMPONDff3 REPAIRD "II' e
NAMI OP NAMI 0F MAWJTACTUtta OTHER TEAR REFL&CED ST D
COMPONINT MANUFACTURER SI111L M.
IDCrTIFICATION WILT OR f4 R,mC.MD.
.s l
J NfBo 90- 1 i
u a
L l
li*[labbp 64 l
I Oh>4kD I M - 6002 V N A-
\\ 2 ATV-)C05~ ' 1979 kM$w b ' h s l o/Y l
[A N n-frSV-/o d t/779 r/ bund b
i j
?
a i N!
s c
u l
~
l N
i c
q k
i i
DESCRIPTION CP WORJC N,/Edtu/>
m2dMA.<W 7.
8.
TISTS CONDUCTED: NTDROSTATIC D FMEWATIC 0 NOMIX1L OPIRATIM PRZSSUREX OTHIR 0 PAISSURI
/4#0 osi TEST TEMP.
f 4/5' _'F NOTE: Supplemental sheets.in form of lists, skstches, or dravings may be used, provided (1) size is 8% in. x 11 in., (2) laformation in items 1 through 5 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.
l
- * *
- op"*
- agv15ED 390 021 04/30/8s Foss Es 2 (Back) l RDGKKs & NPV-/ Y5Wwburbbab>A& A fhude 9.
Applicable Muufseturer's Data Eeports to b6 Attached v
skiMaLock A.nscahubewAansA.
27!s m La/wmd>fudad wab sam's AAuwk'a o A A n w % L fa<.
'y
/
u I
1 l
crnir2cm or conn.!Ancs 1
I I
m/,artifybt the stas ots.ae a ese report er. corr.et and thu i
ve i
mu emfor.e to the raies of tse um e.de, s.ction n.
i l
repair or replacement l
l 1
I I
l Type code symbol stamp N/A l
I I
I Certifieste of Authorizatim Ro.
y/A Empiration Data W/A l
l
/ JJ )) b1L-
,1,u-l sioned casa
//- 7 l
' Cvner or Owner's Desiones, Titla l
l_
R. D. Gillespie - Manager. Cential Support l
1 l
- crxTIrreur or astw2cx Ixsrsetzca l
1 l
l 2, the undersigned, bolding a valid commissim issu+d by the Noticeal Soard of
- l l
Roiler and Pressure Yessel Inspectors and the State er Frerines of l
l
_ AEAX1AS and employed by *mvRIGHT MITTUAL INSURANCE co.
of l
I NORVOOD. MASS.
b4Te insDected M CQupcoents described in this/:4.m I
cvnarts Esport durisg the period 4-?o-91 to /a r#d - 92 1
l and state that to the best of my knavledge and belief, the Ovner has performed i
I examinations and takan correctin measures described in this Cvner's Report in l
l accordance with the requirements of the AsMI code, see' tion II.
l l
I I
Ry signing this certificate neither the Inspector nor his employer naies any l
l varranty, azpressed or implied, coocerning the examinations and corrective meaures !
I described in this Cvner's Report. Furthermore, neither the Inspector nor his
(
i amployer shall be liable in any mannar for any persocal injury or property damage l
1 or a loss of any kind arising from gr connected with this inspection.
t
]
FACTORT MUTUAL SYSTDiS l
l k O. $ 1Bu D commissions N3-9947, ARK-1133 "N" "18A' l
l
()nspector'ssignature National Board, state, Province, and Indorsements l I
J. O. Elliott l
e Date
/// 9 19 9,1 1
, I-I 0
t i
s
~
FORM NIS-2
&PPEND!I II = N&lEMCET RET!5D ENG 021 06/30/09 PORM Ir18 2 OtStER'S RDot! FOR RD&tts OR REPL&CDeffS As Required by the Provisions of the AstlE Code section E1 1.
OWNER Apat/rwTner openations. inc.
D425
/8-/7-M name nr. 3. ser tir o. memvre... in. n:Oi sMEET
/
/
address 2.
PLANT auraun NUct van our WRIT Two Name RT. 3. 101 137C. RDt gri t ytt t.. A1. 72301 1 0. O O 8 7 G M I
address Repair Organisation 70 Be., Job Mo., etc.
3.
WORK FERFORMED ST AP&L/Estract opsm Inc._ TTPE C005 STISOL ST&MP n/A Base
&DT5ctIZAT13 30.
W/A RT. 3. Ses 1370, RUSSELLVILLE,-AR. 72401 Address EDISATICII D&TE n/A IDENT!TICATION OF STITsu M OfEst-N 4.
5.
(a) APPLICABLE CONSTRUCTICIf CODE M 7If 191 DIT10If, 8'-/97I ADDEND &,
/f7F CODE CASE (b) APPLICABLE EDITICII 0F SECT!af II UTILIED FOR 2 0 1115.08 REPIACIMENTS 19 8 i
6.
IDENTITICATION OF CCMPONDfTS REP & IRED OR REP! ACID AltD REP!aCEMDff CQDCNDITS RDAIRED NAME OF NAME OF M& NUT &CTURIA g' OTHER TEAR REP 1&CID,'
"II ST D
COMPONENT MANVT&C!vRES SERIAL 30.
IDDrTIFICATICII SUILT CE
- !=4
=.
,R-iacD=,r O s
Y 6Mlm ee-o$/0
///
.7PSV-/rsF. 1979 Aulemb
$2L ' l o
l Ot>LbO 00 Co/
NM 2 PSV-/f S4
/979 01AbWstW '!lfL l IN i
L i
!Ni t
l 4
k l
l N,
c i
n c
DESCRIPTION OF WORK M,//>
A drA L 7.
(
8.
tests CoWDucTro: NTDRosTATIC D PMIUKATIC D WONIM1LOPERATINGPRESSVREX OTHER c PRESSURE
/S S O esi TEST TEMP.
5'4/5' 'F NOTE: Supplemental sheets.in form of lists,-skatches, or drawings may be used, pr#Vid#d l
(1) site is 9% in.
11 in., (2) information in items 1 through 6 on this report.is +
l included on each sheet, and (3) each sheet is numbered and the number of sheets is
. recorded at the top; of this farm.
a 1
umsn D40-021 04/30/89 FORN n5 2 (Back) nxnuxs die NPV-/ YNwt/n2!ma$afa>MA R-)
s.
Applicable Manufseturar's Data Reporta to Se Attuhed v
~
>>nb+nd'Yld AAtb A+L w &Ltn'uMfc Aewdadmdtke6.!n
/ $2/AsL A1AbuwuwWAHth cdwids AlabMb Abgd GaW Y
fAlab? $1w&
LA/1v1 h
- krJL,
!/
/
u l
l l
cznInckTs or ci:xrttamct l
I I
JtrAIm3 mew /y that the ' statements made in the report are correct and this Wf certif l
I l
confor1ms to the rules of the 1sts Code, s+ction II.
l l
repair or replacement l
l l
l l
1 Type code symbol stasp N/A l
1
__ I l
Certificate of Authorisation Iso.
y/A Empiratice Date w/A l
Signed d
Ulm_
Data ___
//- 9
, 19 l
'ovner or ovnar's Designee,' Title
{
l R. D. Gillespie - Manager, Central Support j
l 1
I cnTIF2cifs of DesnWCI Ixs?scTIcet l
I I
I I, W undersigned, holding a valid canaisalon issued by the National Board of
- l l
soiler and Pressura Yessel Inspectors and the State er Prwince of l
l
_ nraviAs and employed by *ARWRIC1!T MITTUAL INSURANCE CO, of l
i NORvooD. KAss, have inspected the c coents described in thisst m m
i ovnarts Esport during the period A-20-01 to /S-#0-92
,1 l
and state that to the best of my knowledge and belief, the owner has performed i
I ensinations and taken corrective sensures descrhd in this owner's 34 port in I
l accordance with the requirements of the 13M2 code, Socition U.
l l
l 1
87 signing this certificate neither the Inspector nor his emplo*er attes any l
i varranty, expressed or implied, coocerning the azantinatices and corrective measures !
I described in this owner's Report. Furthermore, neither the Inspector nor his l
I esployer shall be liable in any unnar for any persocal injury or property damage 1
I or a loss of any kind arising from gr coenected with this insp+ction.
I l
FACTOM HUTUAL SYSTDiS l
l
- 9. C. 5 K Th l
cessaissicos W3-9947, ARK =n33 "N" "I8' 'k".
l 1
i
!(/nspector'ssignature sattecal soard, state, Province, and Endorsements I tlse * * **
///9 1, 9 A I
,I i
l t
l
I t
l FORM N!4
' &PPENDIE !! - IBMM9ET REf!5Eg 06/30/89 ENG 021 FORM WIS 2 068tER'8 RD0RT FOR RD&tts OR REP!4CIMErts As Required by the Previsions of the &SME Coen Section II i
Ant /rwrener oPeninars tue.
mus
/#-/ /- M
- 1.. OWNER -
i in. neat := T
/
/
_rr. 3. mer tir a. menmntt.
44dr...
2.
PLANT Aurinit rect wAn err WIT Two Name RT. 3. 101 1370. RDilet t yft t v. Am. 72301 J 0, dd8758JY l
Addres.
Repair Organisatian F0 No., Job Wo., stc.
3.
WORK PERFORMED ST AP&L/Estreof BM., tue.
TTFE 0008 STW OL STEMP R/A Base
&UTHORIZATION 90.
M/A RT. 3 Box 1370, RUS$11 LYT 1.LE, AR. 72001 A ur.s.
earnT:0N mT:
ma 4.
!DENTITICATION OF SYSTEN 84/#II/4W[#E88-#)
5.
(a) APPLICABLE CONSTRUCT!W CODE MW19 1 DIT!cW,,,[-/fv5
&DDEND&,
/f74/
CODE CASE (b) APPLICA3La EDITION OF ESCT!cN II Fr!LIZED FOR REP &Its 08 REFIACIMENTS 19 6.
1DENTITICAT!0N OF COMPONENTS REPAIRED OR REP!. ACID Ntp REPLAMMINT COMPMDfTS N
RDMRED ON11' 000I NAME OF M&ME OF M& NUT &CTRER OTHER TE&R REF1&CID D
COMPONENT MANVTACTVRER SERIAL N0.
IDENTIFICAT!cW WILT M
,1=4
=-
-,i.
.s l
h
.1 NS6c0 90-1 l S
L.
l e?-eee 7 NA JP3v- /Grf.
/979 Aelbt_id) 41 l fft h4 AC l} tt A't 1
l htM 0Y4!
hk ff5V- /OSf 1979 habuM dt Ab y
8-l" i
tx 4
[
X, l
c u
< 7.
DESCRIPTION OF WORE M I //A 12&tL r
/
8.
TESTS 00WDUCTED: NYDROSTATIC D PNEWATIC D WOMIX1 LOPER &TINGPRESSVREX OTHER D PussgAE
/dv 0 arei TEST TEMP.
SVs' 'T supp!ameatal sheets la fors of lists, skatchee, or ersvings any be used, provided NOTE:
(1) site is 8% in. s 11 in., (2) informatism in items 1 through 6 as this report.is -
included on each.bett, and (3) each sheet is asad>ered and the ember of sheets is arecorded at the top,of this farm.
o m-
_....--,v-...
.m..
,.,,,-.,,-v...--._m-.,4---
y
. ~ - -.
uma re 021 os/w/es Foest KIs 2 (&ack) 9.
Kou.1K$ $h NPf-l 'lbk tbit4f)Yal4)ktga4Yb
/Ef2 Applicable nutieeturar's Deta Report.s' to be Attached O'
.ht Whk J14Ett /Mb L. Art Mkf>
Ina
- < N o
Aund 2a/wwdn k dm;50mM ufasAus dA -malNduo Aa4vd4!vallas
'f V
l' l
l cxntr cm or cart.tanca I
l l
mAy4esw eartify that b 'statemats mee in m report an correct and this I
I i
c form. to tse na.s.f ts. amm c.4e, actie. n.
i I
rey' air or replacement 1
I l
l l
l Type code symbol stamp w/A l
1 I
l Certifieste of Authorizatico No.
V/A RLpirstlen Date N/A I
I sired
$~1 0 l) d l<-. -
esta
/49
,1s.g.3-ll l
Cvner or CvDer's Designet, Title l
R. D. Gillespie - Manager, Central Support l
l cruirtcLTs of Dermtv2CE Destscytm I
l i
I, W tedersiped, bolding a valid ccanissico issued by the National Board of
- 1 i
Boiler and Pressure Yessel Inspectars and b State or Province of H
I
_ A12A2ns and esplayed by *mvucur mrrUAL INSUPJFCE,,CO, of I
m vooD. Mass, havs inspected % campooents described in thist as.
4 I
Cwnerts Esport during th6 period 4-20-91 to / 4,2 0 - 9 4
.I I
and state that to the best of my EFvisope and better, the evner has performs I
l examinations and taken corrective measures described in this cwner's Report in I
i accordance with the requirements of the A3ML code, Sec' tion II.
1 I
1 l
Sy siping this certificate neither the Irspector nor his es91 oyer makes any varranty, a2 pressed or implied, coocerning the asaminations and corrective measures l l
l
[
described in this owner's Report. Furthermore, neither the Inspector nor his l
1 employer shall be liable in any manner for any personal injury or property damage i
i er a loss of any kind arising frca gr econected with this inspection.
l l
FACTORY HUTUA1. SYSTDiS l
l D d /~ E< C-Commissions WB-9947, ARK-I133 "N" "I"A" l
6tarpector's sipature National kard, statei Province, and Endorsements l die n/v 1, g.,
I I
al FORM N!s 2
' &PPEND!I !! = IGND&TOET Rgv!sgD FORM NT5 2 OWNER'S REPORT POR RD&fRS OR R7. 3 MDM as Required br the Frwisions et the asN ce-wer.the x 1.
owNrm int /rwrrier ommann. rue.
n&ss
/d-/f-M name nr. s. mer 157 a. mennetter"*. Am. ns01 marf
/-
et
/
Address 2.
PLANT 19F1411.1 WDet 'Am OWR W
two Name 17, 3. ROI is7C. RUSIFt t Yff f W. A1. 72801 1 d. d O f f M 6 7 Address Repair orgaalaatian 70 No., Job No., etc.
3.-
WORK PERFORMED ST Ant /tsevner en.. tue.
TTPE C008 013908. ST&MP M/A name
&UTH0 TIS TION B0.
E/A RT. 3. Box 1370,__tOS$t1.1.YIt?E. AR. 72801 Addrssa IIPIRATION hh!E m/A 4.
20 TNT!r2CA720N OF 5737EN
$ 6 f. [2Eff-II) i 5.
(a) APPLICABLE CONSTRUC'T!0N CODE 19 _ 5317105, ADDEND &,-
v COD 4 CASE I
(b) KFPLICABLE EDITION OF SECT 20N II UTILIZID FOR REPLits et REPLACIMDrfs 19 Pfl 6.
IDENTIFICAT!0N OF COMP 0KDtTS RIP &IMD OR REPLACD AND REPLACEMENT COMPWDffS REPA! RED UNII' E
6 NAME OF NAME OF M&WT&CTUkIR OTHER TEAR REPLbCED O
COMPONENT MANVTACTURER SL1LIAL NO.
IDDrTIFIC& TION WILT (R
4 y=>
=,t u. - r
.s l }$" fqf lar r-aW/
\\
l 1
l
/w W
//fa 41tn
]
8 ? Y4l NA JSG.T-/04/7t*
blus-id Ylh l
!\\
l l
lN l
l N'
l l
l U
1 -
1 p
q l
L 7
DESCRIPTION OF WORK __
It10 th)#>,
j 8.
TESTS'CCWDUCTED: NTDROSTATIC D PMEWATIC D WOMIX1L OPERATIm PM55VM D L
oTHER D Pusscu A% osi TEST TEMP.
NA JF NOTE: supplements 1 sheets.in form of lists, sketches, or drawings met be used, provided (1) sine is 8% in, a 11 in., (2) information in items 1 through 6 en this report.is.
i included on each sheet, sad (3) each sheet is numbered sad the number of sheets is i
l
. recorded at the top, of this form.
4
~ _ _. -
asvansa sNO-021 06/30/M pom as a (nask) s.
na mnas A//n-Applicable Manufacturer's Data Reports to be Attached 3
AulAndi ehlb D/4 / 30 yaw-d12 A ( % 9k.1).
/
t
=
=
1 1
l czafincus or courLzancs l
1 1
M>e cor,tify the) the ' statements made la the report are sermt and this l
I W
>>Zr/meauT esaforms to the rates of the Asis code,Section II.
l-l l
l
/ repair et replacemaat l
I i
I l
i Type code symbol stamp w/A i
1 1
l l
Certificate of Authorisatian No.
3/A Empiration Date N/A U
l siped [d O
/M Data
//- f - F L-19 _ l i
l owner er Owner's Desisee, fitas l __
R. D. Gillespie - Manager. Central Support l
l l
l 1
I l
c5371FIC1!E OF DISER71c5 Disp 5CTIM i
I
\\
I I, the undersiped, holding a valid commissian issued the National Board of
- 1 i
Seiler and Pressure Vessel !aspectors and the state er of H
l AREA 31As and employed by *nrvnrCRT MUTUAI. INStmANCE CO.
el 1
I nowoOD. MASS.
bsee lasDested the CGEpeDents destribes la thtSM Ase Ownetts Report charing the period a-20 to /d dd-f>
l 1-and state that to the best of my knowledge _ and belter, the Owner has performed l
l examinattens and taken corrective mensures described in this owner's Report in l
l' accordance with the requirements of the ASNB _ Code, Socitica II.
l l
l
- I ty siping this certificate neither the fas varranty, aspressed or taplied, concerning the =pector mer his employer nahes anyimat l-
=
- I described in this owner's Sepert. Furthermore, asither the gaspector por his L
t 1
espierer shall be liable la any namner for any personal injury or pro l
er a less of-any klad arising from gr esmateted with this laspection.perty damage-I l
l FACTORY MUTUAL SYSTEMS l
1-CO((.184E?#
Canaissions WB-9947. Alut-r133 "N" "18X'
{
l
(/ nspector's $1pature National Seard, State, Province, and Indorsements l' i
I J. O I
- I Date. Elliott
///9 to g I
l-l py*m.m wi eda,W ir+smM n -gw,p.we a.
g-gees,--,--iew-.w-
,,,,,w
'.vi.sre.s.-,pewmem--.-.mewye,,see, e w es--
inn, mm-y
+-a.-9w-g--g
-e m, m -t mre--vyw w-s,*ig-wtw t-r -%- g w eg.--
g4--m----
, ', war
~.. _. _ _ _ _ _ -
FORN NIS 2
&PPENDIE !! = MhlSh&T06T R3723D F010t NIS 2 OWlER'8 RDet! FOR RD&fts OR RplacDerts
&a Required by the Provistems of the AsNE Cees sosties II 1.
0WNER Am/rrtner openmars, fue.
3425
/4-/f-f4 Name RT. 1. nor d7 e tessettYT" *. Am. 72801 NEIT
/
of
/
Address 2.
PLArt nemu unct *An mer WEIT two Name 18,g6dP7925f 17.1.101 117c. kenget t ytt t v. Am. 72801 4
Address Repair Organisatism 70 No., Jeb Wo., etc.
3.
WORK PEMORMED ST AP&L/EsrticT 071.
Inc...
TTFE 0005 BTWOL STRMP m/A Rame
&Utit0RIE&T1 m 30.
n/A RT. 3. Box 137G, RUSSELLYTLIL AB. 71001 Address EEFIR&T! W D&TE n/A
+
4.
! DENT!TICAT!0N OF SYSTDL IMf W > ( 4 8 8 8.7 )
5.
(s) APPLIC13LE CONSTRUef!CN 0005_luIE 191 DITION, 8- /975 DDEND&,
/f7V CODE CASE (b) APPLICA3LE EDITICN OF SECT!cN E! UTILIEED FOR REPAIRS OR REF14 CEMENTS 19 Ed 6.
IDENTIFICAT!0N OF COMPONDffs REPA! RED OR REPIACED &MD REF!aCEMElf! COMPCNDfr$
RDAIRED'
" 0"II' e
NAME OF M&MI 0F M&NUFACTUIER OTHER TEAR
- REFIACED, ST D
COMPONENT MANVTactvtER SERIAL NO.
IDerTIFICAT!cN SUILT M
f REFIACEMINT 0
(
0 -- c o e C NM
/PSV-10S3
/979 Adlutti 4/M :
- N37r090 -
l 18'
(.
l btid.bNJ ee-oeoY NM 2PS V -MS 3
/f 7 9. !Iu/meanf 4lJb l
?
l 6L l
N l
l N I
\\)
h l
u 1
n -
7.
DESCRIPf!0N OF W RX A b OI A fL r
/
r j
l-8.
TISTS CONDUCTED: HTDR057A71C D FME W & TIC D NOMDt&LOPERATINGPRESSURKK
'_F CTHER O PRE 55URE
- 8 5' Dei TEST TEMP.
f#d NOTE: supplemental sheets in form of lists, sketches, or drawings may be used, provided
(!) size is s% in, a 11 in., (2) information in items 1 through 6 en this report.is -
-included on each sheet, and (3) each sheet is numbered and the nueber'ef sheets is
. recorded at the top,of this form.
i
.m.
DO-021 06/M/89 Foul Es-2 (Seck) uMun 1% NPt-/ N/emcbehwss,0$J&md2) /vd<p 9.
Applicable Manufacturer's Data Reports t6 be Attached v
Jj Mkb Jnlo Htl AL _AninEd.h in24bst$$8 v
$' l i' M. _A tR h M otl A M (bbt<'d A 1o both t* b <d b &
Al.AbdMobv band Mlt'Adahl@A Y I
l I
cranncan or cmrtramz I
i l
l We rtify } hat the 'statenuts made in the report are correct and this l
l A>A' Jmtetr conforme to the rules of tM 1.snt code, Sectice n.
l l
rephr or replacement l
i i
l l
l Type code symbol stamp N/A 1
l l
l Certificate of Authorisatico 50.
y/A tapiration Date w/A l
l Signed
[]
O 2/.<.~ %
Data
/ /- 7
, 19 l
Ovner or Cvner's Desionee, Titla l
l R. D. Gillespie - Manager. Central Support l
I l
I carnnetts or Imrav2c Intsenom i
I I
I 2, the undersigned, holding a valid constission issued by the Battenal Board of '
I l
Boiler and Pressure Ysssel Inspectors and the Stata er Frorince of l
1
__ n rittts and esplored by *ARTVRIGHT MirTUAL INSURANCE CO, of H
l NORVOOD. MASS, have inspected the components described in thisk.m i
tvnarts Report during the period 4-20-91 ts /0 -#0 - 9'.7
,l l
and state that to the best of my knowledge and belief, the Ovner has performed l
l ensinations nad taita corrective measures described in this evner's Esport in i
I accordarice with the requirements of the 13MI code, Sec' tion II.
l I
i l
3y ignit>g this certificate neither the farpeetor nor his employar sales any l
I varranty, azpressed or implied, coocarning the azaminatices and corrective measures !
I described in this Cvner's Report. Furt.bermore, neither the Inspector nor his l
l employer shall be liable in any unner for any persocal injury or pro i
or a loss of any kind arising from er connected with this inspection.perty damage I
I I
- TACTORT MUTUAL SYSTEMS r-l
$ O b//eFrP Cossaissions NE-9 9 4 7. ARK-M 3 3 "N" "I A
- l l
l
(/Inrpector'ssignature National Board, state, Province, and todorsements l I
J. O I
l Date. Elliott 11/ 9 19M l
,1 l
e
.