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Inservice Insp Rept of Surry Nuclear Power Station Unit 2, Second Interval,Second/Third Period.
	ML18151A159
Person / Time
Site:	Surry
Issue date:	09/05/1991
From:	; VIRGINIA POWER (VIRGINIA ELECTRIC & POWER CO.)
To:	;
Shared Package
ML18151A160	List: ML18151A159; ML18153C723;
References
	NUDOCS 9109110120
	Download: ML18151A159 (372)
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{{#Wiki_filter:* INSERVICE INSPECTION REPORT OF THE SURRY NUCLEAR POWER STATION UNIT 2 P.O. BOX 315 SURRY, VIRGINIA 23883 FOR

VIRGINIA ELECTRIC AND POWER COMPANY 5000 DOMINION BLVD.

GLEN ALLEN, VIRGINIA 23060 COMMERCIAL SERVICE DATE: MAY 1, 1973 OPERATING CAPACITY: 822 MWe (net) REFUELING OUTAGE: 2nd INTERVAL, 2nd/3rd PERIOD ,. -~--- 91091101209 ! 0905_ _ _ _ _ PDR ADOCK 05000281 Q PDR

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

1. Owner - Virginia Electric and Power Company, 5000 Dominion Blvd. , Glen Allen, VA (Name and Address of Owner)

2. Plant _ _ _S_u_r_r-=-y_N_u_c_l_e_a_r_P_o_w_e_r_P_l_a_n_t~,_P_._O_._B_o_x_3_1_5_~*_S_u_r_r~y~,_V_A__

(Name and Address of Plant) 2_3_8_8_3_____ 23060

3. Plant Unit _ _2 _______ 4. Owner Certificate of Authorization (if required) _ _N_/_A______

S. Commercial Service Date 5/1/73 6. National Board Number for Unit-----~._,__._~----

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

Reactor VesseL Rotterdam 147-1 VA58224 ------ Steam Gen. A WestinQhouse Tamna Div. 2972 VA58226 6817 Steam Gen. R WestinQhouse Tamna Div. 2971 VA58227 6818 Steam Gen.

r. hlosti nohono:::o

                                      -           TRmnR     Div. 2973                        VA58228                 6819 Resid. Heat Exchanger lA                Atlas Industrial                        892                     VA58234                 742

Pressurizer Regen. Heat Exchanger Non-Regen.

Heat Exchanger Westinghouse, Tampa Div. 1071 Sentry Equip. Div. Joseph Oats & Sons A3-13 1674-1 VA58225 VA59806 VA59648 68:....;16 399 309 Excess Letdown Heat Exchanger Atlas Industrial 852 VA58229 703 Seal Water Ini. Filter 4B Commercial Filter - - - - - - - - -

 "R     r. P11mn-  R     T,losri nohrmc:,o  F.MD                 4q3                                                 -

Valve

 ?-C:::T-7Q Vol~n                                   - - -                   -  - -                 - - -

Valve * - 2-SI-82 Velan - - - - - - - - - Valve 2-SI-85 Velan - - - - - - - - - Valve 2-SI-88 Velan - - - - - - - - - Valve

 ? .C:T .01                  Vol~n Note: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is 8'h 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. (12/86) This form (E00029) may be obtained from the Order Dept., ASME, 22 Law Drive, Box 2300, Fairfield, NJ 07007-2300. Page 1 of 17

FORM NIS-1 (Back)

8. ExaminationDates 9/19/89

10. Applicable Editions of Section XI _l_9_8_0 to 6/7/91 9. Inspection Interval from

___ Addenda. W-80 5/J /83 to 5/10/9.li

11. Abstract of Examinations. Include a list of examinations and a statement concerning status of work required for current interval.

See pages 05 through 17.

12. Abstract of Conditions Noted. See page 03 and Attachments 1, 2, 3 and 4.

13. Abstract of Corrective Measures Recommended and Taken. See page-*3 and Attachments 1, 2, 3 and 4.

We certify that the statements made in this report are correct and the examinations and corrective mea-sures taken conform to the rules of the ASME Code, Section XI. Certificate of Authorization No. (if applicable) _ *. . :piration Date ? Date fl(..151.10+ ,3q, 19 9-L_signed v'tRf.,JVl-4 Fucr1?.1c.,+loW~1!.l~,Bylj,_rz1zd&vl11. Owner n.Jw CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State or Province of \/a... and employed by H 5 f3 I+ I C:o of Ha.r-Tford , CT. have inspected the components described in this Owner's Report during the period 1- (9- 'if9 to b~ 7 ~ 9/ , and state that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the inspection plan and as required by the ASME Code, Section XI. By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspection. _.....,,~'+-F--"-------vc.£~. -~~ ___ Commissions _National Inspector's Signature ______:;_'VL=-a..'---'5=---=-L.f-=-3------- Board, State, Province, and Endorsements Date §>-36

19 i{__

e

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

1. Owner Virginia Electric and Power Co., 5000 Dominion Blvd., Glen Allen, VA. 23060 (Name and Address of Owner)

2. Plant Surry Nuclear Power Plant, P.O. Box 315, Surry, VA. 23883 (Name and Address of Plant)

3. Plant Unit _ _2_________ 4. Owner Certificate of Authorization (if required)_N_/_A ________

S. Commercial Service Date 5/1/73 6. National Board Number for Unit ______ N_c_/_A_ _ _ _ _ __

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

Valve 2-SI-94 Velan - - - - - - - - - Valve 2-SI-130 Darling - - - - - - - - - Valve 2-SI-238 Velan - - - - - - - - - Valve 2-SI-239 Velan - - - - - - - - - Valve 2-SI-241 Velan Valve 2-SI-243 Velan - - - - ..- - - - - Valve 2-RC-SV-2551A Crosby - - - - - - - - - Valve 2-RC-SV-2551B Crosby - - - - - - - - - Valve 2-RC-SV-2551C Crosby - - - - - - - - - Class 1 Piping Southwest Fab - - - - - - - - - Class 2 Piping Southwest Fab - - -- - - - - - - Hangers and SUPPO,r-ts Class 1 2. and 3 - - - - - - - - - Note: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is 8Yz 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. (12/86) This for111 (E00029) may be obtained fro111 the Order Dept., ASME, 22 Law Drive, Box 2300, Fairfield, NJ 07007-2300. Page 2 of 17

FORM NIS-1 (Back)

8. Examination Dates 9 / 19 / 8 9 to 6/7 /91 9. Inspection Interval from 5/1/83 to 5/10/94

10. Applicable Editions of Section XI 1980 '. Addenda W 80

11. Abstract of Examinations. Include a list of examinations and a statement concerning status of work required for current interval. See Pages 05 through 17.

12. Abstract of Conditions Noted. See Page 03 and Attachments 1,2,3 and 4.

13. Abstract of Corrective Measures Recommended and Taken. See Page 03 and Attachments 1, 2, 3 and 4.

We certify that the statements made in this report are correct and the examinations and corrective mea-sures taken conform to the rules of the ASME Code, Section XI. Cm;fkate of Au,hm;>>tion No. (;f applkable) . . Exp;ra,;on Da<e =-771-=+ Date 4ufjt.1Q

                      +-    3o J

19 ..9.l_signedlhi261111,*19:£-Ec1"R1G.-t: Owner

                                                                                   ]~:J&ziJ By   ~~~----

CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State or Province of Va.. and employed by H S (3 ;:c: ~ :t:' C' O of t/a.r T Pin* d, Cf. have inspected the components described in this Owner's Report during the period

      <'f- ( ':f - 51'1       to /,.

1 - t:f I , and state that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the inspection ,plan and as required by the ASME Code, Section XI.

By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspection. __(MJ..__...~----'-----i_.-~----Commissions ------=-J~a..~~S~l/-'---3________ Inspector's Signature National Board, State, Province, and Endorsements Date _ _ _ __.g..._---""3--=D=---- 19 !i.L__

Examination Summary

Virginia Electric and Power Company Surry Nuclear Power Station Unit 2 Refueling Outage 2nd Interval, 2nd Period/3rd Period Introduction Inservice examinations of Class 1 and Class 2 components and piping were conducted at Surry Power Station Unit 2 from September 19,1989 to June 1,1991. As allowed by IWB-2412, inspections for the Second Interval, Second and Third Inspection Periods were performed.

Examination procedures were approved prior to the examinations. Certification documents relative to personnel, equipment, and materials were reviewed and determined to be satisfactory. Inspections, witnessing, and surveillance of the examinations and related activities were conducted by personnel from the Hartford Steam Boiler Inspection and Insurance Company, One State Street, Hartford, CT 06102 (Mr. R.L. Coder); Surry station Quality Assurance Department; and Surry technical staff . Limitations Some of the arrangements and details of the piping system and components were designed and fabricated before the access and examination requirements of Section XI of the 1974 Code could be applied; consequently some examinations are limited or not practical due to geometric configuration or accessibility. Generally these limitations exist at fitting to fitting joints such as elbow to tee, elbow to valve, reducer to valve, etc., where geometry and sometimes surface condition preclude ultrasonic coupling or access for the required scan length. Examination Examinations were conducted to review as much of the examination zones as was practical within geometric, metallurgical, and physical limitations~ When the required ultrasonic examination volume or area could not be examined 100%, the examination was considered to be a partial (PAR) and so noted on the examination report. Generally PARs are noted at fitting to fitting assemblies and in areas where integrally welded supports (lugs,

hangers, etc.) preclude access to some part of the examination .

Page 3 of 17

Results Examination of components resulted in a total of 21 items being reported on the basis of procedure recording criteria, which generally are more critical than the specified ASME Section XI Acceptance Standards. A summary of the indications and their dispositions follows: A) Examinations of valve internals on valves 2-SI-85 and 2-RC SV-2551C noted deficiencies. These deficiencies were dispositioned in Attachment 1 and 2 of this report. B) Examination of a welded support on 2-RH-E-lA revealed deficiencies in the weld when subjected to the Code required examination method. These deficiencies are dispositioned in Attachment 3 of this report. C) The following component supports were inspected as part of the IWF inspection program. Inspection reports noted a deficiency, but engineering evaluation determined the supports were fully operable. Evaluations of these deficiencies is included in Attachment 4 of this report .

WMKS-0101Gl WMKS-0103A2-2 WMKS-0103A2-3 WMKS-0118G2 WMKS-0118A2 H-01 H-02 H-01 H-02 H-24 WMKS-0118Al H-01 WMKS-0102Dl H-04B WMKS-0102Dl H-05 WMKS-OlOOGl H-02B WMKS-0100G1 H-03 WMKS-117B1 H-09 WMKS-Or25Al H-02 WMKS-CH-E-3 H-01 WMKS-CH-E-3 H-02 WMKS-CH-E-3 H-03 WMKS-CH-E-3 H-04 WMKS-CH-E-3 H-05 WMKS-CH-E-3 H-06 Statement of Interval Status Virginia Electric and Power Company is currently on schedule with its examination requirements .
Page 4 of 17

ABSTRACT OF EXAMINATIONS:IWB,IWC,AND IWF INSPECTIONS CATEGORY ITEM NUMBER ISOMETRIC ITEM INSPECTED EXAM METHOD INTERVAL/PERIOD PLAN# B-A 81.40 V1R-1-1300A W1(179 11 -358 11 ) UT/MT 2/2 MC-001 I. B-B 82.11 V1R-1-2100 W7(96 -192 ) 11 11 UT 2/2 MC-008 B-B 82.11 VIR-1-2100 W4 UT 2/2 MC-016 4 B-B 82.12 VIR-1-2100 W3 UT 2/2 MC-017 5 B-B 82.40 VIR-1-3100 (A)W1 UT 2/2 MC-021 6 B-B 82.51 VIR-1-3200 W4(6"-19") UT 2/2 MC-179 7 B-B 82.60 VIR-1-3200 W22(6 -19 ) 11 11 UT 2/2 MC-181 8 B-D 83.120 WMKS-RC-E-002 W15NIR VT 2/2 MC-020.1 9 B-D 83.140 VIR-1-3100 (A)NIR1A VT 2/2 MC-061.1 10 B-D 83.140 VIR-1-3100 (A)NIR1B VT 2/2 MC-061.2 11 B-E 84.11 WMKS-RC-E-002 SAMPLE NOZZLES VT 2/2 MC-205 12 B-E 84.11 WMKS-RC-R-1.2 VENT PIPE VT 2/2 MC-208 13 B-E 84.12 WMKS-RC-R-1.2 CRDM WELDS VT 2/2 MC-209 14 B-E 84.13 WMKS-RC-E-002 INSTRUMENT NOZZLE VT 2/2 MC-206 15 B-E 84.13 WMKS-RC-R-1.1 INSTRUMENT NOZZLES VT 2/2 MC-210 16 B-E 84.20 WMKS-RC-E-002 IMMERSION HEATER ELEMENTS VT 2/2 MC-207 17 B-F 85.30 VIR-1-4200 W5DM UT,PT 2/2 MC-065 18 B-F 85.30 VIR-1-4200 W6DM UT,PT 2/2 MC-066 19 B-G-1 86.180 VIR-1-5100A BOLTS 1-24 UT 2/2 MC-063 20 B-G-1 86.190 VIR-1-5100A FLANGE SURFACE VT 2/2 MC-064 21 B-G-2 87.50 VIR-1-4700 3 VT 2/2 MC-061 22 B-G-2 87.50 VIR-1-4700 14 VT 2/2 MC-123 23 B-G-2 87.60 VIR-1-5100A (8)#1 SEAL HOUSE BOLTS VT 2/3 MC-085 24 B-G-2 87.70 VIR-1-6300 71 VT 2/2 MC-019 25 B-G-2 87.70 VIR-1-6300 17 VT 2/2 MC-060.1 26 B-G-2 87.70 VIR-1-6300 77 VT 2/2 MC-094 27 B-G-2 87.70 VIR-1-6300 97 VT 2/2 MC-125.1 28 B-G-2 87.70 VIR-1-6300 92 VT 2/2 MC-171 29 B-G-2 87.70 VIR-1-6300 94 VT 2/2 MC-172 30 B*G-2 87.80 WMKS*RC-R-1.2 MC-01 & MC-02 VT 2/2 MC-007.1 31 B*H 88.20 WMKS-RC-E-002 H001-1 & H001-2 MT 2/2 MC-007.2 32 B*H 88.20 VIR-1-2100 W8 MT 2/2 IA-093 33 B-J 89.11 VIR-1-4200 W7 UT/PT 2/2 MC-022 34 B*J 89.11 VIR-1-4200 W8 UT/PT 2/2 MC-023 B*J 89.11 VIR-1-4100 W14 UT,PT 2/2 MC-024 B-J 89.11 VIR-1-4100 W13 UT,PT 2/2 MC-025 B*J 89.11 VIR-1-4100 W12 UT,PT 2/2 MC-026 38 B*J 89.11 VIR-1-4101 W3 UT,PT 2/2 MC-028 39 B*J 89.11 VIR-1-4103 W8 UT,PT 2/2 MC-029 40 B-J 89.11 VIR-1-4103 W3 UT,PT 2/2 MC-030 41 B-J 89.11 VIR-1-4103 W6 UT,PT 2/2 MC-031 42 B-J 89.11 VIR-1-4103 1,17 UT,PT 2/2 MC-032 43 B-J 89.11 VIR-1-4102 W8 UT/PT 2/2 MC-147 44 B-J 89.11 VIR-1-4102 119 UT/PT 2/2 MC-148 45 B-J 89.11 VIR-1*4102 W10 UT/PT 2/2 MC-149 46 B-J 89.11 VIR-1-4102 W11 UT/PT 2/2 MC-150 47 B-J 89.11 VIR-1-4202 W4 UT/PT 2/2 MC-164 48 8-J 89.11 VIR-1-4202 W5 UT/PT 2/2 MC-165 49 8-J 89.11 VIR-1-4104 W7 UT/PT 2/2 MC-34.1 50 8-J 89.11 VIR-1-4104 W6 UT/PT 2/2 MC-34.2 51 8-J 89.12 VIR-1*4100 W20 PT 2/2 MC-027 52 8-J 89.21 VIR-1-4207 W67 PT 2/2 MC-041 53 8-J 89.21 VIR-1*4207 W68 PT 2/2 MC-042 54 8-J 89.21 VIR-1-4207 W69 PT 2/2 MC-043 55 8-J 89.21 VIR-1-4207 1165 PT 2/2 MC-183 56 8-J 89.21 VIR-1*4207 W66 PT 2/2 MC-184 57 8-J 89.31 VIR-1-4506 W1(BC) UT/PT 2/2 MC-120 58 8-J 89.31 VIR-1-4104 W1(BC) UT/PT 2/2 MC-34.3 59 8-J 89.32 VIR-1.-4507 W1(8C) PT 2/2 MC-018 60 B-J 89.32 VIR-1-4508 W1(BC) PT 2/2 MC-121 61 8-J 89.40 VIR-1-4109 23 PT 2/2 MC-044 62 B-J 89.40 VIR-1*4109 22 PT 2/2 MC-045 63 8-J 89.40 VIR-1-4109 21 PT 2/2 MC-046 64 8-J 89.40 VIR-1-4109 20 PT 2/2 MC-047 65 B*J 89.40 VIR-1-4109 19 PT 2/2 MC-048 66 8-J 89.40 VIR-1-4109 18 PT 2/2 MC-049 67 8-J 89.40 VIR-1-4109 17 PT 2/2 MC-050 68 8-J 89.40 VIR-1-4310 W7 PT 2/2 MC-054 8-J 89.40 VIR-1-4310 W8 PT 2/2 MC-055 8-J 89.40 VIR-1-4310 W9 PT 2/2 MC-056 8-J 89.40 VIR-1-4310 W10 PT 2/2 MC-057 72 B*J 89.40 VIR-1-4310 W11 PT 2/2 MC-058 73 8-J 89.40 VIR-1-4107 W30 PT 2/2 MC-151 74 8-J 89.40 VIR-1-4107 W31 PT 2/2 MC-152 75 8-J 89.40 VIR-1-4107 W32 PT 2/2 MC-153 Page 5 of 17

ABSTRACT OF EXAMINATIONS: IWB, IWC,AND IIJF INSPECHONS CATEGORY ITEM NUMBER ISOMETRIC ITEM INSPECTED EXAM METHOD INTERVAL/PERIOD PLAN# B-J B9.40 VIR-1-4107 IJ33 PT 2/2 MC-154 B-J B9.40 VIR-1-4108 W44 PT 2/2 MC-155 B-J B9.40 VIR-1-4108 W43 PT 2/2 MC-156 79 B-J B9.40 VIR-1-4108 W42 PT 2/2 MC-157 80 B-J B9.40 VIR-1-4110 W47 PT 2/2 MC-158 81 B-J B9.40 VIR-1-4110 W46 PT 2/2 MC-159 82 B-J B9.40 VIR-1-4110 W45 PT 2/2 MC-160 83 B-J B9.40 VIR-1-4110 W44 PT 2/2 MC-161 84 B-J B9.40 VIR-1.-4110 W43 PT 2/2 MC-162 85 B-J B9.40 VIR-1-4110 W38 PT 2/2 MC-163 86 B-J B9.40 VIR-1-4208 W30 PT 2/2 MC-166 87 B-J B9.40 VIR-1-4208 W32 PT 2/2 MC-167 88 B-J B9.40 VIR-1-4208 IJ31 PT 2/2 MC-168 89 B-J B9.40 VIR-1-4207 W28 PT 2/2 MC-169 90 B-J B9.40 VIR-1-4207 W29 PT 2/2 MC-170 91 B-K-1 B10.10 WMKS-122D1 H010-1 PT 2/2 IA-130 92 B-K-1 B10.10 WMKS-122L1 H009-1 PT 2/2 IA-127 93 B-K-1 B10.10 MKS-0125A1 H23 PT 2/2 IA-045 94 B-K-1 B10.10 WMKS-117B1 H009-1 PT 2/2 IA-134 95 B-K-1 B10.10 WMKS-117B1 H009-2 PT 2/2 IA-134 96 B-K-1 B10.10 WMKS-117B1 H009-3 PT 2/2 IA-134 97 B-K-1 B10.10 WMKS-117B1 H009-4 PT 2/2 IA-134 98 B-K-1 B10.10 WMKS-122A1 H003-1 PT 2/2 1A-133 99 B-K-1 B10,10 WMKS-122A1 H003-2 PT 2/2 1A-133 100 B-K-1 B10.10 WMKS-122A1 H003-3 PT 2/2 1A-133 101 B-K-1 B10.10 WMKS-122A1 H003-4 PT 2/2 1A-133 102 B-K-1 B10.10 WMKS-117A1-1 H016-1 PT 2/2 IA-126 103 B-K-1 B10.10 WMKS-117A1-1 H016-2 PT 2/2 IA-126 104 B-K-1 B10.10 WMKS-117A1-1 H016-3 PT 2/2 IA-126 105 B-K-1 B10.10 WMKS-117A1-1 H016-4 PT 2/2 IA-126 106 B-M-2 B12.40 WMKS-0127J1 2-SI-79 VT 2/2 3800105057 107 B-M-2 B12.40 WMKS-0127J2 2-SI-82 VT 2/2 3800088855 .. 108 109 113 114 115 B-M-2 B-M-2 B-M-2 B-M-2 B-M-2 B-M-2 B-M-2 B-M-2 B12.40 B12.40 B12.40 B12.40 B12.40 B12.40 B12.40 B12.40 WMKS-0127J3 WMKS-0122K1-1 WMKS-0122H1 WMKS-0122J1 WMKS-0122D1 WMKS-0122K1 -1 WMKS-0122H1 WMKS-0127J1 2-SI-85 2-SI-88 2-SI-91 2-SI-94 2-SI-130 2-SI-238 2-SI-239 2-SI-241 VT VT VT VT VT VT VT VT 2/2 2/2 2/2 2/2 2/2 2/2 2/2 2/2 3800088856 3800088921 3800095811 3800088922 3800105348 3800088859 3800088860 3800109616 116 B-M-2 B12.40 WMKS-0127J3 2-SI-243 VT 2/2 3800089322 117 B-M-2 B12.40 WMKS-0124A1 2-RC-SV-2551A VT 2/2 3800105895 118 B:M-2 B12.40 WMKS-0124A1 2-RC-SV-2551B VT 2/2 3800105896 119 B-M-2 B12.40 WMKS-0124A1 2-RC-SV-2551C VT 2/2 3800105897 120 C-A C1 .10 VIR-2-1110 W3 UT 2/2 MC-107 121 C-A C1.10 VIR-2-1100 W6,184 11 -369 11 UT 2/2 MC-126 122 C-A C1.10 VIR-2-1110 W2 UT 2/2 MC-135 123 C-A C1.10 VIR-2-1140 W2(30 11 -58 11 ) UT 2/2 MC-189 124 C-A C1.20 VIR-2-1110 W1 UT 2/2 MC-134 125 C-A C1.20 VIR-1-3200 W24(6 11 -19 11 ) UT 2/2 MC-180 126 C-A C1.20 VIR-2-1140 W1(30 11 -58 11 ) UT 2/2 MC-194 127 C-A C1.20 VIR-1-3200 W4(19"-28.86 11 ) UT 2/3 MC-245 128 C-A C1.20 VIR-1-3200 W24(19 11 -28.86") UT 2/3 MC-246 129 C-A c1.30 VIR-1-3200 W23(6"-19") UT 2/2 MC-182 130 C-A C1.30 VIR-1-3200 W22(19 11 -28.86 11 ) UT 2/3 MC-247 131 C-A C1.30 VIR-1-3200 W23(19 11 -28.86 11 ) UT 2/3 MC-248 132 C-B C2.21 VIR-2-1100 W9, 1611 -33 11 UT,MT 2/2 MC-127 133 C-B C2.21 VIR-2-1110 W10(33 11 -6711 ) UT/MT 2/2 MC-128 134 C-B C2.21 VIR-2-1100 W9,0 11 -16 11 MT 2/2 MC-129 135 C-B C2.21 VIR-2-1100 W10(0 11 -33 11 ) MT 2/2 MC-130 136 C-B C2.22 VIR-2-1100 (B)W9NIR VT 2/2 MC-106.1 137 C-B C2.22 VIR-2-1100 (B)W10NIR VT 2/2 MC-106.2 138 C-B C2.22 VIR-2-1100 (C)W10NIR VT 2/2 MC-217 139 c-c C3.40 VIR-2-2102 H4 MT 2/2 IA-115 140 c-c C3.40 VIR-2-2100 H6 MT 2/2 IA-113 141 c-c C3.4Ci VIR-2-2200 H2 MT 2/2 IA-116 142 c-c C3.40 VIR-2-2100 H4 MT 2/2 1A-117 143 C-F C5.11 VIR-2-2510 W48 PT 2/2 MC-141 C-F C5.11 . VIR-1'-4654 W2 PT 2/2 MC-178 C-F C5.21 VIR-2-2103 W12 UT/PT 2/2 MC-173 C-F C5.21 VIR-2-2103 W13 UT/PT 2/2 MC-174 147. C-F C5.21 VIR-2-2103 W14 UT/PT 2/2 MC::-175 148 C-F C5.21 VIR-2-2520 IJ3 UT/PT 2/2 MC-176

. 149    C-F        C5.21     VIR-2-2520             W2                    UT/PT         2/2         MC-177 150    c-c        C3.10     VIR-2-1120             WS1                    PT           2/2          IA-98 Page 6 of 17

ABSTRACT OF EXAMINATIONS:IWB,IWC,AND IWF INSPECTIONS -~ 3 154 155 156 157 CATEGORY c-c F-A F-C F-C F-A F-C F-C ITEM NUMBER C3.10 FA1 ,2,3 FC1,2,3,4 FC1,2,3,4 FA1 ,2,3 FC1,2,3,4 FC1,2,3,4 ISOMETRIC V1R-2-,1120 MKS-117B1 MKS-123N1 MKS-123N1 WMKS-WCMU-10 MKS-123N2 MKS-123N2 ITEM INSPECTED WS2 H31 H3 H4 H1A H3 H2 EXAM METHOD INTERVAL/PERIOD PT VT VT VT VT VT VT 2/2 2/2 2/2 2/2 2/2 2/2 2/2 PLAN# IA-98 158 F~A FA1,2,3 WMKS-CH-P-1A H1 VT 2/2 159 F-A FA1,2,3 WMKS-CH-P-1B H1 VT 2/2 160 F-A FA1,2,3 WMKS-CH-P-1C H1 VT 2/2 161 F-A FA1 ,2,3 WMKS-RS-P-2A H1 VT 2/2 162 F-A FA1 ,2,3 WMKS-RS-P-2B H1 VT 2/2 163 TS3.20 TS4.17 WMKS-0118L1 HSS-144 VT 2/2 164 TS3.20 TS4.17 WMKS-0118L1 HSS-145B VT 2/2 165 F-A FA1,2,3 WMKS-0118G2 HS VT 2/2 166 F-A FA1 ,2,3 WMKS-0118G1-1 HS VT 2/2 167 F-A FA1,2,3 WMKS-0118G1-1 H6 VT 2/2 168 F-A FA1,2,3 WMKS-0118G1-1 H7 VT 2/2 169 F-A FA1,2,3 WMKS-0118G1-1 H8 VT 2/2 170 F-A FA1 ,2,3 WMKS-0118G1-1 H9 VT 2/2 171 F-B FB1,2,3 WMKS-0118G1-1 H9D VT 2/2 172 F-A FA1,2,3 WMKS-0118G1-1 H3 VT 2/2 173 F-B FB1,2,3 WMKS-0118G1-1 H3B VT 2/2 174 F-A FA1,2,3 WMKS-0118G1-1 H4 VT 2/2 175 F-C FC1,2,3,4 WMKS-0118G1-1 H1 VT 2/2 176 F-A FA1,2,3 WMKS-0118G1-1 H8A VT 2/2 177 F-B FB1,2,3 WMKS-0118G1-1 H10 VT 2/2 178 F-A FA1,2,3 WMKS-0118G1-1 H11 VT 2/2 179 F-B FB1,2,3 WMKS-0137A1 H1 VT 2/2 180 F-A FA1,2,3 WMKS-0137A1 H3 VT 2/2 181 F-C FC1,2,3,4 WMKS-012701 HC2 VT 2/2 182 F-A FA1,2,3 WMKS-012701 HC54 VT 2/2 183 F-B FB1,2,3 WMKS-0118L1 HC22 VT 2/2 184 F-B FB1,2,3 WMKS-0118L1 H17 VT 2/2 F-B FB1,2,3 WMKS-0118L1 HC28 VT 2/2 F-B FB1,2,3 WMKS-0118L1 H12 VT 2/2 F-C FC1,2,3,4 WMKS-0123N2 H3 VT 2/2 188 F-C FC1,2,3,4 WMKS-0123N2 H2 VT 2/2 189 F-B FB1,2,3 WMKS-0123N2 H3A VT 2/2 190 F-C FC1,2,3,4 WMKS-0123N1 H3 VT 2/2 191 F-B FB1,2,3 WMKS-0123N1 H4A VT 2/2 192 F-C FC1,2,3,4 WMKS-0123N1 H4 VT 2/2 193 TS3.20 TS4.17 WMKS-0127C2 HSS1A VT 2/2 194 TS3.20 TS4.17 WMKS-0127C2 HSS1B VT 2/2 195 F-C FC1,2,3,4 WMKS-0127C2 H18 VT 2/2 196 TS3.20 TS4.17 WMKS-0127C2 HSS100 VT 2/2 197 TS3.20 TS4.17 WMKS-0127C2 HSS101 VT 2/2 198 F-A FA1,2,3 WMKS-p127C1 H1 VT 2/2 199 F-C FC1,2,3,4 WMKS-0127C1 H2 VT 2/2 200 F-C FC1,2,3,4 WMKS-0127C1 H3 VT 2/2 201 F-B FB1,2,3 WMKS-0127C1 H4 VT 2/2 202 F-C FC1,2,3,4 WMKS-0127C1 HS VT 2/2 203 F-B FB1,2,3 WMKS-0127C1 H6 VT 2/2 204 F-B FB1,2,3 WMKS-0127C1 H7 VT 2/2 205 F-A FA1,2,3 WMKS-0127C1 HS VT 2/2 206 F-B FB1,2,3 WMKS-0127C1 H9 VT 2/2 207 F-B FB1,2,3 WMKS-0127C1 H10 VT 2/2 208 F-C FC1,2,3,4 WMKS-0127C2 H14 VT 2/2 209 F-C FC1,2,3,4 WMKS-0127C2 H15 VT 2/2 210 F-C FC1,2,3,4 WMKS-0127C2 H16A VT 2/2 211 F-C FC1,2,3,4 WMKS-0127C2 H16B VT 2/2 212 F-C FC1,2,3,4 WMKS-0127C2 H11 VT 2/2 213 F-B FB1,2,3 WMKS-0127C2 H19 VT 2/2 214 F-A FA1 ,2,3 WMKS-012702 H18C VT 2/2 215 F-B FB1,2,3 WMKS-012702 H17C VT 2/2 216 F-A FA1,2,3 WMKS-012702 H14A VT 2/2 217 F-A FA1,2,3 WMKS-127K1 H48 VT 2/2 218 F-A FA1,2,3 WMKS-127K2 H47B VT 2/2 F-A FA1 ,2,3 WMKS-0118G1-2 H4 VT 2/2 F-A FA1,2,3 WMKS-0118G1-2 H1 VT 2/2 F-A FA1,2,3 WMKS-0118G1-2 H2 VT 2/2 222 F-B FB1,2,3 WMKS-0118G1-2 H3 VT 2/2 223 F-A FA1 ,2,3 WMKS-0118G1-4 H4 VT 2/2 224 F-A FA1 ,2,3 WMKS-0118G1-4 H19 VT 2/2 225 F-A FA1 ,2,3 WMKS-0118G1-4 H18 VT 2/2 Page 7 of 17

ABSTRACT OF EXAMINATIONS:IWB,IWC,AND IWF INSPECTIONS CATEGORY ITEM NUMBER ISOMETRIC ITEM INSPECTED EXAM METHOD INTERVAL/PERIOD PLAN# " F-A FA1,2,3 WMKS-0118G1-4 H20 VT 2/2

 .26 27    F-B       FB1,2,3  WMKS-0118G1-4            H21               VT           2/2 28    F-A       FA1,2,3  WMKS-0118G1-4            H7                VT           2/2 229    F-A       FA1 ,2,3 WMKS-0118G1-3            H12               VT           2/2 230    F-A       FA1,2,3  WMKS-0118G1-3            HS                VT           2/2 231    F-A       FA1,2,3  WMKS-0118G1-3            H10               VT           2/2 232    F-A       FA1,2,3  WMKS-0118G1-3            H11               VT           2/2 233    F-B       FB1,2,3  WMKS-0118G1-3            H13               VT           2/2 234    F-A       FA1,2,3  WMKS-0118G1-3            H6                VT           2/2 235    F-A       FA1 ,2,3 WMKS-.0118G1-5           H7                VT           2/2 236    F-B       FB1,2,3  WMKS-0118G1-5            H4                VT           2/2 237    F-A       FA1,2,3  WMKS-0118G1-5            H2                VT           2/2 238    F-A       FA1,2,3  WMKS-0118G1-5            H1                VT           2/2 239    F-B       FB1,2,3  WMKS-0118G1-5            H6                VT           2/2 240    F-A       FA1,2,3  WMKS-0118G1-5            HS                VT           2/2 241    F-A       FA1,2,3  WMKS-0118G1-5            HS                VT           2/2 242    F-A       FA1,2,3  WMKS-0118G1-5            H3                VT           2/2 243    F-B       FB1,2,3  WMKS-0118G1-5            H9                VT           2/2 244    F-B       FB1,2,3   WMKS-0127G1            H14A               VT           2/2 245    F-A       FA1,2,3   WMKS-0127G1            H13A               VT           2/2 246    F-B       FB1,2,3   WMKS-0127G1             H9A               VT           2/2 247    F-A       FA1 ,2,3  WMKS-0127G1             H11               VT           2/2 248    F-C      FC1,2,3,4  WMKS-0127G1            H12B               VT           2/2 249    F-C      FC1,2,3,4  WMKS-0127G1            H12A               VT           2/2 250    F-B       FB1,2,3   WMKS-0127G1            H98A               VT           2/2 251    F-A       FA1,2,3   WMKS-0127G1             H22               VT           2/2 252    F-A       FA1,2,3   WMKS-0127G1             H2                VT           2/2 253    F-A       FA1,2,3   WMKS-WAPD-2             H7                VT           2/2 254    F-A       FA1,2,3   WMKS-WAPD-2             H4                VT           2/2 255    F-A       FA1,2,3   WMKS-WAPD-2             H3                VT           2/2 256    F-A       FA1,2,3   WMKS-WAPD-2             H2                VT           2/2 257    F-A       FA1,2,3   WMKS-WAPD-2             H1                VT           2/2 258    F-A       FA1,2,3   WMKS-WAPD-4             H1                VT           2/2 259    F-A       FA1,2,3   WMKS-WAPD-4             HS                VT           2/2 F-A       FA1,2,3   WMKS-WAPD-4             H4                VT           2/2 F-A       FA1,2,3   WMKS,-WAPD-4            H2                VT           2/2 F-A       FA1,2,3   WMKS-WAPD-4             H3                VT           2/2 263    F-A       FA1 ,2,3  WMKS-WAPD-5             H1                VT           2/2 264    F-A       FA1 ,2,3  WMKS-WAPD-5             H2                VT           2/2 265    F-B       FB1,2,3   WMKS-WAPD-5             H4                VT           2/2 266    F-A       FA1,2,3   WMKS-WAPD-5             HS                VT           2/2 267    F-A       FA1,2,3   WMKS-WAPD-5             H6                VT           2/2 268    F-A       FA1 ,2,3  WMKS-WAPD-5             H3                VT           2/2 269   TS3.20     TS4.17    WMKS-0127G2           HSS303              VT           2/2 270    F-A       FA1,2,3   WMKS-0127G2             H45               VT           2/2 271    F-A       FA1 ,2,3  WMKS-0127G2             H44               VT           2/2 272    F-C      FC1,2,3,4  WMKS-0127G2             H57               VT           2/2 273   TS3.20     TS4.17    WMKS-0127G2           HSS304              VT           2/2 274    F-A       FA1,2,3  WMKS-SI-P-1B             H1                VT           2/2 275*   F-A       FA1,2,3  WMKS-SI-P-1A             H1                VT           2/2 276   TS3.20     TS4.17   WMKS-103A2-2            MSSS               VT           2/2 277    F-A       FA1 ,2,3 WMKS-103A2-2            H16A               VT           2/2 278   TS3.20     TS4.17   WMKS-103A2-2            MSS2               VT           2/2 279    F-C      FC1,2,3,4 WMKS-103A2-2             H76               VT           2/2

280 F-C FC1,2,3,4 WMKS-103A2-2 H116 VT 2/2 281 F-C FC1,2,3,4 WMKS-103A2-2 H16 VT 2/2 282 F-A FA1,2,3 WMKS-103A2-3 H15A VT 2/2 283 TS3.20 TS4.17 WMKS-103A2-3 HSS42 VT 2/2 284 F-C FC1,2,3,4 WMKS-103A2-2 H115 VT 2/2 285 F-C FC1,2,3,4 WMKS-103A2-3 H15 VT 2/2 286 F-C FC1,2,3,4 WMKS-103A2-3 H75 VT 2/2 287 F-A FA1,2,3 WMKS-103A2-1 H17A VT 2/2 288 F-C FC1,2,3,4 WMKS-103A2-1 H3 VT 2/2 289 F-C FC1,2,3,4 WMKS-103A2-1 H117 VT 2/2 290 F-C FC1,2,3,4 WMKS-103A2-1 H17 VT 2/2 291 TS3.20 TS4.17 WMKS-103A2-1 HSS41 VT 2/2 292 F-C FC1,2,3,4 WMKS-103A2-1 H77 VT 2/2 293 TS3.20 TS4.17 WMKS-103A2-1 HSS27 VT 2/2 TS3.20 TS4.17 WMKS-103A2-1 HSS28 VT 2/2 TS3.20 TS4.17 WMKS-103A2-2 HSS30 VT 2/2 TS3.20 TS4.17 WMKS-103A2-2 HSS29 VT 2/2 297 TS3.20 TS4.17 WMKS-103A2-3 HSS31 VT 2/2 298 TS3.20
TS4.17 WMKS-103A2-3 HSS32 VT 2/2 299 F-A FA1,2,3 V1R-2-2102 H4 VT 2/2 300 F-A FA1,2,3 WMKS-125A1 H6 VT 2/2 Page 8 of 17

ABSTRACT OF EXAMINATIONS:IWB,IWC,AND IWF INSPECTIONS CATEGORY ITEM NUMBER ISOMETRIC ITEM INSPECTED EXAM METHOD INTERVAL/PERIOD PLAN# ~01 F-A FA1 ,2,3 VIR-1-4106 H3 VT 2/2

.02   F-A       FA1 ,2,3   VIR-1-4204             H1                VT           2/2 303    F-A       FA1 ,2,3   VIR-1-4207             H2                VT           2/2 304    F-B       FB1,2,3    VIR-1-4106             H2                VT           2/2 305    F-A       FA1,2,3    VIR-1-4107             H2                VT           2/2 306    F-A       FA1,2,3    VIR-1-4107             H1                VT           2/2 307    F-A       FA1,2,3     MKS-125A1             H31               VT           2/2 308    F-A       FA1 ,2,3   VIR-2-1300             WS2               VT           2/2 309    F-C      FC1,2,3,4   WMKS-0127G1            H48               VT           2/2 310    F-A       FA1 ,2,3   WMKS-CH-E-4            H1                VT           2/2 311    F-A       FA1,2,3    WMKS-CH-E-4            H2                VT           2/2 312    F-A       FA1,2,3   WMKS-CH-FL-4A           H1                VT           2/2 313    F-A       FA1,2,3   WMKS-CH-FL-4A           H2                VT           2/2 314    F-A       FA1,2,3   WMKS-CH-FL-4A           H3                VT           2/2 315    F-A       FA1,2,3   WMKS-CH-FL-4B           H1                VT           2/2 316    F-A       FA1 ,2,3  WMKS-CH-FL-4B           H2                VT           2/2 317    F-A       FA1,2,3   WMKS-CH-FL-4B           H3                VT           2/2 318    F-A       FA1 ,2,3   WMKS-CH-E-2            H1                VT           2/2 319    F-A       FA1,2,3    WMKS-CH-E-2            H2                VT           2/2 320    F-A       FA1,2,3    WMKS-CH-E-2            H3                VT           2/2 321    F-A       FA1 ,2,3   WMKS-CH-E-2            H4                VT           2/2 322    F-A       FA1,2,3    WMKS-CH-E-2            HS                VT           2/2 323    F-B       FB1,2,3    WMKS-2022A2            H22               VT           2/2 324    F-C     FC1,2,3,4    WMKS-101D1             H1A               VT           2/2 325    F-C     FC1,2,3,4    WMKS-101D1             H1B               VT           2/2 326   TS3.20     TS4.17     WMKS-101D1            HSS10              VT           2/2 327   TS3.20     TS4.17     WMKS-102D1            HSS12              VT           2/2 328   TS3.20     TS4.17     WMKS-102D1            HSS11              VT           2/2 329    F-C     FC1,2,3,4    WMKS-102D1             H4A               VT           2/2 330   TS3.20     TS4.17     WMKS-0124A1          HSS186              VT           2/2 331   TS3.20     TS4.17     WMKS-0124A1            H4                VT           2/2 332    F-A       FA1 ,2,3   WMKS-0124A1           H118               VT           2/2 333    F-A       FA1,2,3    WMKS-0124A1           H12A               VT           2/2 334   TS3.20     TS4.17     WMKS-0124A1          HSS110              VT           2/2 F-B       FB1,2,3   WMKS-RC-E-02            H1                VT           2/2 F-A       FA1,2,3   WMKS-RC-E-02            H2                VT           2/2 F-A       FA1,2,3   WMKS-RC-E-02            H3                VT           2/2 338   TS3.20     TS4.17     WMKS-118A1           HSS142              VT           2/2 339    F-C      FC1,2,3,4   WMKS-118A1             H4B               VT           2/2 340    F-C      FC1,2,3,4   WMKS-118A1             H4A               VT           2/2 341   TS3.20     TS4.17     WMKS-118A1           HSS143              VT           2/2 342    F-C     FC1,2,3,4    WMKS-118A2             H31               VT           2/2 343    F-C     FC1,2,3,4    WMKS-118A2             H34               VT           2/2 344    F-C     FC1,2,3,4    WMKS-118A2             H10               VT           2/2 345    F-B       FB1,2,3    WMKS-118A2             H30               VT           2/2 346    F-B       FB1,2,3    WMKS-118A2             H33               VT           2/2 347    F-B       FB1,2,3    WMKS-2022A3            H1                VT           2/2 348    F-C      FC1,2,3,4   WMKS-122L1             H9                VT           2/2 349    F-A       FA1,2,3    WMKS-122L1             H7                VT           2/2 350   TS3.20     TS4.17     WMKS-122L1            HSS27              VT           2/2 351   TS3.20     TS4.17     WMKS-122L1            HSS26              VT           2/2 352   TS3.20     TS4.17     WMKS-122L1            HSS25              VT           2/2 353    F-C      FC1,2,3,4   WMKS-122L1             H4B               VT           2/2 354    F-C     FC1,2,3,4    WMKS-122L1

H4A VT 2/2 355 F-B FB1,2,3 WMKS-127J4 HS VT 2/2 356 F-A FA1 ,2,3 WMKS-127J5 H12 VT 2/2 357 F-B FB1,2,3 WMKS-127J5 H2 VT 2/2 358 F-A FA1,2,3 WMKS-127J5 H21 VT 2/2 359 F-B FB1,2,3 WMKS-127J5 H15 VT 2/2 360 F-B FB1,2,3 WMKS-127J5 H14 VT 2/2 361 F-A FA1,2,3 WMKS-SI-36 H2 VT 2/2 362 F-B FB1,2,3 WMKS-SI-36 H3 VT 2/2 363 F-A FA1,2,3 WMKS-SI-20 H18 VT 2/2 364 F-A FA1,2,3 WMKS-SI-20 H10 VT 2/2 365 F-A FA1 ,2,3 WMKS-SI-20 H6 VT 2/2 366 F-B FB1,2,3 WMKS-SI-20 H4 VT 2/2 367 F-B FB1,2,3 WMKS-SI-20 H3 VT 2/2 368 F-C FC1,2,3,4 WMKS-123Q2 H67A VT 2/2 F-C FC1,2,3,4 WMKS-123Q1 HSS VT 2/2 TS3.20 TS4.17 WMKS-123G1 HSS104 VT 2/2 TS3.20 TS4.17 WMKS-123G1 HSS-103 VT 2/2 372 F-A FA1,2,3 WMKS-123G2 H3A VT 2/2 373 TS3.20 TS4.17 WMKS-123G2 HSS101 VT 2/2 374 TS3.20 TS4.17 WMKS-123G2 HSS102 VT 2/2 375 F-B FB1,2,3 WMKS-RC~E-1A.2 H2 VT 2/2 Page 9 of 17

ABSTRACT OF EXAMINATIONS:IWB,IWC,AND IWF INSPECTIONS CATEGORY ITEM NUMBER ISOMETRIC ITEM INSPECTED EXAM METHOD INTERVAL/PERIOD PLAN# F-C FC1,2,3 WMKS-RC-E-1A.2 H1 VT 2/2 TS3.20 TS4.17 WMKS-RC-E-1A.2 HSS-138 VT 2/2 8 TS3.20 TS4.17 WMKS-RC-E-1A.2 HSS-140 VT 2/2 379 TS3.20 TS4.17 WMKS-RC-E-1B.2 HSS142 VT 2/2 380 TS3.20 TS4.17 WMKS-RC-E-1B.2 HSS144 VT 2/2 381 F-B FB1,2,3 WMKS-RC-E-1B.2 H2 VT 2/2 382 F-C FC1,2,3 WMKS-RC~E-1B.2 H1 VT 2/2 383 TS3.20 TS4.17 WMKS-RC-E-1C.2 HSS146 VT 2/2 384 TS3.20 TS4.17 WMKS-RC-E-1C.2 HSS148 VT 2/2 385 F-B FB1,2,3 WMKS-RC-E-1C.2 H2 VT 2/2 386 F-C FC1,2,3 WMKS-RC-E-1C.2 H1 VT 2/2 387 F-A FA1,2,3 WMKS-RC-P-1A.1 FRAME VT 2/2 388 F-A FA1,2,3 WMKS-RC-P-1B.1 FRAME VT 2/2 389 F-A FA1,2,3 WMKS-RC-P-1C.1 FRAME VT 2/2 390 F-A FA1,2,3 WMKS-RH-E-1A H2 VT 2/2 391 F-A FA1,2,3 WMKS-RH-E-1A H1 VT 2/2 392 F-A FA1,2,3 WMKS-RH-E-18 H1 VT 2/2 393 F-A FA1,2,3 WMKS-RH-E-1B H2 VT 2/2 394 F-B FB1,2,3 WMKS-RH-P-1A H1 VT 2/2 395 F-B FB1,2,3 WMKS-RH-P-1B H1 VT 2/2 396 TS3.20 TS4.17 WMKS-122A1 HSS19B VT 2/2 397 TS3.20 TS4.17 WMKS-122A1 HSS19A VT 2/2 398 F-C FC1,2,3,4 WMKS-122A1 H9 VT 2/2 399 TS3.20 TS4.17 WMKS-122A1 HSS21 VT 2/2 400 TS3.20 TS4.17 WMKS-122A1 HSS20 VT 2/2 401 F-C FC1,2,3,4 WMKS-122A1 H8B VT 2/2 402 F-C FC1,2,3,4 WMKS-122A1 H8A VT 2/2 403 F-C FC1,2,3,4 WMKS-122A1 H7B VT 2/2 404 F-C FC1,2,3,4 WMKS-122A1 H7A VT 2/2 405 F-C FC1,2,3,4 WMKS-122A1 H3B VT 2/2 406 F-C FC1,2,3,4 WMKS-122A1 H3A VT 2/2 407 F-A FA1,2,3 WMKS-122A1 H6 VT 2/2 408 TS3.20 TS4.17 WMKS-0117B1 HSS101 VT 2/2 409 F-B FB1,2,3 WMKS-0117B1 H2 VT 2/2 TS3.20 TS4.17 WMKS-0117B1 HSS29 VT 2/2 TS3.20 TS4.17 WMKS-0117B1 HSS28 VT 2/2 TS3.20 TS4.17 WMKS-011781 H27 VT 2/2 413 TS3.20 TS4.17 WMKS-0117A1-3 HSS22 VT 2/2 414 TS3.20 TS4.17 WMKS-0117A1-3 HSS39 VT 2/2 415 F-A FA1 ,2,3 WMKS-0117A1-3 H36 VT 2/2 416 F-B FB1,2,3 WMKS-0117A1-3 H34A VT 2/2 417 F-C FC1,2,3,4 WMKS-0117A1-3 H9A VT 2/2 418 F-C FC1,2,3,4 WMKS-0117A1-3 H9B VT 2/2 419 F-C FC1,2,3,4 WMKS-0117A1-3 H7 VT 2/2 420 F-C FC1,2,3,4 WMKS-0117A1-3 H10B VT 2/2 421 F-C FC1,2,3,4 WMKS-0117A1-3 H10A VT 2/2 422 F-C FC1,2,3,4, WMKS-0117A1-3 HS VT 2/2 423 TS3.20 TS4.17 WMKS-0117A1-2 HSS30 VT 2/2 424 TS3.20 TS4.17 WMKS-0117A1-2 HSS14 VT 2/2 425 TS3.20 TS4.17 WMKS-0117A1-2 HSS21 VT 2/2 426 TS3.20 TS4.17 WMKS-0117A1-2 HSS9 VT 2/2 427 TS3.20 TS4.17 WMKS-0117A1-2 HSS31 VT 2/2 428 TS3.20 TS4.17 WMKS-0117A1-2 HSS10 VT 2/2 429 TS3.20 TS4.17 WMKS-0117A1-1 HSS19 VT 2/2 430 TS3.20 TS4.17 WMKS-0117A1-1 HSS20 VT 2/2 431 TS3.20 TS4.17 WMKS-0117A1-1 HSS13 VT 2/2 432 TS3.20 TS4.17 WMKS-0117A1-1 HSS35 VT 2/2 433 TS3.20 TS4.17 WMKS-0117A1-1 HSS18 VT 2/2 434 F-C FC1,2,3,4 WMKS-0117A1-1 H16 VT 2/2 435 TS3.20 TS4.17 WMKS-0117A1-1 HSS34 VT 2/2 436 TS3.20 TS4.17 WMKS-0117A1-1 HSS38 VT 2/2 437 TS3.20 TS4.17 WMKS-0112SI HSS185 VT 2/2 438 TS3.20 TS4.17 WMKS-0112SI HSS358 VT 2/2 439 F-B FB1,2,3 WMKS-0112SI H27B VT 2/2 440 F-C FC1,2,3,4 WMKS-0112SI H44B VT 2/2 441 F-C FC1,2,3,4 WMKS-0112SI H44A VT 2/2 442 F-C FC1,2,3,4 WMKS~0112SI H27-1 VT 2/2 443 TS3.20 TS4.17 WMKS-0112S2 HSS359 VT 2/2 F-C FC1,2,3,4 WMKS-112AB1 H25C VT 2/2 F-C FC1,2,3 WMKS-112AA1 H32C VT 2/2 F-B FB1,2,3 WMKS-127J3 HS VT 2/2 447 F-A FA1,2,3 WMKS-127J3 H6 VT 2/2 448 F-A FA1,2,3 WMKS-127J3 H6 VT 2/2 449 F-B FB1,2,3 WMKS-127J1 H1 VT 2/2 450 F-C FC1,2,3,4 WMKS-127J1 H3 VT 2/2 Page 10 of 17

ABSTRACT OF EXAMINATIONS:IWB,IWC,AND IWF INSPECTIONS CATEGORY ITEM NUMBER ISOMETRIC ITEM INSPECTED EXAM METHOD INTERVAL/PERIOD PLAN# F-C FC1,2,3,4 WMKS-119A1 H2A VT 2/2 .5152 F-C FC1,2,3,4 WMKS-119A1 H2B VT 2/2 453 F-C FC1,2,3,4 WMKS-119A2 H2A VT 2/2 454 F-C FC1,2,3,4 WMKS- *119A2 H2B VT 2/2 455 F-C FC1,2,3,4 WMKS-119A3 H2A VT 2/2 456 F-C FC1,2,3,4 WMKS-119A3 H2B VT 2/2 457 F-C FC1,2,3,4 WMKS-119A4 H2A VT 2/2 458 F-C FC1,2,3,4 WMKS-119A4 H2B VT 2/2 459 F-B FB1,2,3 WMKS-S1-16 H16 VT 2/2 460 F-B FB1,2,3 WMKS-S1-16 H12A VT 2/2 461 F-B FB1,2,3 WMKS-0122D1 H14B VT 2/2 462 F-C FC1,2,3,4 WMKS-0122D1 H7B VT 2/2 463 F-C FC1,2,3,4 WMKS-0122D1 H7A VT 2/2 464 F-C FC1,2,3,4 WMKS-0122D1 H6A VT 2/2 465 F-C FC1,2,3,4 WMKS-0122D1 H6B VT 2/2 466 TS3.20 TS4.17 WMKS-0122D1 HSS23 VT 2/2 467 TS3.20 TS4.17 WMKS-0122D1 HSS24 VT 2/2 468 F-C FC1,2,3,4 WMKS-0122D1 H9 VT 2/2 469 F-B FB1 ,2,3 WMKS-0122D1 H15 VT 2/2 470 F-B FB1,2,3 WMKS-0122D1 H14A VT 2/2 471 F-B FB1,2,3 WMKS-0122D1 H14 VT 2/2 472 F-B FB1,2,3 WMKS-0122D1 H13 VT 2/2 473 F-B FB1,2,3 WMKS-0122D1 H12A VT 2/2 474 F-B FB1,2,3 WMKS-0122D1 H12 VT 2/2 475 F-C FC1,2,3,4 WMKS-1119A1 H3 VT 2/2 476 F-C FC1,2,3,4 WMKS-1119A1 H7 VT 2/2 477 F-C FC1,2,3,4 WMKS-1119A1 H11 VT 2/2 478 F-C FC1,2,3,4 WMKS-1119A1 H15 VT 2/2 479 F-C FC1,2,3,4 WMKS-2022B3Z H6 VT 2/2 480 F-B FB1,2,3 WMKS-2022B2 H1 VT 2/2 481 F-C FC1,2,3,4 WMKS-117B1 H26 VT 2/2 482 F-C FC1,2,3,4 MKS-118A1 H1 VT 2/2 483 F-A FA1 ,2,3 WMKS-122K1-2 H14 VT 2/2 484 F-A FA1 ,2,3 WMKS-RC-1222 H15 VT 2/2 F-A FA1 ,2,3 WMKS-CH-8 H9 VT 2/2 F-A FA1,2,3 WMKS-SI-19 H6 VT 2/2 F-C FC1,2,3,4 MKS-123Q1 H55 VT 2/2 488 F-A FA1,2,3 VIR-1-4207 H1 VT 2/2 489 F-C FC1,2,3,4 MKS-123Q2 H67A VT 2/2 490 F-A FA1,2,3 MKS-125A1 H16 VT 2/2 491 F-A FA1 ,2,3 MKS-125A1 H15 VT 2/2 492 F-C FC1,2,3,4 MKS-125A1 H39 VT 2/2 493 F-A FA1 ,2,3 MKS-124A1 H4A VT 2/2 494 FB FB1,2,3 VIR-1-4208 H11 VT 2/2 495 FB FB1,2,3 VIR-1-4208 H14 VT 2/2 496 F-C FC1,2,3,4 WMKS-122L1 H9 VT 2/2 497 F-C FC1,2,3,4 WMKS-RC-9 H2 VT 2/2 498 F-C FC1,2,3,4 WMKS-117A1-1 H14 VT 2/2 499 F-A FA1,2,3 WMKS-SI-20 H6 VT 2/2 500 F-A FA1,2,3 WMKS-SI-20 H10 VT 2/2 501 F-A FA1,2,3 VIR-1-4207 H19 VT 2/2 502 F-A FA1 ,2,3 VIR-1-4207 H20 VT 2/2 503 F-A FA1 ,2,3 VIR-1-4207 H21 VT 2/2 504 F-B FB1,2,3 WMKS-0125A1 H17 VT 2/2 505 F-C FC1,2,3,4 WMKS-0124A1 H12 VT 2/2 506 F-C FC1,2,3,4 WMKS-0124A1 H18 VT 2/2 507 F-C FC1,2,3,4 WMKS-0124A1 H13 VT 2/2 508 F-A FA1 ,2,3 WMKS-0124A1 H15 VT 2/2 509 F-A FA1,2,3 VIR-1-4110 H6 VT 2/2 510 F-C FC1,2,3,4 WMKS-118A2 H24 VT 2/2 511 F-B FB1,2,3 WMKS-2022A2Z H4 VT 2/2 512 F-B FB1,2,3 WMKS-2022A2Z H3 VT 2/2 513 F-A FA1 ,2,3 WMKS-2022A2Z H1 VT 2/2 514 F-B FB1,2,3 WMKS-2022B1Z H22 VT 2/2 515 F-A FA1,2,3 WMKS-2022A3Z H11 VT 2/2 516 F-B FB1,2,3 WMKS-2022A3Z H13 VT 2/2 517 F-B FB1,2,3 WMKS-2022A3Z H14 VT 2/2 518 F-B FB1,2,3 WMKS-SI-19 HS VT 2/2 F-A FA1,2,3 WMKS-SI-19 H6 VT 2/2 F-A FA1,2,3 WMKS-SI-19 H2 VT 2/2 F-A FA1,2,3 WMKS-122J1 H3 VT 2/2 522 F-C FC1,2,3,4 WMKS-122K1-1 H10 VT 2/2 523 F-A FA1,2,3 WMKS-122K1-1 H9 VT 2/2 524 F-A FA1,2,3 WMKS-122K1-2 HS VT 2/2 525 F-B FB1,2,3 WMKS-122K1-2 H12 VT 2/2 Page 11 of 17

ABSTRACT OF EXAMINATIONS:IWB,IWC,AND IWF INSPECTIONS CATEGORY ITEM NUMBER ISOMETRIC ITEM INSPECTED EXAM METHOD INTERVAL/PERIOD PLAN# F-B FB1,2,3 WMKS-122K1-2 H13 VT 2/2 .2627 F-A FA1,2,3 WMKS-122K1-2 H14 VT 2/2 528 F-A FA1 ,2,3 WMKS-122K1-2 H15 VT 2/2 529 F-A FA1,2,3 WMKS-122K1-2 H16 VT 2/2 530 F-C FC1,2,3;4 WMKS-101G1 H1A VT 2/2 531 F-C FC1,2,3,4 WMKS-101G1 H1B VT 2/2 532 F-C FC1,2,3,4 WMKS-102G1 HS VT 2/2 533 F-C FC1,2,3,4 WMKS-102G1 H6 VT 2/2 534 TS3.20 TS4.17 WMKS-102G1 HSS9 VT . 2/2 535 F-C FC1,2,3 WMKS-102G1 H3 VT 2/2 536 TS3.20 TS4.17 WMKS-102G1 HSS10 VT 2/2 537 F-C FC1,2,3,4 WMKS-102G1 H1B VT 2/2 538 F-C FC1,2,3,4 WMKS-102G1 H1A VT 2/2 539 F-C FC1,2,3,4 WMKS-101G1 H3 VT 2/2 540 TS3.20 TS4.17 WMKS100G1 HSS4 VT 2/2 541 TS3.20 TS4.17 WMKS100G1 HSS3 VT 2/2 542 TS3.20 TS4.17 WMKS100G1 HSS2 VT 2/2 543 TS3.20 TS4.17 WMKS100G1 HSS1 VT 2/2 544 TS3.20 TS4.17 WMKS100G1 HSSS VT 2/2 545 TS3.20 TS4.17 WMKS100G1 HSS6 VT 2/2 546 TS3.20 TS4.17 WMKS100G1 HSS13 VT 2/2 547 F-C FC1,2,3,4 WMKS100G1 H9 VT 2/2 548 F-C FC1,2,3,4 WMKS100G1 HS VT 2/2 549 F-C FC1,2,3,4 WMKS100G1 H2A VT 2/2 550 F-A FA1,2,3 VIR-2-2201 H4 VT 2/2 551 F-A FA1,2,3 VIR-2-2200 H2 VT 2/2 552 F-A FA1*,2,3 VIR-2-2100 H6 VT 2/2 553 F-B FB1,2,3 WMKS-125A1 H3 VT 2/2 554 F-B FB1,2,3 WMKS-125A1 HS VT 2/2 555 TS3.20 TS4.17 WMKS-125A1 HSS102 VT 2/2 556 TS3.20 TS4.17 WMKS-125A1 HSS106 VT 2/2 557 F-A FA1,2,3 WMKS-125A1 H6 VT 2/2 558 F-A FA1,2,3 WMKS-125A1 H31 VT 2/2 559 F-B FB1,2,3 WMKS-125A1 H4 VT 2/2 F-B FB1,2,3 WMKS-125A1 H3 VT 2/2 F-C FC1,2,3,4 WMKS-100D1 H9 VT 2/2 F-A FA1,2,3 WMKS-100D1 H7 VT 2/2 563 F-A FA1,2,3 WMKS-100D1 H3 VT 2/2 564 F-A FA1,2,3 MKS-125A1 H23 VT 2/2 565 F-C FC1,2,3,4 WMKS-125A1 H39B VT 2/2 566 F-C FC1,2,3,4 WMKS-125A1 H39A VT 2/2 567 F-C FC1,2,3,4 WMKS-125A1 H37B VT 2/2 568 F-C FC1,2,3,4 WMKS-125A1 H37A VT 2/2 569 F-C FC1,2,3,4 WMKS-125A1 H1B VT 2/2 570 F-C FC1,2,3,4 WMKS-125A1 H1A VT 2/2 571 F-A FA1 ,2,3 WMKS-125A1 i123 VT 2/2 572 TS3.20 TS4.17 WMKS-125A1 HSS184 VT 2/2 573 TS3.20 TS4.17 WMKS-125A 1 HSS104 VT 2/2 574 TS3.20 TS4.17 WMKS-125A1 HSS103 VT 2/2 575 TS3.20 TS4.17 WMKS-125A1 HSS101 VT 2/2 576 TS3.20 TS4.17 WMKS-100D1 HSSSA VT 2/2 577 TS3.20 TS4.17 WMKS-.100D1 HSSSB VT 2/2 578 TS3.20 TS4.17 WMKS-100D1 HSS6A VT 2/2 579 TS3.20 TS4.17 WMKS-100D1 HSS6B VT 2/2 580

F-A FA1,2,3 WMKS-100D1 HS VT 2/2 581 F-C FC1,2,3,4 WMKS-100D1 H1A VT 2/2 582 F-C FC1,2,3,4 WMKS-100D1 H1B VT 2/2 583 TS3.20 TS4.17 WMKS-100D1 HSS3A , VT 2/2 584 TS3.20 TS4.17 WMKS-100D1 HSS3B VT 2/2 585 TS3.20 TS4.17 WMKS-100D1 HSS4A VT 2/2 586 TS3.20 TS4.17 WMKS-100D1 HSS4B VT 2/2 58.7 TS3.20 TS4.17 WMKS-100D1 HSS8 VT 2/2 588 TS3.20 TS4.17 WMKS-100D1 HSS2B VT 2/2 589 TS3.20 TS4.17 WMKS-100D1 HSS7 VT 2/2 590 TS3.20 TS4.17 WMKS-100D1 HSS2A VT 2/2 591 TS3.20 TS4.17 WMKS-103A2-3 HSS38B VT 2/2 592 TS3.20 TS4.17 WMKS-103A2-3 HSS38A VT 2/2 593 TS3.20 TS4.17 WMKS-103A2-1 HSS35A VT 2/2 TS3.20 TS4.17 WMKS-103A2-1 HSS35B VT 2/2 TS3.20 TS4.17 WMKS-103A2-2 HSS34B VT 2/2 TS3.20 TS4.17 WMKS-103A2-2 HSS34A VT 2/2 597 F-C FC1,2,3,4 WMKS-122A1 H3 VT 2/2 598 F-C FC1,2,3,4 WMKS-117A1-1 H16 VT 2/2 599 F-C FC1,2,3,4 WMKS-2022812 H21 VT 2/2 600 F-C FC1,2,3,4 WMKS-2022B2Z H11 VT 2/2 Page 12 of 17
ABSTRACT OF EXAMINATIONS:IWB,IWC,AND IWF INSPECTIONS CATEGORY ITEM NUMBER ISOMETRIC ITEM INSPECTED EXAM METHOD INTERVAL/PERIOD PLAN#

.01 F-C FC1,2,3,4 WMKS-2022A3Z H12 VT 2/2 02 F-C FC1,2,3,4 WMKS-2P22A2Z H2 VT 2/2 603 F-B FB1,2,3 WMKS-0117A1-1 H22B VT 2/2 604 F-A FA1,2,3 VIR-1-2100 PRESSURIZER SKIRT VT 2/2 605 TS3.20 TS4.17 MKS-117B1 H7 VT 2/2 606 F-C FC1,2,3,4 WMKS-0127J3 H4 VT 2/2 607 F-C FC1,2,3,4 WMKS-0103A2-2 H2 VT 2/2 608 F-C FC1,2,3,4 WMKS-0103A2-3 H1 VT 2/2 609 F-B FB1,2,3 WMKS-0118G2 H2 VT 2/2 610 F-C FC1,2,3,4 WMKS-0118A1 H1 VT 2/2 611 F-C FC1,2,3,4 WMKS-0102D1 H4B VT 2/2 612 F-C FC1,2,3,4 WMKS-0102D1 HS VT 2/2 613 TS3.20 TS4.17 WMKS-0102D1 HSS13A VT 2/2 614 TS3.20 TS4.17 WMKS-0101D1 HSS9 VT 2/2 615 F-C FC1,2,3,4 WMKS-0100G1 H2B VT 2/2 616 F-C FC1,2,3,4 WMKS-0100G1 H3 VT 2/2 617 F-C FC1,2,3,4 WMKS-0102D1 H1 VT 2/2 618 F-C FC1,2,3,4 WMKS-RC-9 H1 VT 2/2 619 F-C FC1,2,3,4 WMKS-122D1 H10 VT 2/2 620 TS3.20 TS4.17 WMKS-125A1 HSS107 VT 2/2 621 F-C FC1,2,3,4 WMKS-117B1 H9 VT 2/2 622 F-A FA1,2,3 WMKS-CH-E-3 H1 VT 2/2 623 F-A FA1,2,3 WMKS-CH-E-3 H2 VT 2/2 624 F-A FA1,2,3 WMKS-CH-E-3 H3 VT 2/2 625 F-A FA1,2,3 WMKS-CH-E-3 H4 VT 2/2 626 F-A FA1,2,3 WMKS-CH-E-3 HS VT 2/2 627 F-A FA1,2,3 WMKS-CH-E-3 H6 VT 2/2 628 F-C FC1,2,3,4 WMKS-0101G1 H1A VT 2/2 629 F-C FC1,2,3,4 WMKS-0101G1 H1B VT 2/2 630 TS3.20 TS4.17 WMKS-0102G1 HSS12 VT 2/2 631 TS3.20 TS4.17 WMKS-0102G1 HSS11 VT 2/2

Page 13 of 17

ABSTRACT OF EXAMINATIONS:SYSTEM PRESSURE TEST PROGRAM TEST# LEADING ZONE FM TEST ZONE DESCRIPTION 1 SPT#1 11548-SPM-68A-3-2 11548-FM-68A-S4 2-CN-TK-1A & ASSOC. PIPING SPT#2 *11548-SPM-68A-3-6 11548-FM-68A-S6 FIREWATER SUPPLY TO AUX. FW SPT#3 11548-SPM-68A-3-3 11548-FM-68A-S7 2-FW-P-2 & ASSOC. PIPING SPT#4 *11548-SPM-68A-3-4 11548-FM-68A-S8 2-FW-P-3A & ASSOC. PIPING 5 SPT#5 11548-SPM-68A-3-5 11548-FM-68A-S9 2-FW-P-3B & ASSOC. PIPING 6 SPT#6 11548-SPM-68A-1-5 11448-FM-68B-S11 AUX. FW X-CONN 7 SPT#7 11548-SPM-71A-2-1 11548-FM-71A-S1 CIRC. WATER INTAKE PIPING 8 SPT#8 11548-SPM-71A-3-2 11548-FM-71A-S2 SW TO/FROM 2-RS-E-1A; 1D 9 SPT#8a 11548-SPM-71A-3-2 11548-FM-71A-S2 2-RS-E-1A 10 SPT#8b 11548-SPM-71A-3-2 11548- FM- 71A-S2 2-RS-E-1D 11 SPT#9 11548-SPM-71A-3-3 11548-FM-71A-S3 SW TO/FROM 2-RS-E-1B; 1C 12 SPT#9a 11548-SPM-71A-3-3 11548-FM-71A-S3 2-RS-E-1B 13 SPT#9b 11548-SPM-71A-3-3 11548-FM-71A-S3 2-RS-E-1C 14 SPT#10 11548-SPM-71B-1-1 11548-FM-71B-S1 SW TO CHG.PP OIL COOLERS 15 SPT#11 11548-SPM-71B-1-3 11548-FM-71B-S2 2-SW-P-10A & ASSOC. PIPING 16 SPT#12 11548-SPM-71B-1-4 11548-FM-71B-S3 2-SW-P-10B & ASSOC. PIPING 17 SPT#13 11548-SPM-71B-2-1 11548-FM-71B-S4 CC PIPING TO CHG. PP SEAL COOLERS 18 SPT#14 11548-SPM-71B-2-2 11548-SPM-71B-S6 CHG. PP COOLING WATER AND SURGE TANK 19 SPT#15 11548-SPM-72A-1~1 11548-FM-72A-S1 CC PIPING TO/FROM 11 A11 RHR HX 20 SPT#16 11548-SPM-72A-1-2 11548-FM-72A-S2 CC PIPING TO/FROM "B" RHR HX 21 SPT#17 11548-SPM-72A-1-3 11548-SPM-72A-S4 & S5 CC PIPING TO/FROM RC PPS (2-RC-P-1A,1B,1C) 22 SPT#18 11548-SPM-72A-1-4 11548-FM-72C-S1 MISC. CC CLASS 3 23 SPT#19 11548-SPM-72A-5-2 11548-FM-72A-S3 CC TO EXCESS LETDOWN HX 24 SPT#20 11548-SPM-72B-1-1 11548-FM-72B-S1 CC TO/FROM CONT. AIR RECIRC. FAN (2-VS-E-2A) 25 SPT#21 11548-SPM-72B-1-2 11548-FM-72B-S1 CC TO/FROM CONT. AIR RECIRC. FAN (2-VS-E-2B) 26 SPT#22 11548-SPM-72B-1-3 11548-FM-72B-S1 CC TO/FROM CONT. AIR RECIRC. FAN (2-VS-E-2C) 27 SPT#23 11548-SPM-72C-1-1 11448-FM-72F-S1 MISC. CC CLASS 3 28 SPT#24 11548-SPM-75C-1-1 11548-FM-75J-S2 COMP. AIR PEN. PIPING (UNIT 2 SUPPLY) 29 SPT#25 11448-SPM-72E-1-2 11448-FM-72E-S1 ANO S2 CC TO/FROM SEAL WATER HX AND NON-REGEN. HX 30 SPT#26 11548-SPM-75E-1-1 11548-FM-75E-S1 SERVICE AIR TO CONT. 31 SPT#27 11548-SPM-82A-2-5 11548-FM-82A-S1 RHR SAMPLE LINE 32 SPT#28 11548-SPM-84A-1-1 11548-FM-84A-S1 RWST AND ASSOC. PIPING 33 SPT#29 11548-SPM-84A-2-2 11548-FM-84A-S6 2-CS-P-1A SUCT. AND DISCH. PIPING 34 SPT#30 11548-SPM-84A-2-3 11548-FM-84A-S5 & S13 2-CS-P-1B SUCT. AND DISCH. PIPING 35 SPT#31 11548-SPM-84A-2-6 11548-FM-84A-S11 CONT. SPRAY RINGS "A" & "B" TRAINS SPT#32 11548-SPM-84A-3-3 11548-FM-84A-S4 RWST/CAT XTIE SPT#33 11548-SPM-84A-3-4 11548-FM-84A-S3 CAT UNDERGROUND PIPING SPT#34 11548-SPM-84A-3-5 11548-FM-84A-S2 RWCAT 39 SPT#35 11548-SPM-84B-1-1 11548-FM-84B-S4 INSIDE RECIRC. SPRAY ("B" TRAIN) 40 SPT#36 11548-SPM-84B-1-2 11548-FM-84B-S5 INSIDE RECIRC. SPRAY ("A" TRAIN) 41 SPT#37 11548-SPM-84B-2-6 11548-FM-84B-S7 OUTSIDE RECIRC. SPRAY ("B" TRAIN) I 42 SPT#38 11548-SPM-84B-2-7 11548-FM-84B-S6 OUTSIDE RECIRC. SPRAY ( 11 A11 TRAIN) ! 43 SPT#39 11548-SPM-85A-1-2 11548-FM-85A-S2 CONT. LEAKAGE MONITORING (INSIDE) 44 SPT#40 11548-SPM-86A-3-6 11548-FM-86A-S3 RX HEAD VENT 45 SPT#41 11548-SPM-86B-2-1 11548-FM-86B-S3 PG HEADER TO CONT. 46 SPT#42 11548-SPM-87A-1-3 11548-FM-87A-S1 2-RH-P-1A 47 SPT#43 11548-SPM-87A-1-4 11548-FM-87A-S2 2-RH-P-1B 48 SPT#44 11548-SPM-87A-2-1 11548-FM-87A-S3 RHR TO/FROM RCS 49 SPT#45 11548-SPM-87A-2-2 11548-FM-87A-S4 RHR PIPING TO RWST 50 SPT#46 11548-SPM-88A-2-3 11548-FM-88B-S1 NON-REGEN. HX (CHG. SIDE) 51 SPT#47 11548-SPM-88B-1-3 .11548-FM-88B-S3 SEAL RETURN HEADER AND SUCTION 52 SPT#48 11548-SPM-88B-1-4 11548-FM-88B-S2 VCT AND LETDOWN HEADER 53 SPT#49 11548-SPM-88B-1-5 11548-FM-88B-S7 BORIC ACID LINES TO CHG. PUMPS 54 SPT#50 11548-SPM-88B-2-3 11548-FM-88B-S4 CHG. ALTERNATE HEADER 55 SPT#51 11548-SPM-88B-2-4 11548-FM-89A-S10 A" LHSI XTIE TO CHG. PUMPS 56 SPT#52 11548-SPM-88C-1-5 11548-FM-88C-S7 REGEN. HX (CHG. SIDE) 57 SPT#53 11548-SPM-88C-1-9 11548-FM-88C-S8 LETDOWN HEADER 58 SPT#54 11548-SPM-88C-2-2 11548-FM-88C-S5 SEAL RETURN HEADER 59 SPT#55 11548-SPM-88C-2-3 11548-FM-88C-S1 RCP SEAL INJ. LINES 60 SPT#56 11548-SPM-88C-2-4 11548-FM-88C-S2 A" RCP SEAL RETURN LINE 61 SPT#57 11548-SPM-88C-2-5 11548-FM-88C-S3 B" RCP SEAL RETURN LINE 62 SPT#58 11548-SPM-88C-2-6 11548-FM-88C-S4 C" RCP SEAL RETURN LINE 63 SPT#59 11548-SPM-89A-1-4 11548-FM-89A-S9 LHSI PP SUCT. FROM RWST 64 SPT#60 11548-SPM-89A-1-5 11548-FM-89A-S6 RWST XTIE 65 SPT#61 11548-SPM-89A-3-1 11548-FM-89B-S10 NI SUPPLY TO SI ACCUMULATOR 66 SPT#62 11548-SPM-89B-1-2 11548-FM-89B-S1 LOOP "A" SI ACCUMULATOR 67 SPT#63 11548-SPM-71B-2-3 11548-FM-72C-S1 MISC. CLASS 3 68 SPT#64 11548-SPM-89B-1-5 11548-FM-89B-S6 SI ACCUMULATOR TEST LINE 69 SPT#65 11548-SPM-89B-1-6 11548-FM-89B-S8 SI. ACCUMULATOR MAKEUP LINE

SPT#66 11548-SPM-89B-1-7 11548-FM-89B-S9 SI ACCUMULATOR VENT LINE SPT#67 11548-SPM-89B-2-2 11548-FM-89B-S2 LOOP "B" SI ACCUMULATOR SPT#68 11548-SPM-89B-3-2 11548-FM-89B-S3 LOOP "C" SI ACCUMULATOR 73 SPT#69 11548-SPM-124A-2-2 11548-FM-124A-S2 B" S/G BLOWDOWN 74 SPT#70 11448-SPM-47B-1-2 11448-FB-47B-S2 FIRE PROTECTION HEADER 75 SPT#71 11548-SPM-71B-1-2 11548-FM-71B-S5 SW PIPING TO CHG. PUMP INT. SEAL COOLERS Page 14 of 17

________J

ABSTRACT OF EXAMINATIONS:SYSTEM PRESSURE TEST PROGRAM TEST# LEADING ZONE FM TEST ZONE DESCRIPTION SPT#72 11548-SPM-86B-1-3 11548-FM-86B-S4 PRESSURIZER HEAD VENT

Page 15 of 17
ABSTRACT OF EXAMINATIONS SNUBBER PROGRAM An as-found visual inspection was performed on all snubbers.

No inoperable snubbers were identified. Twenty-five snubbers were selected for functional testing. None of these failed their functional test. One mechanical snubber, 2-RH-MSS-02 , was damaged after it passed the functional test and was replaced with a new snubber. All snubbers were visually inspected and accepted prior to unit startup *

Page 16 of 17
ABSTRACT OF EXAMINATIONS STEAM GENERATOR INSERVICE INSPECTION Inservice inspection of the "A" and "C" steam generators was performed.

For steam generator "A", no tubes were plugged as a result of the inservice inspection. However, one tube (R41,C28) that was previously plugged was replugged in response to NRC Bulletin 89-01 concerns. Another tube (R41,C27) that was previously plugged on the hot tube end in error was deplugged, tested and returned to service. For steam generator "C",no tubes were plugged as a result of this inspection .

Page 17 of 17

ATTACHMENTS

Memorandum A'ITACHKENT 1
To From station Record*

David L. Roger* June 25, 1991 ISI Engineering 2-SI-85/WQRJC ORDER 380008885§ A VT-3 Exam was performed on the subject valve on 5/19/91. The valve was rejected due to a gouge in the valve seat approximatly 1/8* wide x 1/16* to 1/8" deep x 2 1/2" long. While this indication is worthy of note, it does not fall under the requirement* of ASMB Section XI, IWB-3130. ASME Section III, NB-2121 (b) specifically exempts valve seats from the requirements of the Code. Since this is the case, the requirements ot ASME Section XI, Table IWB-2500-1, Item 812.40 do not apply to the valve seat. Based on the status of the valve seat in relation to the requirements of ASHE Section XI, the VT-3 exam ot 2-SI-85 can be considered fully acceptable. In addition, since the valve passed its PT 18.11 leakage test there are no other ASME XI, concerns.

~~b ISI Engineering Leve1*111, VT-3 concur: ¥?£~

R.L. Coder Authorized Nuclear Inservice Inspector cc: T.B. Sowers T.R. Huber G. Thompson P. Skopic File

ATTACIIMEHT 2 Information Transmittal Record -

VIRGINIA POWER Maintenance Engin~ering - Nuclear Power Station ..

Received By (Name)

                          \-\ ~D.       C u L. <-      R-
                                                                  - ~      " *-
                                                                                . ~
                                                                                            , Date:

Time: 5' - I i - C, I

                                                                                                      /'?.. 3 0
                                                                                                                          .i,.
                                                                                                                                  -t -

ADM 18 Title/Depart_µ;iertt Phone SJ,t) r. l.'AL l ~ l (" p,g__ Tluk) Subject MPt1NTENf\NC.E EN61NE£R.JN& ~ft'.INSi: TO OZ-K.C.-5\J-255/A \JT-3 REJt:CTIL>N. Component Mark Number OZ.-~C..-~\J-255/ ~ Summary of Discussion MP\INT.GNI\NCe cN61NEE.t1Nl.,, C.HUC.K. .SILCO't ( VT-~ &UAUAEO) AND ll5A ~ILS.ERT, PERFORMC:o A 5uPPL£MENTAL EX.AM ON PRESSU~IU.f .SAPEl"Y

   \JAL..\JGt        OZ.- ~C-S\J ~ Z5SJ ~ OlJE: TO r,..,            vr-~     ~c. 'REJE.C..TION. 1ttE \JJ\L\lE WA~ RePc>>2TEO Pr.5 /-tA~iN& f, (FDoK} 60UCse5 IN All..E5.!>U~l.E AKEPo ON ~

l\DJU!')TINC: ~\Nb.

UPoN I N5Pl:CT1 ON OF THE A.l!.e~/8LI? Ptl?E Pt!) 6 F ntE 1\0.Jlbf/Nt, ~IN&

1 Ml\,NlENPrNl.E EN6&NEE lll\llr- OETEKMlNEO Ttt~l 1th: bOU6c!> ~E'fE ~U~PIC1P.L. f..NO THe CA~!: Wfo FlOM THE 'TCOL 0!:>fO ON Tttf. M~ru=>nN& f.\Nl7. ittE MlJU5TltJ£,r tlN~

    ,~ l5NL1 ~             \J\IITH nus TOOL. WHEN 1kE VALIJE' Is BEJNl,, AIUU~Tf.D.                          THEfe~OfE" TH~e MP&V-~ o;:. ~Ou6f:S A~E PclLEPTPi6Le SINfE THEY \NILL NOT                                     Affe:..T THE' PERfbRM~ oF Tit UM.\tE, S-\\- q\

Reviewed By (Name) Copy T.o: Supervisor - Maintenance Engineering Additional Distribution Below:

ANI/Arl!I R.L. CODER NB7009

                                                                          ~~\A
                                                                                            \~~\                   Page 1 of      L Form No. 726769(Feb 88)

SUA°'4-M-20 ATlAC~ENT III PAGE 8 OF 29 ATTACHMENT 2 FORM 1 VIRGINIA POWER VISUAL EXAMINATION REPORT VT-3 PUMP ANO VALVE BODIES i

1. Recore! WOf/DCPs :i£>oo I oSBCt~ 2. Record ot Coa~onent ID I: _ _ __

0'2. :ie_ -~'1 *- '- 5 5.L A,.

3. Remote: Dir*R I J 4.

RELEVANT CONDITION A or I R a) Corroaion or eroeion reduction ~ of pressure retainin9 vall thicJcn*** by .era than 101 St1 L N0 \ (.. b) Wear of Matint surface* that r\ *.fw;f; ,).,.,t,, -) uy lead to lo** of function or --r-'r" :>; -. * ' ,\ leakageo ~e c1'..- ,,Jo\. e_ A c) c:rack*lik* aurtac* indication* developed in aarvic* or trovn

in ai1* bayoncl that pravioualy recorded acceptable. ~-r:- .; f'l ot" '

d) Loo** Part* A M/A*NOT APPLICABLI A*ACCZPr R*RIJICT I*IMACC!SSIILE

5. Comaanta P,dJ~~t,.vGs r2i,,J~ r\n~ ~~~ ,.~J S't-'\ ... :- ,:4-. A,~_,,.":.-S.b 1*,. 1

       ~ ~ l\.':i

C;.u_:::it- ,,~a e\ ~ r ""*..~J~.:\ ~ :: ,.Jb,;;? <2 ~ ~& E.; ,ti! ... <\~ a- r .Q 61..1., r -1 t>

   ~c+e.~ 'tl\)\~,<.2...             ONl"{ t\C(c'.:.."'.):6\e.           P--Q.~~-'::> 0~              \{~\~c 1'.l~U:..J;\~

Pi:"::> '11t,__1ta ~ro'"' \.N\~\- Av-..~ (,J\.L\\-L-\ '--*io{e '2_..,.._Pn°'f',~e,..J

 ,. It valve ia a abecJE valva, diac ahall be                                                           A                                R
         ..nually aa.lDad and evaluated tor tree*

doa ot aotiall wilb no blndl119. N/A N/ f\

7. Recomaended SUppleaental IXU1 * , .. 1 V lfos _ _ _ __

I. Mm ot 1xu~in~)i'r'9ecJes- (. Pr.~ e... Sr Siqnatura~4't::::_~ IXaa Dates s/,o I Leval: ___jl: _ _ _ _ __

/er

t. Mill Si911atura1 Data: _ _ _ _ _ __

ATTACHMENT 3 vorrecuve Acuon Assignment an<J Response for Deviation Reports Al

2. ScrNning Red S- / - 0 S"f 2.. D Crllcll O Slgnllcanl O ~ E RcMN

  ,. Correaive Action Plan 01v1lopment Auignment O SNS                 O Tralnilg O HPES
     ~Eng O Opt O Malnt O RP O NSS D Procedures D Other _ _ _ _ _ _ _ _ _ _ _ __
                                                                                                                   ~-=

s. Other Oepanments AssigMd Actions or Questions 0 Eng D Ops O Maid O RP D NSS D Proclldum 001h*

a. JCO Required? 13 No O v.. 7. Roat Cause Evaluation ov..

8. Assigned Adi0n1 and OuutiOna D Corrective Action Requirementl D Perform Component Faffurw Anllysil D Perform EnginNring Evaluation to OGtannine D Perform Component Repair O Complete~ Screening Chlddilt Reqund Correcdve Action 0 Nuclear Network Entry Required

    '8 Other         O Ci.f       +     ,s.

9. Corrective Action Plan Details:

17. Corrective Action Plan (Continue On ReverH Side)

Item 2: See attached doclrlentation fran IBJ. Iten 3: See attached mmx:> fran E.W. Throcmiorton to D.L. Rogers dated 5/9/91. Prepared By: $l2 it4+ 4::"'.'. concur: ~£~

18. Corrective Action Completion Date 19. SNS Reviewer (Signature)/ Date 20. SNS Independent Reviewer (Signature) I D

22. Supervisor SNS (Signature) 23. Date

21. Response: D Accepted O Rejected O Reusi9ned

24. Quality Assurance Name (If CA Initiated OR.Please Print) 25. Quality Assurance (Signature) 26. Date

27. SNSOC Review 28. Management Tracking

Th* root cause has been correctly identified? DNA O No0 Yes 1-:H:-:-:P==e==s=-:N~u...:m:..,,be-r--'T'"J"""'co~~Nu-m~be-r--....,..,,,OA...,.,..,A-ud"""it'""N~u-mbe--r The corrective action addresses the root causes?O NA D No0 Yes CTS N bar WPJWO Number LER Number Corrective action acceptable and complete? 0 NAO No0 Yes um Corrective adion acceptable; assign to CTS? DNA O NoO Yes ""o~C~P~/E""WR,.,..,,,,,....,.N_u_m..,..ber--+-=pAR.,..,,,.------+-,,Oth...-er----

29. Comments

30. SNSOC Chairman (Signature) 31. Date

     .s: DR-Deviation Report, Eng-Engln11rlng, Ops-Operations, Malnt-Malnt1nance, RP-Radiation Protection, NSS-Nuclear SH1 Services, SNS-Station Nuclear Safety, JCO-Justlflcatlon Continued Operation, IOER-lndustry Operating Experience R1vhtw.

SNSOC-Statlon Nucl11r Safety and Operating CommlttH , CTS-Commltment Tracking System, HPES-Human Performance Enhancement System, QA-Ouallty Auurance, WR-Work Requ1at, WO.Work Order, LER*lanNd Event Report, OCP-Oesign Chang* Package, EWA-Engineering Work Request, PAR-Procedure Action Requeat i=-111a. m079(09c

IMI lllll//A.DI&-* Deviation Report ATTACHMENT 3

1

      .DRNunMr S.Syl&effl
    ... C1aatib1ion:

S - Cf/- 056'2_ D rs O SA O Appendbc A O ea

t. DNc:dptilM of OeviatJon (lndudlng Probable Cause) s14ff""t ive.tJ. l~$J 011 211-1*1: *IAJ .U<<.i" el"-'-;,u>,l "1 '**-**ct pt11e+~ ... f

     "'"* .. ~ d ". ~s ,*c!'~~1.-*eQ(. h3 /15 ,.,,,; :zJ.. _Tiie. fes 1 .-e~~4..l~..ol ,.4.,uLo,..., ,.e,-f,l,I
     , "~ ,c_"-' +, 11 o1. S" c a.~s f ! ~ I:, 1 I4-<* le o ~ f "'"".,,. ~ ..,,.c(. ,oo ;-o~ , -/-) ,-,,_ -Hu. 1J>J ~J. -I!~.,.,

o..-,q,"""'

             ,1 cc.,-,.Tft"'"4,.C..f,..,"

Tl\e "'ua. C::.o,*p. L.e"'~I :U:X ev4,.f"'-~l-*ct. 1-l.t ~.... . ,....*~f , ,*...

     """'d c.lef<<..-n'\i114i~ f-1-_f fl,e ~ .. ~4.~f,;,,"'- o.f fl..e ~._let. UJCII.S Tlu-f Sc.c.,'..fa.l>lr o ,,._,.jo,.d'V\ ~ ,,v.\d.t,lr1,4cl-;,,:t r,ca.-,.,~....;t~~. He .*e!"'-esfe.oL 1-k-..i -..II s~**f
     ~eic.(s        ('i * *t..uCJ po.* l,~"-i e.c*l~ ... J be. .J:-.'4.c..ll1 ,~~J'ec..f*.d f..,.~ C,'o..cic;*,,j

TA, ..,*;.s~.._l e.x,.__;~-t1.;....,.. ""-Cu~le.~ .,,o ;~&L,~J'~"""-S c, / ~'°~c.J,,".,,J.

f\.. e;.bc...bls:* C ... ._-.~*. Ti~ heA-f E>.&cA.o.,,.Je,..s ..,.j~.*e c.o"".s*f...-,,.,"f*-t>l.. f,., /IS*"?'!,_: *IOI re.,~,,...ewil!. .... {S J f'"'ubq,j,/1 19'-6' tEJ..*f,_o*.,.~ ;u(;c.( rn.tc-lces no ~,:*ec..f r-e.fe,..e .... ,~ lo H..~ e.a...-.,:.,,.~_J.~."- "~~..._,*.*e"""~"'-+s., or CLccepfo.,..c~ c.--,fe..-,*~, o-f .Jess'!/ S"7'r40 r 1

   "-'el~s. T"lae_se ~:.lets- ,t.o .*-.of ""'~-et .tlSrt1ci IiT o...-::zI t:l.cc.~pfu..h;l,J.y -i-o

f ~- ~ ~ r rn IV 1) t=

10. How Discovered:

                                  .SCA.,* ~u.,

00poratlng ov,nc1or

11. lnMal Actions/Correc:t;v. Actio~ub e ~ ic c;c. *"" S 0PM 0NRC DCM 0

OPT Other (Identify):

                                                                                                                           ~ lnspectil)n     O Operating Experience Piagrar
    ,) \A..) <... l ct. ~ e ** -i>          .- ..; ..._ / ...._ "- ~ c.cl b J +I,. P. Ni) i.: C:. ..~ ,' .
         ~"'-rt       ~-4*\.&l       "'--,.S'-1..,    fQ 1,/ "i.          to.-     ,v 0,5        fes f ,* ....,
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                                                                                            '4 1
        /-o      .{-e-te.t--rn,*,.-c.         sfrl(.efw...,.-.,/ sf~*",/i, i)to                                   ~le+~.--,:,te{             f-1..e .....,e.lclr ../-

b ~ c. cl P. ~ (A,. o...ifl! . J) C.vrp. Zs I ....ic.o.~ ... ~.,..,,,.,t.,-l ..... ~ "',,.),I( .l*'4.i,""*"}* ~ **-el,e..f ,*ei'<..e)*f lo :.hie.}~ T' t!. re '6 "'-*',. e ;,n ~ , 1 .j!"" *" :i ~,* ~ ~ ~ IL Q.."" S *' f fie~ t-* ~ tt..tcl~,

                                                                    ,c./,e  - f'. rt=

t!S f.

12. Problem Resolved? 0 No 13. Work Request/Work Order Number

14. Personnel Directly Involved (Name)

Key: DR-Devladoft Repo,t, WPTS-Work PlanM'I and Tracblg SJ--. TS-Technical Specfflcallon, SR-Satet, R - - .

EO-Enffonmental Qualtlcatlon, ~ Safwey FeaturN, ISl-lnMrVtoe Inspection, ERF-Emergency RNpOnN Fac:llty, Aclmln-Admlnlstratln. Pll..f'reftnllw llalnllnanoe, Cll-con.ctl¥e ll1lntwnoe, PT PertoclcT.... QA.Qudty 0 Aauran&le

Deviation Report ATTACIIMEBT 3 4Hour 24Hour

30. ~ aasra11on: o 10 CFR so.n 0 10 CfR 73.71 00dw(Spdy): _ _ _ _ _ _ _ _ _ __

D Pol*ntlal 10 CfA 21 010 CfR 20 0 A,lplndlx R o~-pn,vld9--=----------------------

37. DA Is repottable?

Equ~nt operable? DR is I violation cf unit Technical Spec:fications? DR II a violation cf the Station Admin PIOCedurN?

31. Addiional SNSOC Notea or Commera 0 No O Ya 0 No D Ya D No O Yes 0 No O Ya DR constlutes an unreviewed safety question?

Reoommencl SignifatC Event Review to Station Manager? 0 0 ND D Yes , ND0Yes

39. SNSOC Chairman (Name) SNSOC Chairman (Signature)

41. Tm* By (Signature) Name of Individual Notified (Pmt)

(2400 Hours) Supt.Ops. AsslSMNS & L - - - - - - - - - - - - - - - - - - - AalSMO&M SlationManag*---------- -~---- --------------~--~~ VPNOO Chairman MSRC _____ - - - - - - - - - - - - - - - - - - - - NRC EOC

      ~Resident NAC Region II SIii* of V'i,ginia - - - - - - - - - - - - - - - - - - - -

K-,: LCO-Umltlng Condlllon tor Opentlon. CFR.code ot federal Reguladona, SNSOC-l1atlon NuclNr Sa1t1J and Operat... Coaunlflee, DR-Deviation Repo,t, . .L 0pL.sup.tns.ndenl-Operatlons, Aut SIi NS I L-Aaalalant Station Manager NuclMr Sd.ey and Ucmslng. Aul SIi O&II-Aulalant Slatlon llwc,er Operation* and llalntanance. VP NOD-Vice PrN1den1-Nucl11r , Operations, IISRC-llanagement Sat.tr Review CommltlN, NFIC EOC-MRC Ema;.ncr Opendona Cenllt :::,ND. :a,Cll!(Nov

                *--*-* .. ***- ***-*                                        ATTACHHEHT 3       VI r<-~* 11..:::U
  .*

1*

RESIDUAL HEAT EXCHANGERS Rev. 1 6-.18-85

Welds 1 &2: .875"T SA 240 TP304SS Diameter: 42.i C1rcunference: 131.88" Nozzle in Vessel Welds: 10* Diameter - .87S*T SA 240

                                                                                   *yp 304SS (Not ~ccess1ble)

Integrally Welded Support Attactments: 2- .OOO"T Component Supports: 2 Welded Supports* Mechanical and Hydraulic: Not Applicable Flange Bolting: 48-1.375* Diameter 8.o* Length 0

Reference:

Centerline of 10* Inlet Nozzle Class 3 2-RH-E-lA "'Note: Nunber is preceded by Heat Exchanger Designation 2-RH-E-18 c::::,

(*.

                                  /
                                                   \\
                                 ,\                II
                                         -    //

Bolting 10" 10" Outlet Welded Supports O" Inle--- 10" Outlet From RHR Pi.mp) 848

ATTACHMEBT 3 ENGINEERING RESOLUTION OF DR S-91-0582

LOVER SUPPORT ATTACflENT WELDS RESIDUAL HEAT ROOVAL HEAT EXCHANGERS In order to verify operability of the 2-RH-E-lA heat exchanger, visual inspections were perfonned in accordance with . the origina 1 design basis.

Because the prep work for the PT inspection had removed some material, Design Engineering performed measurements to obtain *as lefta weld dimensions for the lugs of the lA heat exchanger. Calculation SE0-1738 was prepared on 4/20/91 to document the acceptability of the *as-leftu welded connection for continued operation until the Unit was defueled {approximately two weeks). The calculation determined that the as-built weld configuration was acceptable for continued operation until fuel was off-loaded and corrective action, if required, could be perfonned. In order to ensure appropriate corrective action was taken, Site Engineering requested that Corporate Engineering Mechanics perform an independent review of the required weld size for purposes of determining what corrective action needed to be performed this outage to allow Unit 2 restart {see Attachment 1, memo dated April 25, 1991). Corporate Engineering Mechanics has performed a separate calculation (CE-0868) which determined that a 5/16* fillet weld is acceptable provided the weld is all around and is of good quality (see Attachment 2, memo dated May 7, 1991). Design Engineering as-built measurements of the lug weld sizes for both the IA and 18 heat exchanger

(Attachment 3) has determined that the minimum weld size, even conservatively treating the welds as fillet welds, is at least 5/16" and most welds are substantially larger. Therefore, it is concluded that the welds are acceptable for continued operation and unit restart with no further corrective action.

It is

our understanding that as part of the long-term corrective action, a relief request will be prepared by the Corporate Programs group to request NRC approval to delete the requirement for future PTs of these welds. Should this request be rejected by the NRC, it is our understanding that the welds will have to be ground out and rewelded to provide PT quality during the next Unit 2 outage.

                                                   /l,j____    s    LJ~

M. S. Whitt yrn-MSW-0509g

AT.rACHKERT 3 VllfOIIIIIA POlt'D NDlmlCAROUMAP011--a-Memorandum To Mr. C. E. Sorrell Office/location Civil Engr./Innsbrook From M. S. Whitt Offlce/Location Design/Surry Date Apri 1 25, 1991 CORRECTIVE ACTION FOR SUPPORT WELDS RESIDUAL HEAT REMOVAL HEAT EXCHANGERS On Friday April 19, NOE performed a PT inspection of the welds of the support lug attachments to the Residual Heat Removal 2-RH-E-lA heat exchanger. The lug attachment are shown on the Atlas Industrial Manufacturing Company drawing referred to as vendor drawing 11448/11548-4.12-4A. The RHR Heat Exchanger shells were originally designed. and fabricated to Section VIII criteria by Atlas. As such, the welded connections for the lug attachments were only subjected to visual inspection. The ISI inspection program has now been upgraded to classify the heat exchanger as a Class II

vessel. This requires PT inspection of the lug attachment welds. The welds were prepped as best they could be for the PT inspection; but it was determined that a PT could not be performed because the welds had not been made with the intention of every having to undergo a PT. The welds were declared PT-reje~table on 4-19-91; a copy of the deviation submitted is attached. The inspector stated that in his judgement, there were slag inclusions and porosity from original construction; there was no service-induced cracking.

In order to verify operability, visual inspections were performed in accordance with the original design basis. Because the prep work for the PT inspection had removed some material, the visual inspection provided nas left" weld dimensions. Calculation SE0-1738 (attached) was prepared to document the acceptability of the "as-left" welded connection for continued operation until the plant is defueled (approximately two weeks). Loads on the support lug attachments used in Calculation SE0-1738 are the Faulted Loads taken from Westinghouse Letter VPA-83-666 of December 28, 1983. Allowable stress in the weld is taken as 18 ksi (normal allowable). The calculation determined that the as-built weld configuration was acceptable for continued operation until fuel was off-loaded and corrective action, ff-required, could be performed. It is necessary to determine what corrective action, if any, is required this outage .

 .vrn-MSW-0425i

... -......... ,..... - ... i,. _.......,.,...,. ..., ........ - ......., ........... *-~*-*** ...... ~. **~ :,.-*-**, ......... *. - . ATTACHMENT 3 C. E. Sorrell Apri 1 25, 1991 Page 2 It is requested that Engineering Mechanics perfonn an independent review of this calculation (including continued validity of loads) for purposes of detennining what corrective action needs to be perfonned this outage to allow Unit 2 restart. As part of the long-tenn corrective action, an exemption request will be prepared by the Corporate Programs group to delete the requirement for future PTs of these welds. Should this request be rejected by the NRC, the welds will have to be ground out and rewelded to provide PT quality during the next Unit 2 outage. If you have any questions or require additional information, please contact me at X2980. M. S. Whitt cc: T. B. Sowers A. R. Fletcher L. J. Cullivan

- K. K. Owivedy - !NlNW D. P. Madden - INlNW

                                                                         ".:>~ Fi Ie.-

yrn-MSW-0425.i

ATTACBMEBT 3 FORM 3 VISUAL EXAMINATION (VT-1) SUAD-M-20 ATTACHMEN"f I PAGE 12 OF ll NDE-R-91-049 STATION/UNIT: 2 jsYSTEM: RHf2.. IDATE: L/- zz.q I ITEM,COMPONENT INSPECTED: CONTROLLING DOCUMENT NO.: I / J:'A-OU? UlS I.LIS.,_ lf'll..l 1.-D.\.l-~-Ul u.li 14 'e\l'Sl. f)M 1 Z~f*lf 38£lnlO ID~~ 1 VISUAL AIDS: FLASHLIGHT REMOTE: DIRECT: v~ INDICATIONS NOTED: YES: NO: NO CONDITIONS EVALUATED ACCEPT REPORTABLE: a) cracking A b) Wear tJ/f>. I

c) Corrosion d) e)

Erosion Physical damage: e.g. gouges, scraches arc strikes u/a.

                                                                                                       ~/A j
                                                                                                        '#JIA Any conditions noted as reportable shall be described below:                                                                                                             Ii t..\oTr:;:'   , .... ~~  .:,"i"I,:_~   ' ,ie:,   1'<     r=,. Q.        r~n """<~ ,riU LV .                                I I  '
                         ~ER.            Cc e  rYll "' ~,-c      \  .... I l!}IJ I -rn- .                                            I I

I RECOMMENDED SUPPLEMENTAL EXAM: YES: NO: ~,,- I AUTHORIZED EXAMINER: LEVEL:

    .tt:t           /PP~ u,,:--                                                                         DATE: f-))*C/ /
           ~                                                                         =zzz
  ~I/ANII:                                                                                    DATE:
                                                                                                                           ~

ATrACBMERT 3 Calculation Cover Sheet

cak:ulalieln Numtler Sl81iOn and Unit SU/?R'/

se~- 1733 lj)./Jj .2 Sllaet Numbe( Protect DCP M.m:ler I << 7 l1tle Work Order Number

        ~JIii JI/:~ T t; ~,- u.a AH!/; D               <'UJIP()ll. r
       /.I)~    /.,(}~ I r,    CAI.I" 111.ATlnAI Key Words
               /VI~         #£AT GXCNIIAl&GR                       S u,-,olJR T LIit!.

Rev Preoared Bv Date ReviewedBy 0818 A-f,,~ii,o ~~ Dall

                                                          ""1£S ;......-r *r                            w\ w;l,.V

A,J s . '-"" . --:-

I) Fvpose

           #tJ~'+>*                      l.f. ).I)* 91     },,/./..._u. h""'-
                                                                                ~
                                                                                     -f-Ll -u-,1 h1        (          st..l,,_~ 4-2C4f TPF.        l'uAPOS c          O.F TN/~            1""/.JLCULAT/DA/               I~  n,    /J(}e(/A,,,ENT               T#c AeC/JTA/11L.ITY                 J:'l)Jl   l"°.;');i/T/NI.J~I)       oPIE/lA 7NNV         ~,&'     TNE Lv6I-D£D UNN~C r10N                /'J~     ii/ SU/J/J4~T LUtf                     FOi{     TJI ,R/;<..JbUAI               HE.AT

c Xf'.J.IANt: &A summary ot Results 2-/VI-F-/A.

eX1ST1N6 wet.I) /'5 4t:CGP'TA8t.c F()/< t:LJAIT/NUb 0 Pe~ '1 TION. Other caicu1a1ions Affeclecl: D Yes [RI No Number Revision Supersedes Sucolements [RI Safely RelaSad

D Non 8afety Relaled Fom\ NO. 7297 IIC,Jlal, Ill

ENGINEERING WORK SHEET VIRGINIA-

  - .... POWm OATI
                                                           'f - "l.(J-~/

UIU Of OJiUii"II

                                                * - l1lmll

1. cw:uLlftCIII c:on:a Sili't J.

i. Ult.I or CXii1111S 2..

J. OIJICrffl 3. HEl'IOD or AIUL!SU 3.

s. DISlGI mvrs ;.

              ,. ASSIICPUQIS                    3.

7. DISIGI cumu 3.

JWZGIOUKD DlSaJSSICII UFD!ICZS

10. APPLlC.UL! COPES I STARl)AIDS

                                                  'f .. ~

3. 3.

u. C&LCULA1'ICII 6-7

12. CCISPVID AJW.!SU

13. CCICUJSICII

                                                  -*7.

14. .AffACIIMlftS 3.

ENGINEERING WORK SHEET

                 ..__ _ _ _ _ _ _ _ _ _ _ _ _ _..., IHIITNO.                            J o,    7

PROJECT--:..;..~....................._ _ _ __.,.

                                                                                                     "IV. NO. 0 DATI VIROINIA POWER                                                                                                          z~o-*~9, SUBJECT~~~l."-~:-a......c.ll;...&.KU,,ir...ill&al;,_..'tt,.~~.,,~~~~l~J~Ka.----~~.........-. ..

DATI SYSTEM _...~,g,.--------.....,. '/-Ztl .t!)J Objective: To analyze the supp0rt to the Dts1gn Criteria given herein. Method of Analysis: C11culat1on using strength of materials and structural a~lysis techniques.

D!SlGH IHPUTSs lvc~TJ/1/(il,/eJUSe I.ETTER VPA - 8'3 - t, ¥1 " ( /NCLUOe'O AS ~TTACN. I)

ASSUMPTIONS: DESIGN CRITERL\/APPtICABLE CODES & STANDARDS:

5 ' Iv BMXGl\Omm eMI) 79-23 DISCUSSION:

REFERENCES:

1) AISC 8th EDITION

2) STANDAllD CONDUIT SUPPORT MANUAL

3) UNISfflJT GENEJW. ENCINEEllNG CATALOG 110

4) BLODGETT " DESIGN OF WELDED STIOCTU1lES" 7th PltINTDIG

5) COMPUTER CODE: NOii/

                           ')    STIJA.1£   t:, We8S7E.R EN4/Ne£~JNt: McC)IAN/C~ /)IVIS/()N MEMt:JllANOVhf, £Ml) 71-2.~, 0AT£0 JUt.Y S 19,9.
                          ~                                                                        )

ATTACSMEHTS: VENIJOR /)f,114. ll'II.J.4/IIS'II- 'f.12 - ~~ . I. WE5TIN(;J/01..1S leTTU VPA-83-(,,(,

2. 5 f W M£.lrfCR4A/OI..IM MD 79- 2.3

3. MEM4 i4 /HIKE AINt:lG'.t; /JATc/J ',I- Zo- 'II I/, OESIGN /NPvr ReVleW Cll£Cl<UST

 *..... ,...       Pro,ea
                      ':JtlRR'/  l/NIT      .2.

IEngineering Work Sheet I Doc. No. j S_E0-1738 Rev. No. Sheel No. POW1* System* Alli Q1,Cll$5{t:JN ~ r)le I/II~ H£AT GXCJIANGERS ~£Re t:J,'?,t;.INAI.I. Y OeJl~NeD r AND FA81UcAre.c i() se<: r10N "g](( CR.1reR/A, S "I ATi.A S

        /}/DUS TRIAL NIANUFA~ TUil/NG C()M,OAIVY.                        AS sucll, TIie W4tlJ4J)

C.~NNeCTll'JNS F~R. TN£. 1..u, ATTACNME.NT.S W£NE dNI.Y Su8JlCTED

71) VISUAl /NSP£CTloAI.

7JIE ISi INSl'l.& TIIJIV PR066'AM #AS Nt!JUI 8££N VMA.,t/D£0 To CLASSIFY 7Hc NeA7 6"J<CN4AIGE'l '4S A c,Ass Z V~SS£1.. THIS

        ~EGLll~ES PT 11.JS>ECT/ON e:>r THe Ll./6 A7TAeHM6NT Wct/)3.

THe WG/.DS We~ /Jli6Pl'cD AS IJeST THGY Cout.D 13e F~~ THe PT JHSPeC7/0Nj !j(JT IT WAS DeTEAM/)i/t() THAT A PT CCJUt.D NOT BE PERF<JAM£.O BE~AVS£ THeY WeRe Nor MAI){: a//7/1 THe. INTeNTION t:)f' eV~A NA INN6 7" VNDcAGO A P7: iHe

         /AJ!LDS WeAE. Dec.LA~ED PT- /iE..l£'-T.lll3Le. ~N ~-11-11. 1'116 INSPEC1oA. STATcD TNAr IN HIS JUOt:MEN7i Tl/£/lc W£/lE SLAt:: INCt.V.Sl~NS AND P()/!OSI TY r/UJM t:Jlil41NAl Cc,NS TRUC 1"/4:W';

TlleltE WAS NO Sc~V/Ce. /NOUC.£1;) C~ACK/NG. lN ()/lOE~ 7() V£1?1FY Ol'RA61£/TY, *v,svAL /NS/>ECT/ON.S WG~~ PIRF()R.M~D IN A~~OHl7AN~e WITH THE Q'.1/t;/NAi. beS/<SN 8A$1S.

        &c~use T/1 P~EP WORK rlfJ,<.. TH£ ~r INS/14C T,1e)N HA.I) ~GMOV~

StJMG MArE.11./Al, TH£ V/SVAt /NS/JtCT/t)N ,P~t'JV/OcO "As ic~T ,, W~I.D OIMENS/ONS. rJ11s C4tCf./lAT/#IV 04CVM£NTS T/1£ At:~ePrAIS/t./7'/ t:,F THe As- LEFT tvcl/)c/) C~A/N,=C T/DN roA Ct,NT/N(./EI) op-e/1.ATN)"/ UNTIL TIie P(ANT IS ~crU£l£P (hV APP,,fOX/MATE{Y r~ w<<KS) oes16N INFtJ~MA T/l)N TN ~l/04l'- HEAT E.XCNAJJGER OUTS/De 5He't.l. P/ME.IVS/IJNS

        /1,V/)   /)/MeN5/()N.S ~F T>/C L.Uti A7TACHM61\/T A,fE SHc:u,vN ON THe A7l.A S /)~AWl'N6 ~t!rellRc D Tc As veN()(JA DRAhn'NG ll'/,'II/IISl 9.12. - If-A. TNc 1)£S/t;N tv~t.O S/ ?ES AAc Ne,;

Oe7Alt.£0 t?N /'Ne /)~Ah.NH~., '8U T k.lc~e C"Nr/AM40 ,8 Y /N.SPe~- TIPN (S~G AT'TACIIMeNT 3 ), AN!) Wll.~ 8t G'VAl.UATe() IIERG~N. loADS ON TIie St./,IIPt:,A'T Ll/6 ATiACHMt!NTS ,4,( TAl(eN /=A.CM WSTINGH0USE t.GT7c/< VPA - 3 3 -"~6 Or 0CGM~ 28, /'183,

      . (ATTA&IIMcNr I).              Al.l~A~t.       '571fe55 /N T#e WEl..0 IS TAKEN i'otm No. 7227121Mall 11!11 IF°"'*"f 9170701 Q;

   *                                                    !Engineering Work Sheet 1uocumet11 Type EN&. ~AlC                                                                 Patl14 Pio,ea                                         Rev. No. l sneefNo.
     ...... l'IDI-  I
                    !    5 Vlllt. Y   UA/17 .2 Subfeet 1
                       ~HI( Jl6A1 GXCN, $UPPoll1 '-Ut.
      -~             System  RHJt As II K.5.1.              7'/e RE4.I.IIR60 W4l/j Sl!E I~ CA'-C'Vl."17£D IN ACCO~l'JANCE             WITH ST~NE & N685T6R eNG~A/6£A/Nt; MECH4NICS 1)/V/SION Nl£M,J~,4NDVM EMO 71- 23, IJAT£1)

JI.It'/ 5, 11,,. WEtO S1Z£S WELD Sizes 0/V T#e I.Pt! .4T1'ACHM6NTS /,vcR~ a,,v,,C/AM£0 8Y MR. MIKe ~1N,1.£A ~,t: Sl7e M6CNAN/CAt /)£SIGN GN~1NEE~INt$ ON '+*2o-fl (S£G A'TTAcNME'NT 3). LN AO/JIT/ON 7~ PAOVIOIN6 W~to S/i'e .S .J. I/ls ($4/\l~AAL CON* ClVSIIJN WA.S THAT TH~ WEI.OS IVeRt! ~()G/fSH ANO t1A/'- Y 1

            ' MAR~1NAL '-Y           AtCcPTAIJlE PEtf Vl-'llA£ INSP£CT/i!'JN . /1"1t,,14Y~A, HE STAT6D THAT TJleRt: WAS NO V/SVAt. cVl0£NCE op                                                       ~

CliACJ<IN(;. IN Vl£W IIF TN (;t:JNDIT/DN OF T#~ ~e~Ds, TH£ ~E6U,Jl/1£l) W6LD SliE rP/.< AcCe-P,AS/~ /TY FD~ PI.IAPose.s p,C THIS CA£CGII.A7/0N WILL. ~ rAKeN ,4S 72v/C TNt CAlCVL/.17E!) S'/l-E1 /Jet? /)/A£~ r1cN it?r 7HG 51,,1Pe~_V/S~~ OF CIVIL OE.51(!,AJ eNt;/NcGAIN(;. J i i

                                                                                                                   ~
 *'                                                                           io,m No. 7227121W. 891Cfcmwlrl1707010J

ATrAcmmtrr 3

  *Mllall~

IEngineering Work Sheet 0 , o1 7 PON 1*

WELD ANAL YS/S FOR. RHR HeAT eXCHAN~ER.

SI.JPP()R T Pl.A Te ? t; USS TSc

t. r,.

F,

ENVe£0PE ltJADS FROM rA I.It,. TED lOAOS II.JI.. ,A , ----+--:..-_--.-Fi.- F3 "J J. 4. --' - ,, /( F, = Fe~ '/7.()1 K. M, sMi :.ry(11)= /2,'IS(ll)r/1/-2.S , fi = F;t. .: Zl.88 '< M ~ =M ~ = 'I- ' 'I. 3 I/ '< l r3 = Fy = 12. 'I~ ~ M3 =My.: F!(,1): l/-7.tJ'l(II); S/8 11 1( A= o..+ 21' = 28.S'-+ 2.(13.5) = 55.5 xz.=- /JI

I!_ b1.(2(L+l,)

C, - 3 (Q.+b) ( /:,.S)~ (2.(28,SJ+/3.S) 3 ( 2.8,S + 13.S-)

                                                                                ~   102.

I l,:. o..(a-t6b)_ 28.5 (2.8.5+ ,(,;.s))

                    '=,             ~~~--------------- ~ 520 b

J/c, * ?, t b <;Q.tb) )(, 2. b~

                                               "-(~~lb)

520 + r;.s (2(28',S) t 13,S) x 3

I I 2 ( 13. 5)'1. l8.S(Z8 .5 + l(/3.S))

                                                                                                      = 513 J/c   = t.       ( o..(a..t2.~>)      . I?>         s1.o ( 21.s(2g.s + 2(13 .s>)                :'I +-lo 2 p      I       lb ( a..+b)      f    "Cr    ~

2(1?.S) ( "l.8.5+13,S)j

                                                        - i2. 7
**                                                                                         *onn NO. 1227121Mat 8911ronnan, !17707010,

A'l'TACBMEIIT 3

  *H 8 -.,.,...

PrOjed S VR ~ "I 1/AIIT 2. Engineering Work Sheet* Doc. No. Rev. No. Sheet No. 7 ot 7 POW1' Subject

                    ~/.IA. ll£A T £JCH. $VPP~AT W~
  --               System  I< HR                                                                               .u:,--, I
                 ~        j [ -+-.,._              M 1                       - ] + l FJ 2

T~ F1. - M, 3 t.t [ -F, tM-i. - , -Mi. - ],_ A i: 1 Lye., _A . J/c, A J/c.p [ 2./ 81D + 11./2,;<.r) J/ I ~2D 5'1800~l_l. t /~l j l:¥70ftJ + 46'/

                                                             + ) I I 5'13 JO(Jl 2. f12,1SO f
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                                                                                                                 '/6t/1 K'2. 1 38or         I

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                                                            .ATTACIIMEKT 3

Memoranaum I * -=-,

          -ro From Mr.* M. So Whitt - Surry/DBO

c. B. Sorrell - IN111W

                                                               .~
                                                                          ~,f~:       :/*:~ .

tnn*b~ook Teohnical Cen~*r Hay 7, 1991

~~-

trQIQ IRIPQU fflQI 111;rppu, PIT BIKQDL CIR) PU llfflllPI 81JQJ Jll!f I A* raqua*ted, EnCJineerinq Mechanic* (EK) hu performed an independent review ot Calculation Sl0*1738, Rev. o and ha* noted s*varal discrepancies. A* a result, EM ha* prepared a saparaee evaluation to deterinine the JdniJWD size fillet weld required to join th* low*r support luq to th* RHR Hea-c Exchangers. This evaluation is documented !n Calculation CE-0868, Rev. O and determine* that a 5/16" tillat weld is accap-eabl* prov1ded the

          ~*ld is all around and is of qood quality.

If you have AJ\y quaationa, plea1e call o. P. Madden at

          *xten*ion 3104 or my.. lt at axtenaion 3114.

1-.-*.

on:a4:37a copy: Hr. c. M. Ro~in*on, Jr. - tHllrW

{!_t.~

c. E. Sorrell Hr. 1' I a. Sower* - Surry Mr, A. R. Fletcher - Surry/CEO Mr. L. J, C'.lllivan - S1.U7:Y/CEO Dr, IC, K. owivedy - IH1NW Mr. o. P. Madden - IN1NW Records Manaqemant, MP-1896 - INGW

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TOI DA~D JlOGDS llfflSBROOK 1ROIC S Z. W. 'l'BKOCDORTOM 9/09/91 IUIR lmAT UCIWIGSR SUPPORTS

                                 ~ 1 ' QQOBST UlfIT 2 A RBLIEP REQUBS'l' 'l'O CHANGE THE EXAIIINA'l'IOH OF THE RHR HEA1' EXCHANGER SUPPORTS        PROM A SURJ'ACB EXAMIMATIOH TO A VISUAL EXAXINA'l'IOlf WILL BE sumlI'rl'ED WITH A PLANNED REVISION TO THE SOUY I8I PROGRAM. THIS RBVISION WILL BB SUBMITTED DI 'l'HB DRLY PALL OF THIS Yr.AR. POR PLANNING PURPOSES A DATE OF OCTOBER 31, 1991, CAN BB USED.      COMPLETION OP THESE iJWIINA'l'IOH WILL NOT BE REQUIRED UNTIL HAY    or  1993 AND WILL MOST LIKELY BB DELAYBD UN'l'IL JONE 1994

BECAUSE OP TH! EX'l'EHDED OUTAGE OF 1988-89
PLEASE CONTACT NB AT 2125 IF AMY ADDITIOHAL INFORMATION IS REQUIRED.

1. W. THROCKMORTON cc TOM HUBER

                                    -   *w* *** - -*** -* -* - - - -* -

ATTACHKDT 4 f/llfOII/IIA POWD POf/11 IIIO<<FHCAIIOUMA ... _ _ Memorandum

To From Mr. D. Wong Mr. M. S. Whitt Office/Location ISi Engr./Surry Civil Design/Surry Date May 30, 1991 REVIEII OF COMPONElfT SUPPORT DISCREPANCIES The memorandum to you of May 29, 1991 provided the results of the Design Engineering review of discrepancies identified by the ASME Section XI, IWF Inspections previously provided by your memoranda. Your memorandum dated May 30, 1991, provided additional discrepancies from the inspection of hanger U2-WMKS-0101Gl, H-01. Design Engineering has reviewed the identified discrepancies with respect to U2-WMKS-0101Gl, H-01. Attachment I provides Engineering's evaluation of the discrepancy and concludes that it does not adversely impair the operability of the support.

If you have any questions or need additional information, please contact me at extension 2980 *

*~cs.LJ~

M. S. Whitt cc: A. R. Fletcher T. R. Huber D. L. Rogers W. D. Grady DEO File Form No 728431 (Oc1 891 sjt-MSW-05309lc (Formerly 970240201

A'l'TACHMDT 4 ATTACfltENT I

REVIEW OF IDENTIFIED ISi PIPE SUPPORT DISCREPAHCIES U2111KS-010161 1 H-01 (11548-PSSK-10161.1)

This support contains a pair of Grinnell Fig. 8-268, Type A, size 14 springs. The spring scales indicate a load of 3900 pounds each vs. the required cold set load of. 3316 pounds (hot set load is 2916 pounds). Engineering review of this condition has detennined that the 3900 pound spring load exceeds the allowable 10% variation. but is still within the working range. The movement of the pipe from cold to hot is upward, reducing the load. The spring is acceptable as is and no innediate corrective action is required. A Field Change to EWR 89-661 will be issued to reset the springs at the next outage of sufficient length

sj t-MSW-053091c

ATTACBHEBT 4 Memorandum To D.L. Rogers June S, 1991 Fram o.w. Wong ISI Engineering

                         ,., support 1Y1luatlon Q2JQUtS-102G1-B03 <ass-11 I 12>

2-SHP-BSS-011 and 012 were inspected by NDI during the ASMB Section XI IWr inspection and identified to have loose piston on eye attachaent. The supports are a pair of snubber* located on the

  *c* M.S. line inside U-2 containment. These snubber* are identical with 8" cylinder in size and piston rod diameter of 4*.        These snubbers were visually inspected during the Unit 2 refueling outage (PT-39B-2). The Inspection revealed that 2-SBP-BSS-011 has minor fluid leakage at the fitting and there is no seal degradation. All attachments, thread engagements for these snubbers are adequate and all conditions met the inspection requirement. These snubbers were also inspected prior to Unit 2 start-up (PT-39A-2) and the result is satisfactory. No corrective action is required for these snubber&.

If you have any questions or need additional information, please contact me at extension 2772.

cc: T.R. Huber W.D. Grady

ATTACIIMDT 4 Memorandum

To From Mr. 0. Wong M. S. Whitt Office/Location Office/location ISi Engr./Surry Civil Design/Surry Date May 29, 1991 REYIEV OF COMPONENT SUPPORT DISCREPANCIES In accordance with your memoranda forwarding results of ASME Section XI, IWF Inspections (most recent memorandum dated May 15, 1991), Engineering has reviewed the twenty-two identified discrepancies; sixteen are for pipe supports and the last six are for the Regenerative Heat Exchanger.

Drawings Hangers U2WMKS-0103A2-2 H-02 U2WMKS-0103A2-3 H-01 U2WMKS-011862 H-02 U2WMKS-0118A2 H=24 U2WMKS-0118Al H-01 U2WMKS-Ol02Dl H-04B U2WMKS-010201 H-05 U2WMKS-010201 H-13A U2WMKS-Ol01Dl H-09 U2WMKS-0100Gl H-02B U2WMKS-0100Gl H-03 U2WMKS-Ol02Dl H-01 U2WMKS-RC-9 H-01 U2WMKS-Ol22Dl H-10 U2WMKS-Oll7Bl H-09 U2WMKS-0125Al H-02 U2WMKS-CH-E-3 H-01 U2WMKS-CH-E-3 H-02 U2WMKS-CH-E-3 H-03 U2WMKS-CH-E-3 H-04 U2WMKS-CH-E-3 H-05 U2WMKS-CH-E-3 H-06 Attachment 1 provides a summary of the reviews for the sixteen pipe support discrepancies. Attachment 2 provides a discussion of the six supports on the Regenerative Heat Exchanger. It is concluded that none of the twenty-two reported discrepancies results in adversely impairing the operability of any of the affected supports . Form No 728431 (Ocl as, sjt-MSW-05239lf (Formerty 97024020)

ATTACBMEIIT 4 Mr. D. Wong May 29, 1991 Page 2 If you have any questions or need additional information, please contact me at extension 2980. M. S. Whitt cc: A. R. Fletcher T. R. Huber D. L. Rogers W. D. Grady DEO Fi le sjt-MSW-05239lf

ATTACIDIKlff 4 U2-WMKS-0118Al, H-01 (11548-PSSK-OllBAl.Ol)

It was reported that the top locking nut on the support was loose. The support was inspected by Engineering and the ISi discrepancy was confinned. The support was found to be carrying load and it is determined that the support would remain functional in a seismic event. No immediate action is required for this support; however, a Field Change to EWR 89-661 will be written to correct this discrepancy at the next outage of sufficient length.

U2-WMKS-0102Dl, H-048 (11548-PSSK-010201.04) It was reported that the load scale for the spring was missing. This support was walked down by Engineering, and the load indicator indicated a load approximately in the middle of the load scale (9250 pounds). Engineering review of the support detennined that the spring will remain within the working range. The support is considered to be operable. The corrective action is to install the spring load scale and to reset the spring to 9589 pounds (cold set), if required,when this can be worked. A field change to EWR 89-661 will be issued to perform this work at the next outage of sufficient length. U2-WMKS-0102Dl, H-05 (11548-PSSK-010201.05) The spring load scale indicated a load of 13i310 pounds vs. the required cold set load of 12,595 pounds (hot set load is 10,775 pounds). This load is within 10%, but exceeds the maximum allowable difference of +/-300 pounds. Engineering

review of this condition has detennined that the as-found load will still keep the spring can in the working range. Therefore, the spring is operable, but should be reset to 13,310 pounds +/-100 pounds (cold set) when this can be worked. A Field Change to EWR 90-661 will be issued to reset the spring at the next outage of sufficient length.

U2-WMKS-0102Dl, HSS-13A (11548-PSSK-010201.02) It was reported that the top base plate of the support was missing an anchor bolt. The anchor bolt identified to be missing was the bolt located in the top right corner of the baseplate. After an Engineering review of the support drawing, it was determined that no anchor bolt was required to be installed at this location. Therefore, the support is acceptable as found and no further action is required. U2-WMKS-0101Dl, H-09 (11548-PSSK-OlOlDl.02) It was reported that the rear bracket for H-09 was missing some weld and also that grout was missing from behind a portion of the rear bracket. After review of the support drawing and an Engineering walkdown, it has been determined by Engineering that the existing as-found condition is in accordance with the original support as-built drawing and IE Bulletin 79-14 as-built review. Therefore, the support is acceptable as found, and no corrective action is required . dhg-MAS-0525d - 2

Ar.rACIIMIIIT 4 U2-WMKS-0100Gl, H-028 (11548-PSSK-010061.02)

It was reported that one of the bolts for the spring hanger riser clamp was missing a nut and other clamp nuts were loose. An Engineering walkdown of this support verified the concerns identified by ISi. The spring hanger support was still carrying load and the integrity of the support was not affected.

However, Work Request 729778 was submitted to install a hex nut for the support eye bolt and to verify that the other pipe clamp nuts are tight. This work was perfonned under Work Order #111708 on 5/27/91. A copy of the acceptance VT-3 examination of the support is enclosed. Therefore, the support has been returned to the design condition and no further action is required. U2-WMKS-0100Gl, H-03 ( 11548-PSSK-010061.03) It was reported that the pipe clamp had shifted around the pipe somewhat and that the nut on the eye bolt for the spring hanger connection to the pipe claq, was loose. An Engineering walkdown was perfonned which verified the concerns identified by ISi. The spring hanger support was still operable as found and was capable of perfonning its required function. However, Work Request 729779 was submitted to straighten the pipe clamp and to tighten any loose nuts on the pipe clamp. This work was perfonned under Work Order #111709 on 5/27/91. A copy of the acceptance YT-3 examination of the support is enclosed. Therefore. the support has been returned to the design condition and no further action is required. U2-WMKS-0102Dl, H-01 (11548-PSSK-0102Dl.Ol)

Engineering was requested by ISi to evaluate the load indication reading* for the constant support as found during the ISI inspection; the indicator was reported to be set at 9. Engineering confinned the infonnation. A constant spring is designed to maintain a constant load throughout the range of the pipe movement. The load for constant springs is pre-set at the factory and there is no spring scale on the outside of the spring. The indicator on the spring indicates the position of the spring from low to high. The spring is indicated to be reading 9 which is at the low end of the scale but the pipe movement from cold to hot will cause the indicator to move further into the working range.

The spring is acceptable in the as-found condition, and no further action is required. U2-WMKS-RC-9, H-01 (11548-PSSK-RC-9.0l) It was reported that one of the two spring cans of the type G double spring hanger had bottomed out and the support was not level. Engineering walkdown of this concern determined that both of the spring cans were acceptably set (1300 and 1320 pounds vs. the 1322 pound design load) and the hanger was level. No explanation is available as to why the support was identified in the condition originally reported. No further action is considered to be required .

dhg-MAS-0525d - 3

ATrACHHEBT 4 U2-WMKS-122Dl, H-10 (11548-PSSK-122Dl.10)

The spring scale indicated a load of 4400 pounds vs. the required cold set load of 3534 pounds {hot set load is 2835 pounds). The spring can is a Grinnell Figure 82, type A, size 14. When Engineering attempted to walk down the identified discrepancy, the area was inaccessible. Engineering review of this condition has determined that the 4400 pound spring load is still within the working range. The final movement of the pipe is upward, reducing the load.

The spring is acceptable as is and no further corrective action is required. An addendum will be issued to the calculation of record to indicate the as-found spring can load. U2-WMKS-11781, H-09 (11548-PSSK-11781.09) It was reported that there was a loose hex nut on the support. Engineering walkdown of this concern determined that one of the inner nuts was loose on the four bolt riser clamp of the support. The inner bolts are not the load carrying bolts, and the support was still functional and was supporting the dead-weight of the pipe. The support would have remained functional in a seismic event. Work Request 729781 was submitted to tighten the nut, and was worked by NSS Construction on 5/22/91 per a deficiency card {copy attached). U2-WMKS-0125Al, H-02 (11548-PSSK-125Al.02} It was reported that there was a loose bolt on the pipe clamp for snubber

2-RC-HSS-107 on this support. An Engineering walkdown of this concern determined that the nut was loose on the middle bolt of the 3-bolt pipe clamp.

Although the nut was loose, the clamp was still functional, and the snubber would have operated in a seismic event. Work Request 729780 was submitted to tighten the nut, and was worked by NSS Construction on 5/22/91 per a deficiency card {copy attached) *

dhg-MAS-0525d - 4

ATTACHMEBT 4 ATTACtllENT 2 U2-WM1CS-CH-E-3 H-01 THROUGH 06

SUPPORTS ON REGENERATIVE HEAT EXCHANGER ISI inspection reports for U2-WMKS-CH-E-3 supports H-01 through H-06 identified that the actual component supports on the Regenerathe Heat Exchanger were not as indicated on the WMKS drawing. Engineering walkdown confinned that the as-installed supports were not as depicted, and Station Deviation Report S-91-0685 was submitted (copy attached). Subsequent review of this concern has detennined that the WMKS drawing inadvertently showed the configuration of the North Anna regenerative heat exchanger supports. A Drawing Change Request has been submitted (copy attached) to have the drawing revised in Innsbrook which will also initiate a revision to the ISI Data Base to reflect the additional inspections required for the welded attachments on three of the supports.

The vendor drawing (Sentry Equipment Corp. Drawing A04195-A01-2) has been used by Engineering to confirm that the as-installed condition does in fact correspond to the as-designed configuration. However, the Engineering walkdown confirmed the ISi inspection findings that one nut was missing and two others were loose; Work Request 729775 was submitted to correct these discrepancies. Work Order 111373 was issued and worked by Maintenance to correct these discrepancies (copy attached) *. Engineering review of the support configuration determined that these discrepancies would not have compromised adequacy of the support configuration, even in a seismic event. The Regenerative Heat Exchanger was supplied by

Sentry Equipment Corp. with the support structure already attached. The heat exchanger consists of three horizontal shells with connecting piping. The supports on one end (H-04,05,06) have pads which are welded to the heat exchanger shells. The supports on the other end (H-01,02,03) are clamped to the heat exchanger shells. Three supports were noted to have deficiencies.

H-01 was reported to have the clamp misaligned; this was inspected by Engineering had considered acceptable as is. H-06 had a loose nut on a U-bolt around the shell; because the U-bolt was still tight enough to remain in contact with the shell, it would have functioned to support the shell and is therefore considered acceptable. H-03 had one missing nut and one loose nut; even with the missing and loose nut, the clamp was still supporting the deadweight of the shell. In a seismic event, the missing nut may have allowed the clamp to open up; however, because of the constraint provided by the piping between the shell and the two well-supported shells above, the Heat Exchanger would act as an assembly rather than as independent shells. As a result, it would not have been possible for the shell to have moved enough to completely dislodge the clamp. Therefore, the support configuration would have remained operable even in a seismic event, and operability of the Regenerative Heat Exchanger would not have been affected. ISI reinspection of the supports during the next Unit 2 refueling outage should be tracked by the ISI program. The reinspection should be perfonned using the revised WMKS inspection drawing and should include inspection of the welds to the heat exchanger shell for supports H-04, 05 and 06 *

yrn-MSW-0525j

ATISCBHKBT 4 Corrective Action Assignment and Response for Deviation Reports ADI,

1. OR Number S- C, /- 0 ~ ~c5

4. Corrective Action Plan Development Assignment ng O Ops O Mffla O RP O NSS

2. Screening Relu!l 0 Critical O SNS O Significant O s ifant O Proc:.durn O Other Potentialy O Training O HPeS S. Other Departments Assigned Actions or Questions 0 Eng O Ops O Maint O RP O NSS O Procedum O Other

6. JOO Required? O No 0Yes 7. Root Cause Evaluation Required? 0No 0Yes 0 Cause O Extent DRemedial Action

11. Date s--

14.

17. Corrective Action Plan (Continue On Reverse Side)

I I

I

   ' 18. Corrective Action Completion Date 19. SNS Reviewer (Signature)/ Date                                20. SNS Independent Reviewer (Signature) I Date I                                                             I

22. Supervisor SNS (Signatwe) 23. Date

21. Response: 0Accepted QRejected 0 Reassigned

24. Quality Assurance Name (If 0A ln~iated OR.Please Print) 25. Quality Assurance (Signature) 26. Date

                                                                                            ..                                 ~-
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27. SNSOC Review 28. Management Tracking The root cause has been oorredly identified? 0NA0No0Yes HPES Number JCONumber 0A Audit Numblr The corrective action addresses the root causes?O NAO No0 Yes CTS Number WR/WO Number LEA Number Cofrective adion acceptable and complete? 0 NAO No0 Yes Corrective adion acceptable; assign to CTS? 0NA0No0Yes DCP/EWR Number PAR Other

29. Commenls O. SNSOC Chairman (Signature) 31. Date I

i Ke y s: DR-Deviation Re port I Eng-En g lnHrln g, Ops-Operations I llalnt-Mllnt1nanceI RP-R6dlatlon ProtectionI NSS-NuclNr Sitt Services, SNS-Station Nuclear Safety, JCO-Justlflcatlon Continued Operation, IOER*lndustry Operating Exper~ R,v..., SNSOC-Statlon Nuclear Safety and Operating CommlttN , CTS-Commttment Tracking System, HPES-Human Perfonnanc:1 Enhancement System, QA.Quality Assurance, WR-Work Request, WO.Work Order, LER-Ucensed Event Report, DCP-Deslgn Change Package, EWA-Engineering Work Reauest PAR-Prn~m* .... ._ .. a.-.. --*

ATTACIOOfflT 4 W JU~&- Deviation Report

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A'l'TACBMEBT 4 Deviation Report

22. T.S. Vlolatbl? 23. Appielbte T.S. Sectiona v.. No 27.

30. Repo,mg Cladication: 010 CfR 73.71 00lhlr(Si)ecify): _ _ _ _ _ _ _ _ _ __

D 10 a:A 20 0 Appendx R ONalHlpo,table*p,ovicMbail: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __

37. DR II rwponabll?

equipnerc operable? DR is a violltiOn of unl Tec:hnicm Speciic:ationa? DA ii a viollltiela of the Station Admin Procedwa?

38. Addtiollll SNSOC NocM or Commera 0NoQYn 0NoQYu QNoQYn QNoQYa DR c:onstitula an unreviewd 1af1ty qu. .ian?

Recommend Significart Event Review to Station Manager?

39. SNSOC Chairman (Name) SNSOC Chairman (Signatura)

Tm*

   "*                        (2400tbn)              Om                   By (Sign::ruN)                    Name of Individual Natlied (Pm)

Supt.Op;. AutSUNS& L - - - - - - - - - - - - - - - - - - - AatSIIO&M Station MMager - - - - - - - - - - - - - - - - - - - - - VP NOO ChumanMSRC _ _ _ _ - - - - - - - - - - - - - - - NRCEOC NRCRaident

NRC A.giDr1 II St** al 'llgilia Dt1y: LCCM I ttg CondltlN to, 0,."lllhn. Cfll.co.

Coe i Safae,

of,..,_ Regudona, IH90C-llallon NP c:11
S.dlly and O,.adtai

                   , DtM)awtatlOft ......... Su,I. o,..*ipartn*Nllllf,Opll1..... AMI 1M NI I L-Aaelallnl Slatloft lbnager NuolNr 1..Joanant. Aul 1M OIN-ANI.... 8llllclll . . . . . . Ope.adoila and lblnllMnoa, VP NOC>Yloe Pra*dlnt-Hl11::l1 0pwa1oa1,    IISAC-llanaca* **nt.....,,.... eom-. NRC EOC-flAC ~ Ope.;alkMa c..r

ATTACHMEBT 4 STATION DRAWING CHANOE REQUEST SURRY POWER STATION .--.~::IIIL--- VIROINIA POWER ~,~*.,,

TO*

DESIGN CONTROL Clw.ot TO IE KU* CMIEFLY DESCRIK NG ATTACH A NM1C£D I.P COPY S>OIIIG CHMDEI IN GMDI CMJDITIGNII NG/OR IIED CDEi.ET I OMS> REVISE OR O ISSlE NEV DRAWING IN ACCORDANCE WITH TtE ATTACHED HMKU' REQUESTED BY* ' PH.EXT.

        ,-=:>~~~

COONIZANT Slff:RY1SCJVEN01t£ER IEVIEI CStffRYISOR/DEO ASSI~ ENGINEER>

11 Di\TE* ENOINEERINO APPROVAL/DISAPPROVAL Oo1WPAOVL ti Di\TE* CSYSTEM ENOltEER/DEO LEAD DISCIPLINE EHGltEAJ DRAFTUG CRAVING REY I SJ~ N>. 1 II IY* .. Oi\TE* YERIFICATlm. Sia.AT~* .. Oi\TE*

** DISTRIBUTION NO.,             II RECORDS ~M!NT DESION CJ-W<<JES IN PAOORESS LISTING \.POATED IY*

DISTRIBUTED IY*

DATE*

/

OWNER'S DATA REPORT FOR REPAIRS AND REPLACEMENTS FOR SURRY POWER STATION UNIT 2 P.O. BOX 315 SURRY, VIRGINIA 23883

FOR VIRGINIA ELECTRIC AND POWER COMPANY 5000 DOMINION BLVD.

GLEN ALLEN, VIRGINIA 23060 COMMERCIAL SERVICE DATE: MAY 1, 1973 OPERATING CAPACITY: 822 MWe (net) REFUELING OUTAGE: 2nd INTERVAL, 2nd/3rd PERIOD

1. Owner FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI Virginia Electric and Power Co, Name 5000 Dominion Blvd., Glen Allen, VA Sheet _ ___.l..__ of_ __...A......-*- - - - - - - -

Addr- 23060

2. Plant Surry Power Station Unit _ _ _.....__ ___,_ _ _ _ _ _ _ __

Neme P.O. Box 315, Surry, VA 23883 1't1b ~ti 3800095';),05_~,-~'1 Add~ Repelr Orgenlzetlon P.O. No., Job No., etc.

3. Work Performed 1,y _ _V_i;.;;r....g,_i_n_i_a___P_o~w_e_r_________ Type.Code Symbol Stamp-bl_,,~/A __

Neme Authorization No. _ _ _.a;N-.,,1'-JIA..___ _ _ _ _ _ __ P.O. Box 315, Surry, VA 23883 Expimion Oate _ _ _ _ _N...,./... 8.________ Addrea

4. Identification of System {\I\ o..\"' S+e.e:wn

 - 5. (al Applicable Construction Code              B3 l. l               19§1_ Edition,_N_/__A (bl Applicable Edition of Section XI Utilized for.Repairs or Replacements 1980W80

_ _ _ _ Addenda, N-1 I N- 7

6. Identification of Components Repaired or Replaced and Replacement Components

ASME Code Natlonal Repaired, Stlll'IPld Name of Name of Manufacturer Board Other Year Replaced, (VII Component Manufacturer Serial No. No. Identification Built or Replacemant or Nol "l'JJ:l- Pl~£- t/Nkt/)0(,))N tJIVk.N~N I N/A 2-MS-// C, U~I\IIOICII "t.PL.f\ab ~o

                             .1oHNli fRtSCij/(Oj\l\'I      ~"(~                              PO .. csy
       ~ " 'lln PIf"&            .fR. , li.Jt.               "3\l-?,S"'2. I I

N/A lSl.\\ot* °:<, 198"f ~~LJ\Cel\B.\j ~o r* 'A16 VAtVE UNKNCJU>,v ()t\Jl<,NOWN I 'N/A '2*{(1S-ll 9 1/~IC~tl 11,EI) 1.1\Cl:~ NO

    ~II   q~~     V~LV"t*
                              ~Oil l:lA~Ut<~

VfltL\l 't- er,*

                                                          ~,.."'F'Sl,11+   I    N/F\

Po~ (NT 3-ttC %0-1 \~~i ~~C.~11\lN'T NO B. Tests Conducted: Hydrostatic O Pneumatic O Nominal Operating Pressure g---- Other O Pressure _ _ _ _ _ psi Test Temp. °F NOTE:* Supplemental sheets in form of lisu, sketches, or drawings may be used, provided (11 size is 8% In. x 11 in., 121 informa-tion in items 1 through 6 on this repon is included on each sheet, and 131 each sheet Is numbered and the number of 1heea is recorded at the top of this form .

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

FORM NIS-2 (Back)

9. Remarks _ _,_,f,s:_'S=-'~--__,,Ca~c::>=-='c--::;;.......,.C_.J.:,,.:,c<f'c?;:._.,..,,6...__?.....-

Applicable Menufacturer'1 Data Repom to be attaehed CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this l Z U ~ T conforms to the rules of the ASME Code, Section XI. repeir or rep1acament Type Code Symbol Stamp __ N_/_A_________________________________ Certificate of Authorization No,_N_/_A _____________ Expiration Date __N..;./_A____________ Signed or Province of {LWJi(,._ TsI.

                     ~~;,.;;de1111nn, Title *, ",

Virginia bv6itrJUi=- CERTIFICATE OF INSERVICE INSPECTION Data ____ a""""'(J'-!~*-c,(6--=...;1....---. 19 I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vassel Inspectors and the State and employed by HSBI&I Co* 9I of H11. r tfor- cl ct. have in?ected the components described in this Owner's Report during the period £-to- t./ *, and state that to the best of my knowledge and belief, t'1e Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section XI. By signing this certificate neither the Inspector nor h.is employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this i_n_5:P_.ec_~_io__n _--="""-::::':-::=::::--::f::--.::~:'""::--'

                          ._;~+-                           .......'------Commissions __V_A--'5...4_..;;3_________________
                              ~Signature                                                             Natlonel Board, Stata. Province, and Endorsements Date*----~,,,_~_}~7_19                                     4-j

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

1. Owner Virginia Electric and Power Co, Date ---'3==-:u=L-'<...__......._.IS""--,-,--+-19__,_9~\- - - - - -

Name 5000 Dominion Blvd., Glen Allen, VA Sheet_...;.i.=--- of i. Address 23060 )

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

f Name P.O. Box 315, Surry, VA Address 23883 j"ob No. .3S0Ql Repair Organization P.O. No., Job No., etc.

                                                                                                                                                                                           ~is ts5':t         :Re,~9 \-       8le

3. Work Performed by Virginia Power Type Code Symbol Stamp _ _ __,_N,,,l<-.LA.,___ _ _ __

Name Authorization No. ------..lN~'f-/..lB::i...._____ I P.O. Box 315, Surry, VA 23883 Expiration Date _ _ _ _ _ _....,N!."',IC/_Ai.;;:,,L._ _ _ __ Address 7

4. Identification of System _ _ _.,,S::..:~=.,e""t'--:y.,__1,1:l.Jn\-lS"r'e~c-+/- ......;o...,n_.__ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __

5. (al Applicable Construction Code B31. l 19§.Z___Edition,_N;.:.,../,;;.;A;;___ _ _ Addenda, N-1, N-7 Code Case (bl Applicable Edition of Section XI Utilized for Repairs or Replacements 1980W80

6. Identification of Components Repaired or Replaced and Replacement Components

Name of Component Name of Manufacturer Manufacturer Serial No, National Board No.

Other Identification Year Built Repaired, Replaced, or Replacement or Nol ASME Code Stamped (Yes (oCl..,S U~k~OV)N VtJ~~O\.l:ll'\.:) N/A ~-~1.-~~C\ IAA\\~Ol.:IN Rl:PLFH£b ~o Ct\~\~I',\.. :tN'b 1-\"I" ~ PO ..I;\" BoL,S P~~'tS .:t~c. l:>'l.d... \C\ \ N/A- 33 ':f-O"l!- I \'\C\ \ R.'i:P ~ CE'l'()'!:1\1)" ~o l\i\)""\'S V tLPrN IJN\<..\\)Ou9 N N/A :i.-SI-cll.~C\ Llr,;)l<,\)ocb R."e~Lf\et:b t()o C.P.~\\\)RL .ll\)!) 1-1-r~ ro ..\t c.S}' l\)l)'"fS

                             ~il.owcr'll .:!NC         c~~~1°\                                              "1/A-                      ~ssei~-2 1~iq                                           ~i'L~~'                    t-:lO
                                                      ...c""l....._....,,\.,_l~....~.......0-.....u:..,,.+.._c,.....__&=-_.(..,_l~=..:..~""""""b""'p_,_\:l;+.........

1 11

7. Description of Work _ _ ___._R-e""\:~"""\""c;..._c:f :s ....,...(::-'l-'_,Lf...... , . ) ' - - - - - - - - - -

8. Tests Conducted: Hydrostatic O Pneumatic 0 Nominal Operating Pressure la---

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

FORM NIS-2 (Back)

9. Remarks ---.-/tr.......;:;..6..:....(Y)..c.,£=----b-Cnl..'-'D-=-""---'<C,..,,.t,-1{.,B:2~2"----'h:<....::..__ _ _ _ _ _ _ _ _ _ _ _ __

Applicable Manufacturer's Data Reports to be attached CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this ?Ept4£rv.f::'.l\[T conforms to the rules of the ASME Code, Section XI. repair or replacement Type Code Symbol Stamp __N_/_A __________________________________ Certificate of Authorization No. _N....;./_A_____________ Expiration Date _ _N-'/_A _____________ Signed_"'{/(~~~+-,.,.,(,cJ'-l""-1>>:,=,.,,~-=-,*>----'X:"='-S....T...._-=&[=->-'-'6,'""/..,A/"'l:;,e..,==----Date _ _ _ _

                     ~n..:o1b°wner's Des(gnee, Title CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State QA.c;;z.:=-c.+---/""'8"'--, 19_9_1_ _
                                                                                                                                               ~

or Province of Virginia and employed by HSBI&I Co* of f/ac T f e:, t- d )*C 1-. have ins_gected the components described in this Owner's Report.during the period 9-/'1-!?'7 to t:,-/'jf-'f/ , and state that to the best of my knowledge and belief, the Owner has performed examinations and.taken corrective measures described in this Owner's Report in accordance with th.e requirements of the ASME Code, Section XI. By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspection.

                        ~                                                       ........~'-"'=---Commissions _ _V_A__5_4_3__________________
   ----..\01-'""4'1.,,.~C',1""'n::c.sp-ect-'-'-o-r'-s-l!IS":-.,g""'n-a-1;t[Y=u"'re~~

National Board, State, Province, and Endorsements Date_ _ _ _ _ 1~--('(~_19 q 1

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

1. O,*,mer Virginia Electric and Power Co, Date _ _:f'....,.u.,.L=-',...[-2...'-/. . . ._,_l.._9.......,ct.....(_ _ _ _ _ _ __

Nam* 5000 Dominion Blvd., Glen Allen, VA Sheet _ _ _,,l..__ of ___l~--------- Addrea 23060

2. Plam Surrv Power Station Unit _ _ _ _ _..,__ _ _ _ _ _ _ _ _ _ __

Neme P.O. Box 315, Surrv, VA 23883 1o'b NO 3 8(Ml) ,,LGP 3 ~ l ?, g.e.#-CJ 1~as-Addrea Repalr Organization P.O. No., Job No.;etc.

3. Worlc Performed by Virginia Power Type Code Symbol Stamp _N,.../_.A"---------

Nam* Authorization No. ------"'Na.,1~tf\~------- P.O. Box 315, Surrv, VA 23883 Expil'lltion Oate _ _ _ _ _N,.,._,,/~B;i________ ( . Addrea

4. Identification of System _ _ _ f...EF~...b......,.u...,...e""""'JF..._...'fl.=..--------------------------

5. (al Applicable Construction Code B3 l . 1 19§1__Edition,--'N:,_:_/.;.;A;....__ _ _ Addenda, N-1 N-7 (bl Applicable Edition of Section XI Utilized* for Repairs or Reolecements 1980W80

6. Identification of Components Repaired or Replaced and Replacement Components

I I

I I National Reoaired,

                                                                                                                                                                                                                          ~El Stamped Name of                  Name of                          Manufacturer .I                          Board                             Other                           Year                    Replaced,         (Yes Component        I      Manufacturer I         Serial No.              i             No,                       Identification                        Built             or Replacement or Nol II I                                                                      I srvh.s            I I

V"3 \(N Crt,) I,.) iI Vt..lKf'-l<'MN I N/A 2.-1=(0-\"3.\ ! ll ll:ll\tlOIUN ~PU'ICl:b :s\O I i srut>s ICAR.b\N~L ~ti Hi-;\\, N/A IPO~:, :)__ c;CSYsq 1- l. \ I qqO ~P IJ'ICSfit:t.\1' I ~o Ii I l>~\JC.-is. .!NC, ! ~ct r:i. 4-n I NOT.S I I UNl,:.l\}~ i I/ N le.NOCON ! N/A 2.--FW-l3 \ 1\/~ll~N, "1:P LI\ CJ;b NO I Irt ~ltt>IA)ARI: I 1-\f.1\ i N/A f>o-:\'t c.sy I

            \\)l) TS          Sl"c.(.11\Li'( (ll.J    '!Ilk. --r S-ti Pt 11                        I                                       .2313'2.'f-C.                  I \~ 8'1               ~PJ.fKl::11\~~            NO I                                  I                                                                                                                         '

7. Description of Work _ _ _.... R ...e-1~~\,...o,,,..c.s;e....J,,.__..,::;~...,p""'--')<--..,SC.J.t~uQJ,,:'1.:,,!!,,"1,_ _(.;&~~c...!£-Odt.l...QL...G!...J,.,1li.S,.T-l,..;.:C,:a..-....:L=.,~*.d.*):..__ _ _ __

8. Tests Conducted: Hydrostatic O Pneumatic O Nominal Operating Pressura ~

Other I i Pressure _ _ _ _ _ psi Test Temp. °F NOTE: Supptememat sheets in form of lists, sketches, or drawings may be used, provided (1) size is SY.a in. x 11 in., (21 lnforma-tion in items 1 through 6 on this report is included on each sheet, and (31 each sheet is numbered and the number of sheea is recorded at the top of th is form . (12/821 This Form (E000301 mav be obtained from the Order Oept., ~SME, 345 E. 4~th St., New Yorlc, N.Y. 10017

FORM NIS-2 (Backl

9. RemarKs -.-J~'--'==M~E-=--~C....-OP-'"=...E"'--__.C_J._."--A'"""$""'S~...., ....3'---------------------

Acplicao1e Manuracturers Data Aepon:s to oe attacneo CERTIFICATE OF COMPLIANCE We cemfv that the statements made in tne reoort are correct ana tnis ~ c o n f o r m s to the rules of the ASME Code, Section x I. repair or reo1acament Type Cede Symbol Stamp __N_/_A ____________________________________

                                             - - - - - - - - - - - - - - - - E x p i r a t i o n Date _ _N...;../_A_____________
  ;r Province of

_________.f/i_._o... CERTIFICATE OF INSERVICE INSPECTION I the undersigned. holding a valid commission issued by tne National Board of Boiler ana Pressure Vessel lnsoectors and the State Virginia and emo1oyed by HSBI&I Co* ___r-_!......,f_..o-=-r-..,.J""-:1,.._.,C""t....__ _ _ _--:c_ _ _ _ _ _ _ _ _ have insoectea the comoonents descrabea of

  -                                                           )

in tnis Owner's Aecort during the ceriod _ _ _ _ _ _q~--/_'f..._-_!f.._.q....__to_.. lo._-_._(....8._-__.9....../ _______ , and statll that

   ;o tne best of my knowledge ana belief, the Owner nas oertorrnea examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section XI.

By signing this certificate ne.ither the lnsoector nor his employer ma_kes any warrantY, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his emoloyer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connectea with this insoection. !. ~

    ----~..,._""°'   __=---_--:--L~--=~'"""""

lnsoKtar'I Signature

                                                                . . . .--.~---COmmissions __v_A__.;5_4_3~---------------

National Seara. Stata, Province, and Endor1Ament1 Date*_________ 7_-~a_s-_ _19 'U

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

  ,. Owner       Virginia Electric and Power Co,                                                                                     Date _-::J-=.,1..1J11.._'{....__..,2._4.>.+,--'-jCJ      ........t::t.,_(;..___ _ _ __

Nam* 5000 Dominion Blvd., Glen Allen. VA Sheet _ _ ..,!..__ of _ _..,l=---------- Addrea 23060

2. Plant Surrv Power Station Unit-----~------------

Name P.O. Box 315, Surrv, VA 23883 :lak Na, 2,8e,e,1Q5:f: ?-3 ~91::Bcf Addrea Repair Organization P.O. No., Job No., nc.

3. Wortc Performed by Virginia Power Type Code Symbol Stamp~tJ&a..,e/_.A:i__ _ _ _ _ __

Nam* Authorization No. _ _ _.....,N'-1/uAci________ P.O. Box 315, Surrv, VA 23883 Expinttion Date _ _ _ _....N....,_/... 8......_______ Addrea

4. Identification of System _ _---'8:£:....,,a. ....t>...._.\.._,J..1.Jf'.x~T.,_,,&....,_t3--

5. (a) Applicable Construction Code B31. l 19~Edition,_N;:..:.:../.;:.;A~_ _ _ Addenda, N-1, N-7 (bl Applicable Edition of Section XI Utilized for Repairs or Replacements 1s80W80

6. Identification of Components Repaired or Replaced and Replacement Components

i I

Name of Component I Name of Manufacturer I II Manufacturer I Serial No. i I I i National Board No. Other Identification

                                                                                                                                                                            .,     Year Built Repaired, Rep Iaced, or Replacement ASME Code StamPld (Yes or No)

I I I I

           <2:.TObS         I' UNkNOW/'J                             I I    l:J!ovl<NOWN !                      N/f\                       .2-'f~-\3(,                          t V11;>1\NC\llN               ~Pl.J\Cl:b I  :"\O I
                                                                                                                                                       ~\- 2.

Cf\Rb \1' l\L J'.l"I \,\T s-n,.rt>s I P~1::>l)c:rs ~ I Bo%~o N/A PO~

                                                                                                                                          "5 ~_(,, t5                         i \Ct 'i._Q: I~~U\Cat\ct.\j I                  ~o   I
  '         ~VTS I

I VN \<.10-oWl\.l i u ~Nev., t-l l\l N/A :t-~lt)- l"3 b !v~K\!Oelt.1 ~Hf\ Cl:'.b NO

  !                          i Hl\R.t:>W~P-1::                       1\-11~                                                           Po~              CS'/
  '         NOTS             ISl't(1~LiY c...01.i~c.                     -1"    '5"014-FI                      N/A

n J 3i'f-{, Ii~i, ~PJ.fK1::1Tl~NT NO i

I I I I I1*

7. Description of Work _ __,D "...e"--ff"\.,, '

                                                  "'"-V\"°'c=e,..,o\~_...aa..;-<...""O"-..:.....            ..L~                1;:,          C\a'                    .,,.L ~~ 1 C""'J....:."1.._l.l'.~:,.."-""-.c,--.::C>>::;._.._.:>a...l.~J:..._..:::-"::::...S:~\J...CJ-...~.:::.:::2;;;.,_~~-:.!....:::.J
                                                                                                                                                                                                           .1"' _ _ _ _ __

8. Tests Conducted: Hydrostatic O Pneumatic O Nominal Oparating Pressure G--'

Other O Pressure _ _ _ _ _ psi Test Temp. °F NOTE: Supplememal sheets in form of lists, sketches, or drawings may be used, provided 11 l size is 8~ in. x 11 in., (21 Informa-tion in items 1 through 6 on this repon is included on each sheet, and (3) eech sheet is numbered and the number of sheets is recorded at the top of this form . (12/821 This Form (E00030) may be obtained from the Order Dept., ASME, 345*e. 47th St., New Yortc, N.Y. 10017

FORM NIS-2 fBackl ftc.:S=.:.{l;f_,_£'""----lo~0,..D""-f:-a:.--'C'-""'1...,A6~'-s.__...,

9. RemarKs _ ......... _3.__________________________

Aoolicac1e Manuracturer's Data Aeoorts to oe attachaa CERTIFICATE OF COMPLIANCE We cert1fv tnat the statements made in me reoort are correct ana this ~4cr: conforms to the ru1es of the repair or reo1acement ASME Code, Section XI. Type Code Symbol Stamp __N_/_A _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ Certificate of Authorization No. _N_/_A_ _ _ _ _ _ _ _ _ _ _ _ _ Expiration Date _ _N_/_A_ _ _ _ _ _ _ _ _ _ _ __ Signed Cz.l.v, ~ =

            ~ n e f s Oasignee, Title
                                        <<     ,'-f:ST bf6t11/£1!..--                                       Date _.,_,~~::=1,,,-----"rd=---/,____ , 19-2_/__

CERTIFICATE OF INSERVICE INSPECTION I, the undersigned. holding a valid commission issuea by the National Board of Boiler ana Pressure Vessel Inspectors and the State or Province of Virginia apd erno1oyed by HSBI&I Co* of tla ~ TEcJ" d 1 c+ have insoected the components aescribea in this Owner's Reoort during the oeriod _ _ _ _ _ _ __.'l._-_._f_.9_-_..E .....q'--to_...G'--_.(-'g.,_-__,_9'...;/_______ , and state that to the best of mv knowledge ana belief, the Owner has periormeo examinations ano taken corrective measures descnbeO in this Owner's Report in accordance with the reouiremenu of the ASME Code, Section XI. By signing this certificate neither the Inspector nor his employer makes any warrantV, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connecteo with this inspectio~.P. ~

    ----~11-=-~-->:........;---::-'~=--.,_...~.....:i~""-'------Commissions_""'.'V_A                         __S_4_3  ________________

1n11>ector'1 Signature National Seara, State, Province, and Enaonementa Date _ _ _ _ _ J._-.. .s+=,-!,__ q/ 19

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

  ,. <mner           Virgir;,ia Electric and                                     Power                 Co.

Nam* 5000 Dominion Blvd., Glen Allen. VA Addrea

23060 Sheet _ _ ~l1:.-_ of _ __,l=-----------

Unit _ _ _a,..;;....______________

2. Plant Surrv Power Station Name P.O. Box 315, Surrv, VA 23883 Addrea Rec,elr Organization P.O. No., Job No., etc.

3. Work Performed bv Virginia Power Type Code Symbol Stamp -N.-.+/....A;,.________

Name Authorization No. _ _ _......,N..,/uBi....______~ P.O. Box 315, Surrv, VA 23883 Expinition Date _ _ _ __.N""+/"-'B'--------- Addraa

4. identification of Svstem _ _F.._..E.,.t;.,.b....i.oh..1.l.c;J?i~IF.......__,B,i.a,.- - - - - - - - - - - - - - - - - - - - - - - - - - - -

5. (a) ApplicableConstructionCode B31.l 19~Edition, __ N..;../_A_ _ _ _ Addenda,N-l N-7 (bl Applicable Edition of Section XI Utilized for Repairs or Replacements 1980W80

6. Identification of Components Repaired or Replaced and Replacement Components

Name of Component Ii I

I Name of Manufacturer I I Manufacturer I Serial No. I I National Board No. Other Identification Year Built Repaired, Replaced, or Replacement or Nol ASME Code Stamped (Ye1 I I! I

           I\.)\) ,s.        :

i VNW~ j UNl(.~~N I N/A i-Fw~13~ ! llll\'IDION V ~Pl.JKJ:b ~o I

                                 ~MbW~PJ!                              H~~                               i                      IPO ,\t (. $J NUT<;             'ifltC!Ati)' c..o.         ;r,.J         1'S'bt'i-A                       I     N/A                  ~.:3 I 3 :l..,- -{, \ Iqi i                   ,~PIJ'i(.B'f\t:).\i         NO i

I

            .BO-LTS            i    LJl\)Kt\)MN                    I 11~1<~~!                                  N/A .                 '2.-Fl\)-\3~               \v~K~t,I.               ~HI\CEb               NO
   !                           ' lf\R't>1N~L.          me 11-\ T ~

1 Po-.\\ csy i

l ~ClLTS ! PR~t>uc:r~ ~c:.. 8ou t1to I N/F\ 31bS"I I -2. I 1~ ~o ~PJJK'l:::1'1\~tJ'T NO

\'

I I I

7. Description of Work _ _ ei"",, +. .

                                        --18.... 'f'p....1='3,.:.C:f!:::>;..<J4-__,(..,_')1--Sti....J.L-~b..,o._l... s.2-_~&;:i____,!a(....:2.~o:..!)~n.wr~A...lf:...::s.....__F12J:f:..LC=.-.1..P..!..M~,- - - -

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

Other O Pressure.Jb\,=O..:.:P _ _ _ psi Test Temp, /tt,tB1e;otr °F NOTE: Supplememal sheets in form of lists, sketches, or drawings may be used, provided 11) *size is 8% in. x 11 in., (21 Informa-tion in items 1 through 6 on this report is included on each sheet, and (31 each sheet is numbered and the number of sheea i1 recorded at the top of this form . (12/821 This Form (E000301 may be obtained from the Order OePt., ASME, 345 E. 47th St., New York, N.Y. 10017

FORM NIS-2 (Backl

9. RemarKs =-------------------------

             --1-ft:.._6'"""-fv\E,....:.,."'----'C-o.....* D~*"----'C--"-1""A6""'"""S"--'L=*

Aoplicaole ManuTacturer's Data Reports to ce attacnea CERTIFICATE OF COMPLIANCE We cemtv tnat tne statements made in me reoort are correct ana this 'ypeLA;rE.Mg,{T conforms to tne rules of the ASME Code. Section x I. repair or reo111cement Type Code Symbol Stamp __~_/_A ____________________________________ Certificate of Authorization No. _N_/_A_____________ Expiration Date _ _N_/_A_____________

             ~             rJ.,,411"'=

Signed I ;,: or Owners Desi6nee, Title XS r '2.16 rt/Ee----: Date ----'9-..fJ==-i,,_____.ef"-'-Lf....._,-* 19 q; CERTIFICATE OF INSERVICE INSPECTION I, the undersignea. holding a valid commission issued by tne National Board of Boiler ana Pressure Vessel Inspectors and the State orProvinceof Vir inia andemployedby HSBI&I Co. of

   -------f-'"-=...__._......,~..---t~C~'T,__,_______--:=---:------.have                                                      inspectea the components describea in tnis Owner's Reoort during the period                                                     q-/q- ?1      to      b-(8 .. q I                        , and state tnat to  the best of my l<nowledge ana belief, the Owner nas pertormea examinations and taken corrective measures described in tn1s Owner's Report in accordance with the reauirements of the ASME Code, Section XI.

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

    ------'1-~--""'=---~-=:-"i'-'.'-----"'&c~'--'~=....-..;;;--Commissions __V....;Ac:_..;;..5....;4.:;3_ _ _ _ _ _ _ _ _-::-_ _ _ __

1 nsoactor't Signature National Boara. Stat*. Province, ana Endorsamenn Date* _ _ _ _ _7......_-_3.'---'<,1..__19_..q.._.l__

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

1. Owner Virginia Electric and Power Co, Date _ _ JJ~l..,L'""{_L.,;I<e'"-+-l_\,_9..._C(,....,_,_\_ _ _ _ _ __

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

2. Plant Surry Power Station Unit _ _....__ _ _ _ _ _ _ _ _ _ _ _ _ __

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

3. Work Performed by Virginia Power Type Code Symbol Stamp___.N~/.cAc__..

Name Authorization No. _ _ _ _N~/u:&:i......_______ P.O. Box 315, Surry, VA 23883 Expiration Date _ _ _ __.N:>>.f/..i:BL--------- Addrea

4. Identification of System _ _ _F'--=l;~E..J)'"""'W._.!'....irt...,E...B........__ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __

5. (al Applicable Construction Code B31. l 19~Edition,_N.....;.../_A_ _ _ _ Addenda, N-1, N-7 Code Case (bl Applicable Edition of Section XI Utilized for Repairs or Replacements 1980W80

6. Identification of Components Repaired or Replaced and Replacement Components

Name of Component Name of Manufacturer Manufacturer Serial No.

National Board No. Other Identification Year Built Repaired, Replaced, or Replacement or Nol ASME Code Stamped (Yes acn.,!:. C~r-)t-JE: Ulllk~8-Wl\.l I N/A .2.-v:w -~'1\-o Ut,l~N R.~f\.J>rc.&i:) 1-\0 Co.~""'\ -:fnol. 1-\'f :\I PO~ c.sy loOl..TS Pro J.u.L.t .s .!nc, &&b'\13~ N/A 3~ oio2-L I<\ '\I ~1:P LI\C:Em~ T ~o l'tt!T!> ~~\\.I 1)1\)~ll:)O'L&)'N N/A :i..-rW-!t'i<l 1/!Qkll'l~ ~l.~ NO 1-\~d..vwe. \..\1 ~ f'O~ (!:,") N\lTS S~<U\-!,' Co. 3Ho'6 N/A .l~O'c;';l.1-:).. ,~i~ ~p t.A<EMctJT NO 7 1..i.B!.. .' L)_ _ _ _ _ _ _ _ __ J,.____,(:,,..;\..,b._'\....._,s""';t...,,u,..,d...o.;~..____.i,:fu~.l..(..i.3~?.!>..~J..Nl,,:1.Ll.l>.i.T~~-....L.(..:.

7. Description of Work, _ __.B,..,..,,'9'f""'\a,...c..,_,e...

8. Tests Conducted: Hydrostatic D Pneumatic D Nominal Operating Pressure G}-'

Other D Pressure #J.DP psi Test Temp. Au.&1E:N:t ° F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is 8% in. x 11 in., (21 lnforma-tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form . (12/82) This Form (E000301 may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017

FORM NIS-2 (Back)

9. Remarks _..........,A...,_~=..c..~--=---Coe>.<..:D"-E::::=-_.,,,C"""LA-'=--'"6~5~--j~--------------------

Applicable Manutac1:urer's Data Reporu 1:0 be attached CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this 1<:e~ conforms to the rules of the ASME Code, Section XI. repair or *replacement Type Code Symbol Stamp __N_/_A ____________________________________ Certificate of Authorization No. _N.....;.../_A_____________ Expiration Date _ _N....c/_A _____________ Signed or Province of f/lv-v-C, I 7 6 ) ; , ( . , ~ ~ n e e , Title Virginia

                                                      '   ::rsr                                      Date --~9R""'-i_.fl."-'O"da.-----'lc....,,{e,a___ ,

CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State and employed by HSBI&I Co* 19 91 of

   -----f-H-'-"'l.l~t"~TE        .......~0~1-~d~-+J~C~t~--------------------, have inspected                                            the components described in this O.wner's Report during the period _ _ _ _ _ _~q~~~/~q~--~-2--to                                   ~-lb-Cf f                                , and state that to the best of my knowledge and belief, the Owner has performed examinations and tak.en corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section XI.

By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspection.n }19- !. *~~

    ----~:S....::.V.--"'--'=::1.......c...-:~"'-::-:---'Le.....,
                                                             ...~'-'~~=....c...---Commissions _ _   V_A_._S_4_3_________________

Inspec,:or's Signature National Board, State, Province, and Endorsement, Date _ _ _ _ _.7'--_/,_b=-_19 q f

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

1. Owner Virginia El!;:ct:ri!;; am! PQw~:r !:;Q, Date -::Ju, \/ lo, \CfC\. I Nama 5000 Dominion Blvd., Glen Allen, VA Sheet 1 of l Addrea 23060

2. Plant Surry Power Station Unit Name P.O. Box 315, Surry, VA 23883 Job No 382l01C'.l5~S6 gie.-:i:t-qi-19 Address Repair Organization P.O. No., Job No., etc.

3. Work Performed by_....;V....;;i::..::ra...g-"1.;;;.;*n=i.;;;;a_;;_P..;:;o..:.;w...;:e:..::r'-------- Type Code Symbol Stamp__,Ni.a.+-/.ICIA'---

Name Authorization No. _ _ _....1.N.lL,f-/cf:s_ _ _ _ _ __ P.O. Box 315, Surry, VA 23883 Expiration Date _ _ _ _.uNo..i/u8.1......_ _ _ _ _ __ Addrea

4. Identification of System _ __,R'"""'e....sucioL""""1.,...c.... l.__----'\:\L..!..>.eo.""'-'+--Ll\~e_,mL.Lk.1"1.;;;;,J..b'>i~A....-------------------

5. (al Applicable Construction Code B31. 1 19§2_ Edition,.........;N:;.;/:....:A=-=----Addenda, N-1, N-7 Code Case (bl Applicable Edition of Section XI Utilized for Repairs or Replacements 1980W80

6. Identification of Components Repaired or Replaced and Replacement Components

Name of Component Name of Manufacturer Manufacturer Serial No.

National Board No. Other Identification Year Built Repaired, Replaced, ASME Code Stamped or Replacement or Nol (Yes STOI) Arvt.WoP.~l>flmlN~ l,Sq~c,-11 I N/A ;t-R\-1~!).~ ll).i.lKNOu.Jt.\ N:PLAc.ED ~o i,r ~ Co..rcl\ ~~ .:t:no\. PO~ STOt> ~rcr!I.Uh :!v,c, ~<a'l,<t 139 I N/A 340i-'fO~I IC\~I 'R1:Pm~~IN1 NlO NL5T -- - 1-11-=l' N/A :.t -R\-\ - ~J.j LJtv)b,\ov'1 ~PLFK&i::> NO er..ro\~"'a..l Loi. a~..:u q 1 N/A. PO=\t NO NOT Pn,Jlu.c+G :!oc, 3 :;u '-+ f}-{,-% lq90 Rl;~l})Ci;:MB\\'

8. Tests Conducted: Hydrostatic D Pneumatic D Nominal Operating Pressure D Other [krPressure ND P psi Test Temp. !'lo, °F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (11 size is 8% in. x 11 in., (21 informa-tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form .

(12/82) This Form (E000301 may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017

FORM NIS-2 (Backl

9. Remarks _........,_A_.:__S....:\\'\....:..=E.--=---_C"-<-UoCJ,eb:..,,E...~....,C-lk:i..:..:-S=.S_c,L-""----------------------

Applicable Manufacturer's Data Reports to be attached CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this '.Rc.ei-e,C.EMENT conforms to the rules of the ASME Code, Section x I. repair or replacement Type Code Symbol Stamp __N_/_A ____________________________________ Certificate of Authorization No __N_/_A_____________ Expiration Date _ _N_/_A_____________ Signed ~~

             ~ f Owner's Desig\iee, Title or Province of       Virginia I5T         &J616(£.&e..            Date _ _ _....,,~..-,=ac....:..b,--,/.....,,.D'----*, 19..,_'f..,_/_ _

CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State and employed by HSBI&I Co* of fltJ.x*Ifo .. J 1 Cf- have inspected the components described in th is Owner's Report during the period q-1 q- e'f to ~ - I ~- qI . and state that to the best of-;.r,y knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section XI.* BY signing this certificate neither the *inspector nor his employer makes any warranty, exp~essed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or.a toss of any kind arising from or connected with this inspection/)~!. /l) {\

    ---~~~=:>...<~:=--c.-L-..:...~d.,.""':::--~---'~=-=--'------Commissions __V_A_5_4_3________________

Inspector's Signature National Board, State, Province, and Endorsements Date _ _ _ _.7'--__,_/-=S___19 Cf I

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

  , . Owner      Virginia Electric                                  and Power Co, Name 5000 Dominion Blvd., Glen Allen,                                                                                VA                             Sheet _ _..:,1:....-_ of _ _- = l " ' - - - - - - - - -

Address 23060

2. Plant Surry Power Station Unit _ _- " " ' - - - - - - - - - - - - - -

Name P.O. Box 315, Surry, VA 23883 ;fob No. b~CtJ(2)l05e5?,. ierL"'91-,B AddrBII R11p11lr Org11niz11tion P.O. No., Job No., etc.

3. work Performed by Virginia Power Type Code Symbol Stamp N /A Name Authorization No. _ _ __,N'.Lf/""'A._________

P.O. Box 315, Surry, VA 23883 Expiration Date _ _ _ _.._N.-,,f..J/A.....__ _ _ _ _ __ Address 4, Identification of System _ _.R...,,e,.,~...'i...J,....1,1~a,...l1,..,-1B........e...P1.....+.,____.R..>.J:;.e..>.;'Mt.\.S~U.\L.>.t(l""'"""'l_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __

5. (a) Applicable Construction Code B31. l 19§l___Edition,.......;N:.;../:..:A:..:....._ _ _ Addenda, N-1, N-7 Code Case (b) Applicable Edition of Section XI Utilized for Repairs or Replacements 1980W80

6. Identification of Components Repaired or Replaced and Replacement Components

Name of Component Name of Manufacturer Manufacturer Serial No.

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

>.-Rl-l-.llO SiUb A,I\JC\iCP.- 't>A~UNq .i5980- l\ I N/A ~

l:!Jt~,J Rl:~LAC.1t.t> ~o c..w-J:1 n().J ~cl, HT"1 po o\\"

       $iVb                  Proc.\.u.ds :Inc.                                8%<.'310~                              I             N/A                      $1'01-lb -1           \°\ '\ I      ltefl.ACc(l/\'£;~T     NO N\JTS                     --                                             --                                   I             N/A                    ~-     R\-1-:2.,0 1.),11(,uQ.o.W P-tfi.A<£-~           NO Co.rJ..~V'lcJ 1-nol.                          1-l"f ;If                                                                      po~

NV1"$ Proc\.~0+& *L,c. B~.2.1'11 I N/A 3:l.ll\ 0(,-'6 \q°to ~PLACJ;i'lltN: NO

7. Description of Work_~R=e."f~-=\ru:=-ed=-___.;(=-1'-=-t).,__~,..c..;.:"-+:.:..s..__-'(?9,,_,_-'S=:\:....,µ.""'J,,-"'Q,._...;fl..!:e=-1c_..:E:..L0.=....:.R.-=--....:i~3.1..-.....=:::S..!:::8"-j~(i.:-_'..:.i;/'bL").L

8. Tests Conducted: Hydrostatic O Pneumatic 0 Nominal Operating Pressure 0 Other ~Pressure A/0 P psi Test Temp. NoT OF NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is 8% in. x 11 in., (21 informa-tion in items 1 through 6 on this repon is included on each sheet, and (31 each sheet is numbered and the number of sheets is recorded at the top of this form .

(12/821 This Form (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 100i7

FORM NIS-2 (Back)

9. Remarks _...,{Jc.c..;c...~-'-fv1_,£-=c....-_f~o=D,=£~-~~~~:5~~2,-----------------------

APPlicable Manufacturer's Data Reports to be attached CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this [:eet-9C/;/l,IEM/r conforms to the rules of the ASME Code, Section XI. repair or replacement Type Code Symbol Stamp __N_/_A __________________________________

                                                                                            --D~--~-----~~---.19 CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State orProvinceof             Virginia                             andemployedby HSBI&I Co.

V of Ha. r-T f'o rJ *, Cr have inspected the components described in this Owner's Report during the period q:.. f 1-8q _to_ fa~/ 'if":° q j. , and nate that to the* b*est of 'my knowledge ani:I *belie( the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the req*uirements of the ASME Code, Section' XI.

               .           .              :                 . 1 l.                   .     *. '.    .           !    .    * '             .

By signing this certificate neither the 1*1 nspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be** liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this i_n_sp_ec_t-io-1-~-**~~*=*==:=:--.:.,_*f7"*::-:-* Inspector's Signature

                                                      *_Q
                                                       ...-c~_.
                                                            * ..*=...a,...=-----Commissions _ _  V_A__S_4_3_________________

National Board, State, Province, and Endorsement* Date_ _ _ _.,........7_-_,_/.,,,'.$'"'------"-19 qf

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

1. Owner Virginia Electric and Power Co, Date -SuL::( 12..., I ':'.l 9.I Name 5000 Dominion Blvd., Glen Allen, VA Address 23060

2. Plant Surry Power Station Unit_--'J..=---------------

Name P. 0. Box 315 , Surry, VA 23883 1c,'6 hlo 3800083:Pi,54 'f?.e.~9 /-77 Address Repair Organization P.O. No., Job No., etc.

3. Work Performed by Virginia Power Type Code Symbol Stamp _ __,N.::.L.1-/-'ACJ...._ _ _ __

Name Authorization No. _ _ _ _ ____.")_:,,y.l.LA......__ _ _ __ 1 P.O. Box 315, Surry, VA 23883 Expiration Date _ _ _ _ _ _...J..:N¥/..iA=t-____;__ J Address l1...

4. Identification of System _ _R,. . ., e~~-*r. . . w""""'\.__...,\-\ o:-:t. . . .

                                                                                ......e....                                          ,z....

_'R."""'-"'-e°n"........_.....,p.... o.1......,,_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __

5. (a) Applicable Construction Code B31. l 19§.L_Edition,_N--'/'-A....;__ _ _ Addenda, N-1, N-7 Code Case (bl Applicable Edition of Section XI Utilized for Repairs or Replacements 1980W80

6. Identification of Components Repaired or Replaced and Replacement Components

Name of Component Name of Manufacturer Manufacturer Serial No.

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

     \:ioth                ~\11<:fltiP..- tt\R\ll\lGr                   ~is~iO-lo                                 N/A                                  ~-~\1-\q            tG'--            ~~\o.c.ec\                 l\)O Po~

C~nJ :kl. N/A I C\91 BoL~ P, u.e.\-s :I:nc. !>t'ti~l.6\0 3'1.\-Cl~':\-O- I \\lt\l\o..~e.nt N)O NUT$ -- ~/A -;i.-Rl-1-19 -- ~~\rx.ec\ (\JO Co..vo\'t"o..\ :!~, HT~ PO:\\ NIJTS !'l"a &u.c+s ::r:i-ic, B:tl\C\\ N/A 3~ll.\,o(.-~ l~9o R~\"-cR..men-t "-'.10 [i4J 1

7. Description of Work _ _.R..,.e."""~f'\..,.a.....,(;£...,j.....____,_S,;..._;\:~11r-4\.=,.$--1&~..1.:\\\.u.k\.!l,.J"t...=S'---V.!...le;.i,r_--!L::..:W~R~-~t!....!q~---'51d.'e>J.L.19---1.l_.:'/i~B::...L.')____

8. Tests Conducted: Hydrostatic O Pneumatic 0 Nominal Operating Pressure 0 Other@' Pressure NOP psi Test Temp. AMP>IE;NT °F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is 8% in. x 11 in., (21 informa-tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form .

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

FORM NIS-2 (Back)

9. Remarks --iA. . . . 2.__rv\....a.=E.~~C.~o~D=e.~~C

                        .                                  . . ..L~A-~~~2~~2..

Applicable Manufacturer's Data Reports to be attached CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this 1(EPLAC~ conforms to the rules of the ASME Code, Section XI.

repair or replacement Type Code Symbol Stamp __N_/_A _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __

Certificate of Authorization No._N.....;../_A_ _ _ _ _ _ _ _ _ _ _ _ Expiration Date _ _N""/_A _ _ _ _ _ _ _ _ _ _ __ Signed Ziar'u~r{b-/=ee, Titlh ::rS_r Date--~'J't-'"-'-r---/,_~cil~--. CERTIFICATE OF INSERVICE INSPECTION 19 91 I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State or Province of Virginia and employed by HSBI&I Co* of ti~ rJ:fo:r J ) Cf: have inspected the components .described in this Owner's Report during the* perio*d _ _ _ _ _ _ _ _q_--/~'f-*_?f_._~o 0*l 'if-'1 / , , , and state that to the best of my knowledge and belief, the Owner has perf'.ormed examinations and.taken corrective measures described.in this Owner's Report ,in* accordance with the req*uirements of the ASME Code; Section XI.

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

                 -=~:-'--..:......-:---!"i':::'.--'~=-
   *m--sp-e_c_t-io_n_,~~*                        ......."""'='-----Commissions __V_A_5_4_3_ _ _ _ _ _ _ _ _ _ _ _ _ _ __

Inspector's Signature National ,Board, State, Province, and Endorsement, Date_ _ _ _ _ _ -~7_-~/~5'---19 q /

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

1. Owner Virginia Electric and Power Co, Date _ __.:S::....,.v..:L..::a..::f1.--'l'--"2"-+-I_\,__C\.,_'\-"--'-\- - - - - -

Name 5000 Dominion Blvd., Glen Allen, VA Sheet _ _ .,.l'---_ of _ _-=l:...__ _ _ _ _ _ __ Addrea 23060

2. Plant Surry Power Station Unit---:""""--------------

Name P.O. Box 315, Surry, VA 23883 Addrea Repair Organization P.O. No., Job No., ate. 3, Work Performed by Virginia Power Type Code Symbol Stamp N/ A Name Authorization No. _ _ __.N.:a+/...,f\.___ _ _ _ _ __ P.O. Box 315 2 Surry, VA 23883 Expiration Date -----"'N,-,1,_./B""-------- Addrea

4. Identification of System _ _l\.us.es..,~wi,,\. ,. 11....0,,.,_~.___.l-\...u;eo

                                                                                     ;\._~,._,,,.e_.moUJl.jc.icV:°'-!::>..i.\_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __

5. (a) Applicable Construction Code B31. l 19§l___Edition,_N-'-/A _ _ _ _ Addenda, N-1, N-7 Code Case (bl Applicable Edition of Section XI Utilized for Repairs or Replacements 1980W80

6. Identification of Components Repaired or Replaced and Replacement Components ASME Code National Repaired, Stamped Name of Name of Manufacturer Board Other Year Replaced, (Yes Component Manufacturer Serial No. No. Identification Built or Replacement or No)

I

         ;-\-u.J.          If\~t~OR~"t>Pt1'1,ll\1(t                  ~q&~-1~                        I         N/A                     .l.-tl,.\-1-IS               ~!>\OJ~               ~P~C."ct>                  ~o Ic~~l°r'....., ::r:"'G\

li.1' :l,\ POall' NiC.

s~J ?ro~c.-k k, S~G9\'59 I N/A :!,L\ O"t-'tO- I \'\ct\ \l..~~~C£~T i t'J ~..\, L\~ -cf) -- --- N/A :l- R\-\ ~ 15' IJ-'l14,1~,J ~~LAC.r:1) NO Co.rc\,Y"IC\.l .::CviJ. l.\.'I"~ PO~ t-J <A.t PC"7~-+t. :Lie. ~~~,q \ N/R 3l.\J*\ei 6-'8 \C\°tO 1<1:~U1CEm~r NO

8. Tests Conducted: Hydrostatic O Pneumatic 0 Nominal Operating Pressure 0 Other G3" Pressure N o-P psi Test Temp. AM s,e.J..Ir °F "

1

                                                                                                                                                                                                            /         '. ~~/.
                                                                                                                                             .                                                                *,c;, }~ (

NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is B% in. x 11 in., (21 lnf~~~a/ . tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets i~ ' recorded at the top of this form . (12/82) This Form (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017

e: FORM NIS-2 (Back)

9. Remarks -~__,_A_6_1V\_E. __C.~o_D~E.-~~C~kA~S~S~_"L _______________________

Applicable Manufacturer's Data Reports to be attached CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this '&-PUll-E..ME:l\[T conforms to the rules of the ASME Code, Section XI. repair or replacement Type Code Symbol Stamp __N_/_A ____________________________________ Certificate of Authorization No. _N_/_A_____________ Expiration Date _ _N-'/_A _____________ Signed ~'}.,/7*.U~ 7Swn7or Owner's Designee, Title or Province of Date __9,,,,...~.::,~;+-----'-/,..';?"----, 19 CERTIFICATE OF INSERVICE INSPECTION

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

_ _ _ _ _ __,_H~a~r~J~~f_o_t--~O~~,~C,~f~*------------=--=-:::a=-----have inspected the components described in this Owner's Report during the period _ _ _ _ _ _ _q_-_/_'f~*-B_'f~to i, -(t-q I , and state that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section XI. By signing this ce'rtificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspection. _ _ _ _-J.UJ.<~""-:--"'---:-:l.::--.-~-=-------Commissions __V_A __5_4_3_______________ Inspector's Signature National Board, State, Province, end Endorsement* Date _ _ _ _ _ _ 7.__-_/=S-__1g___.'f'"""/__

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

1. Owner Virginia Electric and Power Co, Date_~T.___.._,_v-'1'._~lZ-=-+-,...,1_9~'1~1_______

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

2. Plant Surry Power Station Unit _ _.....,....__ _ _ _ _ _ _ _ _ _ _ _ __

Name P.O. Box 315, Surry, VA 23883 38ooo9Q5'f~ ggz '11-,+ Address Repair Organization P.O. N o . , ~ etc.

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

Name Authorization No. _ _ _ _ _ _,.,N /:....&u..._____ 4 P.O. Box 315 1 Surry, VA 23883 Expiration Date _ _ _ _ _ __,_N.,.,,1-l..,_A..,__ _ __ Address

4. Identification of System _ ___._f\_..e._.s.....,;""'d'-"11~0,""\l..-__.\-\.....,.e""'c,.;>.J+/-.._.....R_..,.e_rn.w.,.QL,LV""c\J""""'---------------------

5. (al Applicable Construction Code B31. l 19§l__Edition,_N-.:.../_A_ _ _ _ Addenda, N-1, N-7 Code Case (bl Applicable Edition of Section XI Utilized for Repairs or Replacements 1980W80

6. Identification of Components Repaired or Replaced and Replacement Components

Name of Component Name of Manufacturer Manufacturer Serial No.

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

                                                                                                                                            ~-IQ~-~

li 11 'fhr~J RoJ I\WQ-IOR-l)BRU NEr q~-lll~-13 N/Pt ~ ~~ fl \'El U11KNO~ J:l..~\o.ce.cl tJo

                                                              \-Ii~                                                                       PO~

I~" 1~roJeJ l\ee\ (o.TdlnoJ :fJ,frJ.~ 886"! l 39 N/f.'.I 311 f-ol\:;J,_-*\ \C\C\.O ~~r' keme:n..-\ No

                                                                                                                                                ~-(h{-~

NtA+s IJ ~ kl\)i.,-wN lJNK'll:iewN N/A -l--{3 lrlc ~ 18 Ulllk.filO~ R..p\t\cec\ l\)a,

                                                             \fl'~                                                                       PO~

N-IA,-h C'o.td~no.\ JnJ. frr,.\ ,J;:.c, C~\-'t;)..Cf N/A o0'65E, 1-l... I9~ tl R.ep\c,,ce.~e¥\_t: No 11 0

7. Description of Work _ __,R'-'-"'e_'i~'""\C\J=O=~='-------'-'~.... ) ...,,1....,:\:-._,c;.....___,&...__,B,""""Q..,.rl"--c.,.,___,&=-)-o__,Q::::.._..:.l_.:::f>:_ _ *- - - - - - - - - - - - - -

8. Tests Conducted: Hydrostatic O Pneumatic 0 Nominal Operating Pressure 0 Other 0"Pressure 6,1 0 -P psi Test Temp. N or OF NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1 I size is ax. in. x 11 in., (2) informa-tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form .

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

FORM NIS-2 (Back)

9. Remarks -,-/,A..j..S~/\1-'-£_=---'--'C o....J').......,E-,c.......,C=LA'-'-=$'""'$"--...2 . . = - - - - - - - - - - - - - - - - - - - - -

Applicable Manufacturer's Data Reports to be attached CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and.this2::Pb,4c.e:.Jl:IE/\lT conforms to the rules of the

XI repair, or replacement ASME Co d e, Saction .

Type Code Symbol Stamp __N_/_A _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ Certificate of Authorization No._N_/_A_ _ _ _ _ _ _ _ _ _ _ _ Expiration Date _ _N_/_A _ _ _ _ _ _ _ _ _ _ __ Signed 0.~,,,1.Lm<'

            ~ O w n e r ' s designee, or Province of        Vir inia T'ST Title
                                                                        .Ev6Cl\(fi.tliL CERTIFICATE OF INSERVICE INSPECTION Date _    __._9z..¥-=~-==:,--'-'/.;/'-'--'-,- - , 19 C/ /

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

  -------f--L~'......l...i::~.:....,,,,,,_;-_...::JL--------:::--::---:-:'.'-:::-----;-have inspected the components described in this Owner's Re1>ort d.~ring the period                                                    .l{-/(j-ff'[ to .(?-:-(&"'.f       J ' *' .                  ;and siate*thet inv 1

to the best of knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in accord11nce with the requirem~nts of the ASME Code, Secti~n XI..

                      *        *    '                            '    i'.,.                   >          * * '

By signing this certificate neither th_e Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations. and corrective meas4res described in this ow*ner's Report. Furthermore; neither the 'Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspection. .f) . / ' .

   ----*...;~"--'~....,..--*-*-:L~*:--M_*                 ~*~*______ Commissions __V_A                          __5_4_3 ________________
        .                Inspector's Signature                                                               National Board, State, Province, end Endorsement*

Date*_ _ _ _ 71--__._f..:::5"'---__19 '1J

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

  , . Owner        Virginia        Electric                      and Power                                  Co.                 Date _ _=ri""-""uc..:L;:::..'{.___,lu.S"+-;.....\_'t._9~l______

Name 5000 Dominion Blvd., Glen Allen, VA Sheet _ _-=l.___of __""la....._________ Address 23060

2. Plant Surry Power Station Unit _ __ . , , " - ' - - - - - - - - - - - - - - -

Name P.O. Box 315, Surry, VA 23883 :iok Na. 3i00 10;> s ss0 u.tl=cj1--u Address Repair Organization P.O. No., Job No., ate.

3. Work Performed by Virginia Power Type Code Symbol Stamp bl / A Neme Authorization No. _ _ _......,,NLt/'-'P,:,...__ _ _ _ _ __

P.O. Box 315, Surrv, VA 23883 Expiration Date _ _ _ _.....N""'+/"'-BL-------- Addrea

4. Identification of System _ _..,$.. c. .

                                            \;..i.;P,,.,y..,,... E:.......                        f B....,,.----------------------------

1,._.)c,.'fc.,.::t..i.;_.,'...

s. (a) Applicable Construction Code B3 l. 1 19§2___Edition,_N;;,c,.:./.;;;A:...__ _ _ Addenda, N-1, N-7 Code Case (b) Applicable Edition of Section XI Utilized for Repairs or Replacements 1980W80

6. Identification of Components Repaired or Replaced and Replacement Components ASME Code National Repaired, Stamped Name of Name of Manufacturer Board Other Year Replaced, (Vas Component Manufacturer Serial No. I No. Identification Built or Replacement or Nol I I I

NV-TS I UNKl\\cwl\.l I Vl\'l"~~~ I I N/A ~-SLO-~~ 1\11'.l~NlllllN ~Pl.JK;b ~o I I I t\) v,<J. I"'~"' ~q,~~"'

                            .    :it- , :tN  e..

I \-\, ~ RN \ ':{-(. l. I N/A t>o~ csy 33bVS':{--~ I \q'to ~fl l.PICBI\E:).\T NO r i

          \:,c:>L"t .$              V'E:l I\~                           l> ll}~Nt,\1-)N                      I I

N/A .l.-SW - ~'l.. l11~1t1,lo.:it1 1\1:Hl\c.t::b NO Cfll\"'t>l~1'L J:Nb \-\1' :.\\ i Po'\\ c.sy j

             \z,C,lJ .s        l'Rotiucrs me.,                             So%\l\-o                          I    N/A.                  33'.f-!,9~-')          \q~\              ~P~Cc'l'I\Et.tT      NO

8. Tests Conducted: Hydrostatic O Pneumatic 0 Nominal Operating Pressure E:r"'

Other O Pressure ND P psi Test Temp. A:ruB1E.Af:Z:: °F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1 I size is 8% in. x 11 in., (21 Informa-tion in items 1 through 6 on this report is included on each sheet, and (31 each sheet is numbered and the number of sheets is recorded at the top of this form . (12/821 This Form (E00030l may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017

FORM NIS-2 (Back)

9. Remarl<s ~.....,A.....__S_M_,_E;;~_. .c_._o=b=*EE=-_C~L--~fl~:S=S~&:~------------------

Aoplicable Manufacturer's Data Reports to oe attached CERTIFICATE OF COMPLIANCE We certifv that the statements made in the reoort are correct and this eePL,K£J1,1£/'.IT conforms to the rules of the ASME Cade, Section XI. repair or reooacement NIA Type Code Symbol S t a m P - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Certificate of Authorization No. _N_/_A_____________ Expiration Date _ _N_/_A_____________ or Province of CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State Virginia and employed by HSBI&I Co* of ______ft""'"""'g...... . _I~f.~e~r~J~,--C~"t----------::=-----:-::---:.;;=----have ;nspected the components described in this Owner's Report during the period _ _ _ _ _ _ _ f~-.~/~9..-~~"--"__ ( to 6:,-f ~~q I .* and state that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section XI'. By signing this certificate neither the Inspector nor his employer makes any warrantV, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, ne.ither 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

   ;o,o,c~_;/....,_~*'--*-&--                 ~--~~~-----Commissions _ _
                             ~ o r ' s Signature V_A__5_4_3__________________

National Boara. State, Province, and Endorsements Oate _ _ _ _ 7_-~{~1_19 q f

1. Owner ---'V~1.1a..'r.......

FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME'Code Section XI i= inu..i.liial....j,E...l1o,.:1e..i...c t.._r~iac.....lila..Wn.lodi....j,P_.i,0,1.1Wll.leiii.r-,l,IC,Mo.,.,_ _ Date __;1A:;.i.i...P~<S\u.U:..S~EC-*..t.2:::.o=-,.,i....1.)9...L...q:...\1--_ _ _ _ __ Name 5000 Dominion Blvd., Glen Allen, VA ShNt _ _ l__ of _ _.=l~-------- Addr- 23060 Unit _ _..es..___ _ _ _ _ _ _ _ _ _ _ __

2. Plant Surry Power Station Name P.O. Box 315, Surry, VA 23883 :Ink I\),,_ 3~e!0 \4)51\: \ % _g.&91-70 Aepelr Organization P.O. No., Job No., ate.

3. Work Perfonned by Virginia Power Type Code Symbol Stamp N ! A Neme Authorization No. _ _ __.N~/..a&a..-_______

P.O. Box 315 1 Surry, VA 23883 Expiration Date _ _ _ _...,Na.i/...A.,________ Addrw

4. Identification of System _____ F..,e...e..,,\.,_1...l..:':...0...+/-e.,.,...,...r:_____________________..;....____

5, (al Applicable Construction Code B3 l. 1 1 9 ~ Edition,__;N;.;./:..;A:=...._ _ _ Addenda, N-1, N- 7 lb) Applicable Edition of Section XI Utilized forR.epain or Replacements 1980W80

6. Identification of Components Repaired or Replaced and Replacement Components

Name of Component Name of Manufacturer Manufacturer Serial No.

National Board No, Other Identification Year Bullt Repaired, Replaced, or Replacement or Nol ASME Code Starni,ed (Vas MUtS UN~Cu:iN \jjl.3K_~I\J, N/A ~-l;"l..u-lO lllllll.llOIOII kt.P~b i-\o i-l~Rb\.\:ll=IRE- HT.:k PO~ csy N\JT~ SPRIPll"T)' co,""?11\1 1"5'"011.\- ~ II N/A :t.31~"1+-C \°I 8 'i ~~LJ$Sf\&.\j ~o S'1:Ut>5 ui-.i,.;r..,~ l, IJ\(1JO"-' ...:i I N/A '2..-rt.o-to ll~lt~ l\l:f) 1.1\~b NO 51'$'17;; ll'l~lNAI.I~D 1-11"~ I N/A. Po-:1 (. 5 ')

                                                                                                                                                                                                                         ~lhC.'E:1'\\NT          NO Pf\ol)l)C(S :n:ic,                                     i0>'-3 ~1-'-'-D                                                   :s1ro'=f-?.-2                        \ C\%ci

7. Description of Work. _ _.B,.=-e'"""~t'".... ) AJ:'°'"""e...JQ..__ _._(...2"'G'-)..__.d .......,""".J.""""S,'-----4'!&,P-.-~(..JLf~<Y~)~..1.h:!A.u.:l....1.f...:;'S!L-___i.(_t!...",1.)_ _ _ _ _ __

8. Tests Conducted: Hydrostatic O Pneumatic O Nominal Operating Pressure W Other O Pressure _ _ _ _ _ psi Test Temp, *F NOTE: Supplemental sheets in fonn of lists, sketches, or drawings may ba used, provided 111 size is 8% in. x 11 in., (2) lnforma.*

tion in items 1 through 6 on this repon is included on each sheet, and (31 each sheet Is numbered and the number of 1heet1 ia recorded at the top of this form,

112/821 This Form lE000301 may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017

FORM NIS-2 (Back)

9. Remarks --""~'-""S==-""--=£-=-_.,.Cp=1:>::c.E..=-....,_Ci..,..Pr""'-,;:'=';..:'.:>:;.__.;L-.._ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __

Applicable Manufacturer', Cata Reports to ba attaehad CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this WWJ;I\\W* conforms to the rules of the ASME Code. Section XI. repair or rep1acament Type Code Symbol Stamp __N_/_A________________________________ Certificate of Authorization No __N_;../_A____________ Expiration Date _ _N....;./_A ____________

            ~~     r                                                                                                       ~

1 1

                                 .,              :zG::C 5-1:'~

Signed_,.~~-#liJu,,.===-.,,-=~-.....;."--'=:--'~"""""2.u."<>~=='--------Date ~o _ _ _=""'*---6:...._.......___ , 19 9/

            ~wttorowner'1 Ouignn, Title CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State or Province of         Vi r g i n i a ? n d employed by HSBI&I Co*                                                                                             of f/g:l"lfurd, C1',                                                               have inspected the components described in this Owner's Report during the period                                                   5'- / -5°0       to   £-( D-Cft..J                   , and state that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section XI.

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

  '"'"~'*"**~f. {.£fJ._                                                                        Commissions __V_A_...;;5_4_3'-----------------

lntpactor'sSlgnatu re National Board, Stata, Provinca, and Endorsament1 Date*------~~~<+/-:.___19 rtJ_ '\ 7 al1-

/

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

1. Owner Virginia Electric and Power Name Co, Date :J7 1/ 'i J9 J I':!CJ I 5000 Dominion Blvd., Glen Allen, VA Sheet_~....._~of_--=:l=----------~

Address 23060

2. Plant Surry Power Station Unit _ __ , . , . ~ - - - - - - - - - - - - - -

Name P.O. Box 315, Surry, VA Address 23883 J".,b Nm 3%00:U?91:S5 ~1-1t1,, Repair Organization P.O. No., Job No., etc.

3. Work Performed by Virginia Power Type Code Symbol Stamp _ ___,_N.,;,.,._l.,__A..__ _ _ __

Name Authorization No. ------~'-"7/'-'A'-'------ 7 P.O *. Box 315, Surry, VA 23883 Expiration Date _ _ _ _ _ __._t\~1,./~A.__.______ Address 7

4. Identification of System _ _..._$.,_,}1._._..f_,.E:_T.____..Y_...I_.t\)-"'-'-::5"........,t:,._.,C,;_T......_.l'""'O...N...,,___ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __

5. (a) Applicable Construction Code B3 l

1 19§1__ Edition,_N-'-/_A_ _ _ _ Addenda, N-1 , N- 7 Code Case (b) Applicable Edition of Section XI Utilized for Repairs or Replacements 1980W80

6. Identification of Components Repaired or Replaced and Replacement Components

Name of Component Name of Manufacturer Manufacturer Serial No.

National Board No. Other Identification Year Built Repaired, Replaced, ASME Code Stamped (Yes or Replacement or No) 6: ,, STU't) ~ c.~~>' llN\<.NOWl'v ~/A .1. -SI ~I/ ~2~81.

                                                                                                                                                               - ... UN~~I.L)lll Rci>LACE-D      ~o cA~blNA-L II-Jt>. 1-\T '<<                                                                                     po~          c.sy
        $  TUb/1\cit,        ?Mt>\lC."'f5.     ~                  ~C'j b1-!.\-0                                        N/A                     .330~Cl'l.             19'\l      P.ti' L~Wil~T    NO

7. Description of Work _ _....,1' \

lK~e;f>"-~e>s-c=e."' 1 1.

                                                        -'-'c.:.____,.S._,T._,U,              '
                                                                                     ......c\.~S'----=-..:...\       C\.L...:'----'~"--'-"O::__.,).c..._

1 -5/.,_ ,.,

8. Tests Conducted: Hydrostatic D Pneumatic D Nominal Operating Pressure g--

Other D Pressure--A&,.,.10._.P _ _ _ psi Test Temp, AMBll!AlT °F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is 8¥.z in. x 11 in., (2) informa-tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form . (12/82) This Form (ED0030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017

FORM NIS-2 (Back)

9. Remarks --~A:~S~M_E:.._~C@~~E.~-C~-'=tt~=i~S~~2~--------------------

Applicable Manufacturer's Data Reports to be attached CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this l?EPJA<-E-M£.NT conforms to the rules of the ASME Code, Section XI. repair or replacement Type Code Symbol Stamp __N_/_A __________________________________ Certificate of Authorization No __N_/_A_____________ Expiration Date _ _N_/_A_____________ Signed c/{r;/)£L21'ili-= " f&j,.;.;rar Owner's Desig'nee, Title or Province of Vir inia r.s.r EAl/;,!A[eFf'?- Date---C)?J="'"rl"""'"'===--__,_/....,.2 CERTIFICATE OF INSERVICE INSPECTION and employed by HSBI&I Co* _ _ , 19 I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State 9/ of to the best of my knowledge arid belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section XI. By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspection. (.) /J -I}- ;;:J

   -----..J~..=::.~......::=-=--.:;;.........,/,-;... ..,L,f_"""'~"-'='-----Commissions _ _V_A_._5_4_3_________________

Inspector's Signature National Board, State, Province, and Endorsements Date 7-Ji. 19 q,

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

  ,. Owner       Virginia       Electric and Power Co,                                                                                            Date --'Ti=-'1....J..,L_.'{_..,.2~4-'--+1-+/-q._q......_/- - - - - -

Name 5000 Dominion Blvd., Glen Allen. VA Addrea

23060 Sheet _ __.l,.....__ ot _ _ _,l=-----------

2. Plant Surrv Power Station Unit ---,lA;,--------------

Name P.O. Box 315, Surry, Addrea VA 23883 Sob No s3'.80eJi,@ 3 Bei 3 e/2-:"q 1-<e.5 Repair Organization P.O. No., Job No., ate.

3. Work Perfonnedby Virginia Power Type Code Symbol Stamp N / A Nome Authorization No. _ _ __._,Ny/uA:;i________

P.O. Box 315 1 Surrv, VA 23883 Expiration Date _ _ _ _. ., Na.+/.... 8.________ Addrea

                                                                              , __,.(_..Q"'Q..._.,l._A-.,_t\:

4. Identification of System -----'Ri...:>.1..F:...a.l:J-"(._J:.,_1._.'):8.~.... ~--11.--------------------------

5. (a) Applicable Construction Code B3 l. l 19~Edition,_:..;N.:../.:;.A:.__ _ _ Addenda, N-1, N-7 Code Case (b) Applicable Edition at Section XI Utilized for Repairs or Replacements 1980W80

6. Identification at Components Repaired or Replaced and Replacement Components

Name at Component Name of Manufacturer I

Manufacturer Serial No. I I I National Board No. Other Identification Year Built Repaired, Replaced, or Replacement or No) ASME Code Stamped (Yes I co Pf: $ - \JUL(f\N I uNj(l\)tlu)tJ i-R.c-rw -2'1-S'SBI ulll~t1011l11 ~o I I~" N-l,\,ts I N/A po~ csy I

                                                                                                                                                                                                             ~PUKl:b I

I ICP.RDl~l\-l. ~b. , H 1"* 3 7; 3 15.2.1t-i\ l9 ~ I

         ) II N/A                                                                                                               NO I~       V\.lLltS     \'RoD\JC.i':. .If\JC, C?.. 1-t 2.°I                                         I                                                                                                \\cf> U'\CE]',\E:~1' I
                                        -VU ~

I I ~11 NllTS C:OP~S I l)l\lKl\lOWN I I N/A i-p.c-KV-~%Jot?.lu~1<~i.a 11.E \) I.I\ Cl::b NO

                            ~ d, £'\c.B'll<?/111~~                        Hf~                             ,                                        f>o~               csy I
        '>;  11 Nl>i$       ~ ::tr--;~c.                                    Hi -P..Nlrd                                  N/A                          3:> \'is'(,~-\                        191/         P,i:PJ.IK'E:Tl\~NT              NO

7. Description of Work _ _....,R..,.~fp-"9,=c.~=~-~rn.,..4'~....,

D , l' 11 O l ~ I

                                                                                                         ....:,'4...._....,hM..:=>,..i..+/-~~-....l,Q<,Qc....l.,LP:.R...J.)'._..!._.28_~___JI.Y)J-'Ll:~+/-'-'.s.~\):i..:!:f'i:::..J....C--l.P..1M~----

8. Tests Conducted: Hydrostatic O Pneumatic O Nominal Operating Pressure [!21' Other O Pressure _ _ _ _ _ psi Test Temp. °F NOTE: Supplemental sheets in fonn of lists, sketches, or drawings may be used, provided (1) size is SY.s in. x 11 in., (21 informs.

tion in items 1 through 6 on this report is included on each sheet, and (31 each sheet is numbered and the number of sheets is recorded at the top at this fonn . (12/82) This Form (E000301 may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017

FORM NIS-2 (Back) 1

9. Remarks -._...!../Jr'-'S~M.-=-£...=-__.Co=

                                            -"-"-"p=E,-=-___._C_'J......,.A:-'-"'SS=*'---....c..-----------------------

APPlicable Manufacturer's Data Reports to oe attached CERTIFICATE OF COMPLIANCE We certify that the statements made in the recort are correct and this ~ f . t . i T conforms to the rules of the repair or reo1acement ASME Code, Section XI. Type Code Symbol Stamp __N_/_A __________________________________ Certificate of Authorization No. _N_/_A_____________ Expiration Date _ _N_/;__A_____________ or Province.of CERTIFICATE OF INSERVICE INSPECTION

                                                                                                                        -tro Date _ _ __,rl;,;=.fi',~_...;dc..:....:.~--,1-- - , 19 1, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State Virginia                   and employed by HSBI&I Co*

9J of __________.H...._o..."-'-"-l~b.....,,Oa.....r-'J=-,.)-C=-+/-

                                                          .......1_ _ _ _ _ _-:=:c----::-::-::c---------, have inspected                   the components described in this Owner's Report during the period _ _ _ _ _ _ _ _q,_~. . . .£            ....9....~...,R..._Cf.__to h;i-(8~ q /                                    , and state thet to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the reouirements of the ASME Code, Section XI.

By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspection. t,) /\ _ _ _ _ _ _Q-1,...;":""'~'--':---:--:::-~/.~*-..;;;~;...=-=="'-"-Commissions __V_A_...:;5_4_3c....________________ I nspeci:or's Signature National Boara, State, Province, and Endorsementa. 7 -.A-< Date'----------'---'r!""""":,,.1.___19 q (..I

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

1. Owner Virginia Electric and Power Co. Date _~_j~u=L~'{-~?_4-'--1-1__.__ICf

                                                                                                                      . . . .9~1-----

Name 5000 Dominion Blvd., Glen Allen, VA Sheet 1- o f _ - = = - - - - - - - - - - - - Address 23060

2. Plant Surry Power Station Unit ---~2-,~--------------

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

3. Work Performed by Virginia Power Type Code Symbol Stamp _ _.,. 1,. _1-i--/L-'A:'--------

Name Authorization No. _ _ _ _ _...,.IV'-+'{A:-'-------- P.O. Box 315, Surry, VA 23883 Expiration Date _____--1-A1,1l+{,1..A-!......_ _ _ _ _ __ Address I

4. Identification of System }2.Ac.-roe.. CoDU-t"1T

5. (a) Applicable Construction Code B31.1 19~Edition,_N~/_A_ _ _ _ Addenda, N-1, N-7 Code Case (bl Applicable Edition of Section XI Utilized for Repairs or Replacements ,s80W80

6. Identification of Components Repaired or Replaced and Replacement Components

Name of Component Name of Manufacturer Manufacturer Serial No.

National Board No. Other Identification Year Built Repaired, Replaced, ASME Code Stamped or Replacement or No) (Yes CP,~1JP,I.. :J:'J-JC>. 1-ff;t!,. Fe>"" l (J'-+ ,, STUD ""'oI:Ur~ :-r;;...,. P."PITL"I le, ~A 331oc;1-1 1qcu l'!Ze:Pt.!\le~ ~lD 1 I [le] I 'le, 11 /I

7. Description of Work '12&1 Ar£.Q Nrirs [BJ 1 4 1 1 13) STUD::, l If

8. Tests Conducted: Hydrostatic D Pneumatic D Nominal Operating Pressure Q----

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

                                                                                                                                                            .: ~ ..

FORM NIS-2 (Back)

9. Remarks - ~.....As~--'(Yl--=£._'---c'"'~""'"'"D""-'E-==-___,C_---Ll¥s~~~S~~----------------------

Applicable Manufacturer's Data Reports to be attached CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this ~ conforms to the rules of the ASME Code, Section XI. repair or replacement Type Code Symbol Stamp __N_/_A _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ Certificate of Authorization No._N---'-/_A_ _ _ _ _ _ _ _ _ _ _ _ _ Expiration Date _ _N_/_A _ _ _ _ _ _ _ _ _ _ _ __ Signed (L'l,.,,,,G /~ * ;:r:--;r dw,le~~~nee, Title fub//\lEE,L Date _ _ CERTIFICATE OF INSERVICE INSPECTION

                                                                                                      """V""""'t=,,,,----"~'-'-'i_.~,--, 19 ....'7..._/_ _

I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State or Province of Vir inia and employed by HSBI&I Co* of

  --------I-J~,L_...L4-...J...L!....!~...j....-c=...L------.,.,--,,.,,-==----rhave in~ered the components described in this Owner's Report during the period _ _ _ _ _ _ _ _...___,_...__._............ to        6-/8-       't                         , and state that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section XI.

By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this i n s p e c t i o n ~ ~- /{) f"i

   ----'~"---"--"-----~d_:':--_~                __     ...c...._ _ _ _                   __5_4_3________________

commissions __V_A Inspector's Signature National Board, State, Province, and Endorsements Date,_ _ _ _ _ _ _ 7-~<

                              ....._.,..Q:....:J=----19 q1

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

1. O.Vner Virginia Electric and Power Co, Name 5000 Dominion Blvd., Glen Allen. VA Sheet _ _...:!l,....__ of _ _ -l--=-..,,'L:::::......i:J.?::!r=~-----

Addrea

23060

2. Plam Surrv Power Station Unit --=-a'.Z,.=---------------

Name P.O. Box 315, Surry, VA 23883 Sob Na 3 80 e, i e> '3 '62)4- ge_:tJq1-lA Addrea Repair Organization P.O. No., Job No., etc.

3. Work Performed by __V_1.; ;.*;;;.r_..g""i;.cn"'1.~*a-'---P""o""w..::e;...r;..._______ Type Code Symbol Stamp___.N.M.+.-/...,A_

Name Authorization No. _ _ _ _Nuy/c..,;PI:,...__ _ _ _ _ __ P.O. Box 315, Sutrv, VA 23883 Expiration Date _ _ _ ___.N.,.,.,_/.._A..__ _ _ _ _ __ Address

4. Identification of System _ _ _R,.u...:a'£:.1A...,,_,.C.T}c.U..Ou.8....,__.,_(.,.0'-'-0"""l....,_P,.,._l\,_,J......I4-_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __

5. (a) Applicable Construction Code B31. l 19~Edition,_N;:.;.:./.;:_A:....__ _ _ Addenda, N-1 N-7 Code Case (bl Applicable Edition of Section XI Utilized for Repairs or Replacements 1980W80

6. Identification of Components Repaired or Replaced and Replacement Components

Name of Component I

Name of Manufacturer II Manufacturer Serial No. I I I I I National Board No. Other Identification Year Built Repaired, Replaced, or Replacement or No) ASME Code Stamped (Yes I' ,, NOT~ I I UN It.NO uJN I N/A IU:.P~l::, ~o

            ~                     vl\'.>KN~l\l                                                                                  'l.-"fl.C-i'Ql/-;i_~$7\1U~I\N01l:lll
                              , l\~G ~~11\lEE~I I-\,:;\\                                         I         N/A PO~
                                                                                                                                                                                                        ~o
         \ l
           ~

I/ 1\)0 TS '.1[ ) -:r N C.. l*\1" -1\N I':IL :l I 33\ib"5 -/ / 191 J l\cP).1$8'1\c~"T I' I l ~// NOTS VNK.ND\.dl$ I VhlkN01.ol'-l' I'i N/A :),,- P-c.- l'c.1/ -:l.%5A \l!ll\(\.l~lil llJ: !) U\ Cl:l) NO Y, CPtR.~11\.lPt L '1"1b 1-\i-:\\ i f>o~ t i If NUTS ~~t>l.lc..,~ XNC-, C ~~l-0..~ I N/A

                                                                                                                                      '3YS5~l...\-~

1qq1 ~PJ.IKE:l'I\E>>T NO 11 (ePes-I~ STOb VVLCTIN lll\'.ll::1'lOWl\.l I N/A ;L-~(~ltV-'.:t~~ l/Nl<t.:lOW ~ R'S'LACE-b No

7. Description of Work _ _ ~R~e~c&a:1::;l\~ouT:::::::=tC:ia~,[l,tJJ, I I l 1 *t .k) D S!iJ.,~t.~::::_~?>~e~~~)lowt..ePJctL_:nV\JJOl::+/-bss..._O(V,cs..~&tJ~jjLL~O!IL...:5tluu.dd~SL + I __

8. Tests Conducted: Hydrostatic O Pneumatic O Nominal Operating Pressure [a--'

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

FORM NIS-2 {Backl

9. Remarks ~....,,A6µ:~fv1-'-=f:-==--__,C_-Ob'-r£--+-"-"::..__..,,_C_,J>...,A6$'-'-="'=-.:\ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __

Applicable Manuracturer's Data Aepons to be attached CERTIFICATE OF COMPLIANCE We cemfv that the statements made in the recort are correct ano this gEB.f\:CE.~ conforms to the rules of rhe repair or rec1ece,ment ASME Code, Section XI. Type Code Symbol Stamp __N_/_A ____________________________________ Certificate of Authorization No. _N-'-/_A_____________ Expiration Date _ _N_;_/_A_____________ Lrm_,d,ne-I Signed ,t ISL Erf0//t/££?- oZJ.~;owner's Designee, Title CERTIFICATE OF INSERVICE INSPECTION 1, the undersigned, holding a valid commission issued by the National Board of Boiler ano Pressure Vessel Inspectors and the State or Province of Vir inia and employed by HSBI&I Co* of _ _ _ _ _ _ _ __l.....!,.;~---l.....1.-'-<~=+...ec::=:.....L..C------:c--=---,=::-----,.. have in~ected the components described in this Owner's Report during the period _ _ _ _ _ _ _ q_-.../_qL--_.[?.._Cf.__tc 6-f S- i / , and state that to the best of my knowledge and belief, the Owner nas performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section XI. By signing this certificate neither the Inspector nor his employer makes any warrant¥, expressed or implied, concermng the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his emo1oyer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this i-n-sp-ec_t_io_Ql,l"...!<ll-~.::....>..1-~-:l-'n-sp..;.ec....;.._t_Oi r'"-1-::;-:-ig-n""'~-tu""~""re""--'=-==--'-----Commissions __N_v_!_i_o_~-:-/-a-o-.-ra-.-S-t-..-t-o,-P-r-o-v-in-c-e-.-a-n-d-E-n-d-O-rse-m-e-n-t-.- Oate _ _ _ _ _ 1.L...--...._d-_,,~'---19 ClJ

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

    , . Owner        Virginia Electric and Power Co,                                                                                         Date          ::Ti JJ V 39 J I qq I Nam*

5000 Dominion Blvd., Glen Allen. VA Addrea

23060 Sheet _ _ _.l....__ of _ _-=l~---------

2. Plant Surrv Power Station Unit---=""---------------

Name P.O. Box 315, Surrv, VA 23883 Addrea Repelr Organization P.O. No., Job No., etc.

3. Work Performed by Virginia Power Type Code Symbol Stamp _N.....,.I_.A"--------

Nern* Authorization No. _ _ _...uN1..:1/uAi.._______ P.O. Box 315, Surrv, VA 23883 Expiration Oate _ _ _ __.N~/.i;;f\1-_______ Addrna

4. Identification of Svstem _...,.,C_...b...:e...ro......,1,..,0,"'""'i,._____,&=-_\_,.l..o_..L. .,1_.m,.u. ;.J>.____._c....cru~:n:~fl""'\'--------------------

5. (a) Applicable Construction Code B31. l 19~Edition,_N"-'-/.;.;Ac...-_ _ _ Addenaa, N-1, N-7 (b) Applicable Edition of Section XI Utilized for Repairs or Replacements 1980W80

6. Identification of Components Repaired or Replaced and Replacement Components

II Name of Component I

I

                              I Name of Manufacturer I

II Manufacturer I Serial Na. I j National Board No. Other I~antification Year Built Repaired, Rl!Qlaced, or Replacement ASME Code Stamped (Yes or Nol I I

                                                                                            ..            I i,,                                                                                                                      !l..-C\i.-1C..V-'l.l.1t'3, Illt.ll\lolCIOW          I ~PI..J'\Gb                 ~o S.'TUbS     '+

i C.OPES-\/lJLCPr\\\[ tJNkNO'(J)M I N/F\ c.s.y I Cf',R"t:>\1-Sf:\-l JNb H 1" ~ ' PO 1/f

             ?,.Dt:,.5        ! ?Ra1>UCK :f.NC..,!                                 80~b tl\.O             I             N/A                          3 '3 C'i$02.'- 5           I t~~ I             I~p LPlcatil!:l.\T           ~o
    ;         NUT"':.         I     l/NKN~                                  IVNJl<..~N Ii                                 N/A                  l- C.\\-itV -~I.\~ \1.1t,3K\.kl&)tl                  I ~HI\Cl:b                    NO
   !i                          ~ ?/t ~11\l~Nql l-\1" :t\                                                   i                                   f>o-:\'t     cc.,y '

I N'\J,~ CO,, I.NI c AAll'38 I N/R '3~4~-!'f.f,-/ I l°l°to*- l~P.UK'E:1"~NT NO i' I I I i I R \

7. Description of Work_-l.,..e'1~r'""c,....c... l e.u,,._~(""2..')~__,s:::.t...,.....,.,_d... I S..;::,.;. I)

                                                                                                                      .. -~Q;;,"'                 \                                              ,n
                                                                                                                                  -~C..~l-\.l...1...._XW.:l.!::.lli.;+L.:S:i__~v~e.s:r:..........11[w.M.:..i.--1.       I":

3/;..,.~J..1.-___ (___

8. Tests Conducted: Hydrostatic O Pneumatic O Nominal Operating Pressure .W Other O Pressure _ _ _ _ _ psi Test Temp. _ _ _ _ _°F NOTE: Suppiemental sheets in form of lists, sketches, or drawings may be used, provided n) size is 8% in. x 11 in., (21 Informa-tion in items 1 through 6 on this repon is included on each sheet, and (31 each sheet is numbered and the number of 1heea is recorded at the top of this form .

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

FORM NIS-2 !Backl

9. Reman,s -....J/16i~~!/??-"£'-=---'Cb~D/E.~'-'a~;il6zc:,:;-;..<;....__~:L=----------------------

Aoplicac10 Manuracturer's Data Reports to oe anachea CERTIFICATE OF COMPLIANCE We cemtv tnat the statements made in tne reoort are correct ano tnis /2£Pt-A;C£f1.fEt,ff" conforms ta the rules of the ASME Cade, Section x I. reoaor or reo111cement Type Cade Symbol Stamp __N_/_A ____________________________________ Certificate of Authorization No __N_/_A_____________ Expiration Date _ _N-'-/_A_____________ Signed f/~,. 1,$L Gv6tuE?

              '$;t~~or Owner*, Desighee, Title Date---~~"""""""9_....._3(2.......__ _ , 19 9/

CERTIFICATE OF INSERVICE INSPECTION

1. the undersigned, holding a valid commission issuea by the National Board at Boiler ana Pressure Vessel Inspectors and the State or Province of Vir inia andemo1oyed by HSBI&I Co. at

   ----------fi=.L..-1-,1--'"'-!.r->=::L.1'--..:C=*~T-------:..---:-,;:;-=r,----rhave in~ected the comoonents descrrbea in this Owner's Reoort during the oerioa _ _ _ _ _ _ _ _ _...,__,__._. ._.__10      6- /f!-'t/            .         , and state that to  the best of my knowledge ana belief, the Owner nas oeriormea examinations ana taken corrective measures aescrrbed in this Owner's Report in accordance with the reouiremenu of the ASME Code, Section XI.

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

    -----~t-'~~~---:--"-::-:-'r;L.,.~---~-------Commissions __V_A_5_4_3__________________

1nsa~or's Signature, National Boara. State, Province, and Endorsamenta Date _ _ _ _ _.7_---=-J_/_19 q/

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

  ,. O,yner      Virginia          Electric and Power Co.                                                             Date     -:J"IJI Y:  /9   1    1'1°! I Name 5000     Dominion Blvd., Glen Allen, VA                                                                    Sheet _ _..::,l,___ot _ _-=l=----------

Addrea 23060

2. Plant Surry Power Station Unit _ ___....__ _ _ _ _ _ _ _ _ _ _ _ __

Name P.O. Box 315, Surry, VA 23883 1ok Na, ;z,9;0coco93e,B'. g~1-<ez.. Addrea Repair Organization P.O. No., Job No., etc.

3. Work Performed by __V'-=-i;;..r...g.,,i;.;;n;;;.;i:;.;a:;;.....P;;.;;..ow..:.:....:::e;..::r'-------- Type Code Symbol Stamp_..t,1~/""A'--

Name Authorization No. _ _ ___.N~/..._A._________ P.O. Box 315, Surrv, VA 23883 Expiration Date _ _ _ __.._N,:w..{-/...,F\._________ 1 Address

4. Identification of System _ _...,.S:if\:.,_,f_t._T.J.Y-1--........I='-'t--...._)J

                                                                                  .......EC~T_.\""O...,I\.\....__ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __

5. (al Applicable Construction Code B31. l 19~Edition,_N-'-/_A_ _ _ _ Addenda, N-1, N-7 Code Case (b) Applicable Edition of Section XI Utilized for Repairs or Replacements 1980W80

6. Identification of Components Repaired or Replaced and Replacement Components

Name of Component I

Name of Manufacturer Manufacturer Serial No. I I National Board No. Other Identification Year Built Repaired, Replaced, or Replacement or No) ASME Code Stamped (Yes

  !       s,u Pl s          I   tJ ~K\IJOWN                 I {J ~ I<'flj eu.,r,.\           I           N/A           :i.-sr- pp-,s-:3     IUt..\\\NC\llN I
                                                                                                                                                               ~PI.J'K;l:,          ~o I."'t>.,       \.\T ~                                                            ccsy * .

i Js I/ STUb ICtlN:>INIH

                                \>~at>VC\"S :ffit,                    ~ 'J..l \°I I          I           N/A Po~

3"5'!l-e't 1-'J I \'i°I I 1\1:~ J.i'IC9\1:).\i NiO i I N-VTS U~\(.NOWN I Ut\\~&u,N I N/A .2.-SI.- Pf-1$"3 l.l~lt\.laa:lN 11..cHl\c:.t:h NO

  !                                                                                          i A&. 9 ~l\'ltERl~ 1-rrllll                                        i                        f>o~       CSJ     .

I NV-n '.:J[ ) :!~c.. c;,. 't't- fl.\, I N/A

                                                                                                                           .331 LCl-l:,       ONl(f:)IJU:)IJ ~PJ.JKE:l'l\\:.tJT     NO

8. Tests Conducted: Hydrostatic O Pneumatic 0 Nominal Operating Pressure ~

Other O Pressure N Dl'> psi Test Temp. Af\\Rt i=NI: ° F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is 8% in. x 11 in., (21 informe-tion in items 1 through 6 on this report is included on each sheet, and (31 each sheet is numbered and the number of sheen is recorded at the top of this form . (12/821 This Form (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.V. 10017

FORM NIS-2 (Backl

9. RemarKs -.......1-h,.,$_,_,__M-'-'E:.-=--Lb='-"'D""E.~___,_C_.....L~AS"'"S"---?------------------------

APPlicable Menuracturer's Data Reports to be enached CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct ana this RfAJ,a;.Mf.cl:C conforms to the rules of the ASME Code, Section XI. repair or reo1acement Type Code Symbol StamP __N_/_A _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ Certificate of Authorization No,_N.....;../_A_ _ _ _ _ _ _ _ _ _ _ _ _ Expiration Date _ _N_/_A _ _ _ _ _ _ _ _ _ _ _ __ Signed fA"a::).~ 1 T6L lq)..{neror Owners Desilfnee, Title or Province of Virginia 6N6ll'IEF,e,. CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler ana Pressure Vessel Inspectors and the State and employed by HSBI&I Co* of chcTfi>rr-d) ct. t'.ave in~ected the components described in this Owner's Report during the period _______q.,_-_._/_,_f_- .......8.._'f,.__to - ( 3* "( I ; and state thet to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measu,es described in this Owner's Report in accordance with the requirements of the ASME Code, Section x1; By signing this certificate neither;the Inspector nor his employer makes any warrantV, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the lnsoect.:,r 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 Commissions_~V_A_5_4_3_ _ _ _ _ _ _ _ _ _ _ _ _ _ __ National Boara. Stata, Province, end Endorsement* Date,_ ___,:/_- i"--'~'-19,_q-'---'-/-

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

  , . o,*,mer     Virginia Electric and Power Co,                                                                                            Date          3  Uf,,.\(  l ':'li Ic,q I Nam*

5000 Dominion Blvd., Glen Allen. VA Sheet _ _...:!11'--- of _ _...;;;l;.___ _ _ _ _ _ __ Addr- .:'.J060

2. Plant Surrv Power Station Unit---"'---------------

Name P.O. Box 315, Surrv, VA 23883 Addrea Repair Organization P.O. No., Job No .. nc.

3. Work Performed by __\;...;'i;:..r;:..g=i""n..::;i..::;a;....;;;P...::o;.;w.;..:e::..;r"-------- Type Code Symbol Stamp__,N.....,../~A,__ _ _ _ _ __

N*m* Authorization No. ----'N.:&..1-/.cAL-------- P.O. Box 315, Surrv, VA Addraa 23883 Expiration Oate _ _ _ _....,N....,;/-J/ a~------- 4, Identification ot Svstem _ _ -'=5"'1(3.. .U. .E.c.E:;. JIL..Y.L. ....--I NL:><..,I,J-k'E...C_:t.._.1-1.o.L.JN~-------------------- 5_ (al Applicable Construction Code BJ 1.1 1 9 ~ Edition,_N....;.../A...::__ _ _ Addenda, N-1 N- 7 (bl Applicable Edition ~t Section XI Utilized for Repairs or Replacements 1980W80

6. Identification of Comoonents Repaired or Replaced and Replacement Components

Name of Component I

I Name of Manufacturer I Manufacturer , Serial No. i I I i National Board No. Other Identification Year Built Repaired, Replaced, or Replacement ASME Code Stamped (Yes or Nol i I ! ! STUJ:)5 I VE-LR-'N I VNkrvt11.,}]\J N/A .l.-~-MOll-~F) julll~t1010NI ~P~b ~o I l\&.C,~11\1~ l{'l"~ : PO':\\' c.sy 51llb5 I llll .. :n:. 1 :r~c. I '5Cf~u.Ot i N/A I "3 I $032-1 I14~0 I~p U\(Bc\l:).\, ~o IJ\!1;TS ! VH.AN i t/~ I N/A ~-S!-l't'ioV~l~bSlf i11~1tWO&lto1 j 11,E!)l.t\c..Eb NO

  !                         ICIW,b(Nlt)..           IN)), ,             Hf~                                                                    f'o-:\11     csy NUT'=>            PRbl:)llC..1':> :INc..                      'i~e>~ 8l\      ,,

I I I N/Fl

                                                                                                                                                        ;tt.Sl4-S-l    l 1~rq       1~UKct'\\:.NT     NO I

I I I i .1 I o I

7. Description of Work _ _ _J\...,.,.f"ff':;.s.1<0...c.,,:e...

                                                                     ~                                   o                      t               c1'1,")'*
                                                                                                                   ...d;"".u11u.r;c,,lC,;;,___!,. .J.,l....:..t.;P?~-=----------------
                                                                '.B"'~'--.JJ'O..,.tJ.~t'-:',S;:,_........1,©.x...._Sii

8. Tests Conducted: Hydrostatic O Pneumatic 0 Nominal Operating Pressure !3-Other O Pressure /J bl? psi Test Temp, AmB!Sclr ° F NOTE: Supplememal sheets in form of lists, sketches, or drawings may be used, provided n I size is 8% in. x 11 in., (21 lnforma-tion in items 1 through 6 on this report is included on each sheet, and (31 each sheet is numbered and the number of sheea is recorded at the top of this form .

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

9. Remarks _ __,_A..<-=S...:.fll.--'=(£_::__--tc..-L"D'=D=t;.-::__..,,._C~.....

FORM NIS-2 (Back) A-S'--5..,__...:.Z....-=--------------------- C.... Aoolicaole Manuracturer's Data Aeoorn to oe ettachea CERTIFICATE OF COMPLIANCE We certify that the statements made in tne reoort are correct ana this -RE.Pl AC F~ontorms to the rules of the ASME Code, Section XI. reoair or reo1acament Type Code Symbol Stamp __~_/_A ____________________________________ orProvinceof _ _ _ _ _.../'4...1.:<t..v<t_._fu CERTIFICATE OF INSERVICE INSPECTION I, the undersigned. holding a valid commission issued by the National Board of Boiler ana Pressure Vessel Inspectors and the State Virginia andemc1oyedby HSBI&I Co.

                                .....'--rd-='-Jt-'c~t_.'----------~-:--::---::::-::-----have inS?ectea the components described of in this Owner's Recort during the period _ _ _ _ _ _ _q_-_._J. .                                      ?_-.......ftl
                                                                                                                  . . . .__ to _ _b_-~/_;_-_'7_/______, and state that to the best of mv knowledge ana belief, the Owner nas certormeo examinations *and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section XI.

By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connectea with this i_n_S?_ec_t_i_*\2~*~"'~'-"""LJ=l:::n;;;;s;,::.ac,:.=.-o-,..~tf::s~\-,n.::~:::t'""u::.re-------- Commissions--:-11-~-io-~-\-;-!-o-.-ra-.-S-t-at-.-.-P-r_o_v-in_c_e_,_e_n_d_E_n_d_o_r_sa_m_a_n_t,-- Date ]- ~ Q_ 191.,/

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

1. Owner Virginia Electric and Power Co, Date ~

2o I I 1'.1 I Nam*

5000 Dominion Blvd., Glen Allen. VA Addrea

23060 Unit _ _ _....,.,......._ _ _ _ _ _ _ _ _ _ _ __

2. Plam Surrv Power Station Name P.O. Box 315, Surrv, VA Addrea 23883 :YobRepair No Organization c3B000g:S0 I ?f: ~91-1,o P.O. No., Job No., nc.

J. Woric Performed by Virginia Power Type Code Symbol Stamp _.,.NL.J/:..iA:1-_______ Name Authorization No. ----J.JNL,/1-JPsC1-------- P.O. Box 315, .Surrv, VA 23883 Expiration Date _ _ _ __.N.>>.;./.,_f\...________ Addrns

4. Identification of SYstem _ __..S~F\.,_f._"E.. . _J....Y_--=I,.,Nc...;..,,J._.E:c::.-C::=.I"'"-'\.,.0:..:..~-=------------------------

5. (al Applicable Construction Code B3 l. 1 19§1___ Edition,_N_/_A_ _ _ _ Addenda, N-1 N- 7 (bl Applicable Edition of Section XI Utilized for Repairs or Replacements 1980W80

6. Identification of Components Repaired or Replaced and Replacement Components

Name of Component I

Name of Manufacturer i I I Manufacturer I Serial No. I I I I National Board No, Other ldantifi~ion Year Built Repaired, Replaced, or Replacement ASME Coda Stamped (Y111 or Nol I

                           '.].

I, _-) I

  '        S.TU'bS           I 0 l\lKNot.oN                        l   () N\<Ne-t..ur..)I    N/f:\         2-SI-    Ff: -a_~lj.O  !Ut.1)1\t.lOUlW
                                                                                                                                                     ~Pl.J'lab         ~o I

eoL,c;

                             . CfH,'t> \N P,L :I:NI) , 1-l 1" :\f I   f~'t>\lC\S           :rnc..i            %S'l 1 l3'i \

N/A j Po~ csy 3 J. 0 ~!;4 -, I 111 0 I

                                                                                                                                                   ~p IJ'ICSi\E:~T I  ~o I

NVTS ! UNKNO'Wl-.l I VNKNOt>>Nj i I N/A 2.~ sr.-,r: -:l1"1-0!11~tc\lO&lt,1 P.EHI\Cl:l) NO I

iC.FIRblNAL !Nb j HT~ Po-.\t t':>Y \ i i i 1'.) \) \ ~ rRo t>\J'C"f~ .:m;c_ i C :.}.,- +~q i N/A. cl69~<\~-;,1.. 1q-&q ~P!ACJ:::1'1\~NT NO j I I I I B. Tests Conducted: Hydrostatic O Pneumatic O Nominal Operating Pressure (a--' Other O Pressure _ _ _ _ _ psi Test Temp. °F NOTE: Supplememal sheets in form of lists, sketches, or drawings may be used, provided 11) size is BY., in. x 11 in., (21 informa-tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheea is recorded at the top of this form . (12/821 This Form (E00030) mav be obtained from the Order Dept., ASME, 345 E. 47th St., New Yoric, N.Y. 10017

FORM NIS-2 (Backl

9. Reman<s _ _ r,bJ...!.::::::.;fv\E-:_.:::;.___Co=-=DE.,.=--.,,.~='-'-""'='...._--'-2_-=----------------------

Aoolicao1e Manuracturar's Data Aeoorts to oa anachea CERTIFICATE OF COMPLIANCE We certitv that the statements made in tne recort are correct ana th is B,E-P!..P.(E..IY<E.,N"\ conforms to the rules of the repair or reo1acemen't ASME Code, Section XI. NIA Type Code Symbol S t a m P - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Certificate ct Authorization No._N_/_A_ _ _ _ _ _ _ _ _ _ _ _ _ Expiration Date _ _N_/'-A_ _ _ _ _ _ _ _ _ _ _ __ Signed ~b2~esig£.~e orProvinceof Virginiaindemo1ovedbv bl 6,1,JE£/l. Date _ _ _.... CERTIFICATE OF INSERVICE INSPECTION a"'

                                                                                                       . ..,~_..-.. .e?i~D~--, 19 91 I, the undersigned. holding a valid commission issued by the National Board of Boiler ana Pressure Vessel Inspectors and the State HSBI&I Co.                                                               cf
                              !fLr-T    :forcl_J   c1.                                        have inspected the ccmoonents described in this Owner's Recort during the ceriod                        EI - '10        to       f; -ID - 9 lf

and state that to the best of mv Knowledge ana.,belief. the Owner nas certormea examinations and ta1<en corrective measures aescribed in this Owner's Report in accordance with'the reauirements ot the ASME Code, Section XI.

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

   --->t-Gt. ~~~~f_@_kR:
                     .. I nSP~Or'I Signature

___ commissions_V_A_54_3_ _ _ _ _ _ __ National Boara. Stl!ta, Provinc11, and Endor..mentl Date-----=~,__-_,,,_a_.]_19 1(

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

1. Owner Virginia Electric and Power Co, Date _ _ _ _'f-....,

1 _/-t_R_*...,./~01_j_______ Name 5000 Dominion Blvd., Glen Allen, VA Sheet _ _-=!'--_ of _ _- = l ~ - - - - - - - - - Address 23060

2. Plant Surry Power Station Unit _ _~ ~ - - - - - - - - - - - - - -

Name P.O. Box 315, Surry, VA 23883 .Jo\:, No .3 80009595 I ?R*91-5'i Address Repair Organization P.O. No., Job No., etc.

3. work Performed by Virginia Power Type Code Symbol Stamp~N"'+-/~A-Name Authorization No. ---~N'""f/~Pl~-------

P.O. Box 315, Sutrv, VA 23883 Expiration Date _ _ _ __.N,->>+/.._8.___ _ _ _ _ __ Address

4. Identification of System _ _ _ _ _ S~Cl);~:i~f-+~).,,.'-~L,~8'-t,-E~c:~=t~'i-e~O----------------------

5. (al Applicable Construction Code B31. l 19~Edition,_N_/_A_ _ _ _ Addenda, N-1, N-7 Code Case (bl Applicable Edition of Section XI Utilized for Repairs or Replacements 1980W80

6. Identification of Components Repaired or Replaced and Replacement Components

Name of Component Name of Manufacturer Manufacturer Serial No.

National Board No. Other Identification Year Built Repaired, Replaced, ASME Code Stamped (Yes or Replacement or Nol l\jl.)T$ UN\C'No-i.,c.)1\.1 lJ I\) IC.\\) Ot.ol\l ! N/A :l-Sl-lo!f- UN~/OOJJN R.HLP!Cl:D ~o Hc..i-dwa,e. S'fe£1(;.~ r\1 ~ P0:11 csy He..x ~UT Co' :I>'\.c. ' "5'jb\l.{ N/A .:2.3 .2. Cl,t-0-,.3 IC\ i !2. Rl=~Ll,<E\V'ltNT NO r,'\t>L-;\\ ~ STLl'b 'J)f7RLlt>J~ 1'.L '5350 W N/A .2 -sr. .. l o==t Ul\l!Q\\OUW ~\'U4<:E-b NO F\ ll, (:r EN~l~EfR- 1-\T.\1 po~ SJ STU-'D IN~ eo. Ji./tNc.. s-%4 ~ N/A 3\Sb32-l l qit RE PLF)(E-\V\00 NO [ii(,'] [,~] 11

                                                              ...._....:\\j=-:.~"'--+/-'-=s.~----'=&"---"S'"'-:r-'-'u""'dL<>-->s.__,,C....,1'-?-k.f.:.....:::...)_ _ _ _ _ _ _ _ _ _ __

7. Description of Work_---'R'-"e<.-jr:'-'l"""c..,..L=e,;;;"""J

8. Tests Conducted: Hydrostatic O Pneumatic 0 Nominal Operating Pressure 0 Other ~Pressure ND P psi Test Temp. Ai OT °F NOTE: Supplememal sheets in form of lists, sketches, or drawings may be used, provided (1) size is BY.. in. x 11 in., (2) informa-tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form .

(12/82) This Form (ED0030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017

FORM NIS-2 (Back)

9. Remarks ---+fo..,_6=-c.M.w£~-~C=L,4~:SS=---JL......___________________________

Applicable Manufacturer's Data Reports to be attached CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and th is /i?£l:>L.t1C£M£!\[L conforms to the rules of the ASME Code, Section XI. repair or replacement Type Code Symbol Stamp __N_/_A _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ Certificate of Authorization No._N.....;../_A_ _ _ _ _ _ _ _ _ _ _ _ _ Expiration Date _ _N_/_A_ _ _ _ _ _ _ _ _ _ _ __ CERTIFICATE OF INSERVICE INSPECTION Date _ _ 9~. .fr""I----Lld?c..,__ _ _ , 19 I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State 91 or Province of Virginia and employed by HSBI&I Co* of _________,_H-'--"a,..._.f_T~~6'-o~r~J-=--J,t--'C~*~r...______=-----=,-:-----ehave inspected the components described in this Owner's Report during the period _ _ _ _ _ _ __.Cf'--..,/....9.._--it'f--to_..,,~-~/c-..=.ff_-_9-'-/_ _ _ _ _ _ , and state that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section XI. By signing this certificate neither the l,nspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or.a loss of any kind arising from or connected with this inspectiona&J . -f, ~ Commissions _ _ V_A__ 5_4_3_________________ I nspec1:or's Signature National Board, State, Province, and Endorsements Date_ _ _ _7...._-_,_{__,,5'--_19 q{

1. Owner FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI Vir~inia Electric and Power Co, Date 4wn, 1.o, /99'(

Name 5000 Dominion Blvd., Glen Allen, VA Sheet_.....,1_ _ of _ _.=1:.___ _ _ _ _ _ __ Addr- 23060

2. Plant Surry Power Station Unit _ _~ ' - - - - - - - - - - - - -

Neme P.O. Box 315, Surry, VA 23883 1o'a No 3~0009S9 ~ o 1 .gfZ.P-cu~7

                 ** -* -* * - **               Addr-                                                                                          Repelr Org1nlzetlon P.O. No., Job No., ate.

3. Work Performed by Virginia Power Type Code Symbol Stamp H/A Name Authorization No. _ _ _.e.;N-,,~{f\"1.--_ _ _...;;..._ __

P.O. Box 315, Surry, VA 23883 Expiration Dete _ _ ____.h,11&1-/~A..__ _ _ _ __ Add,-

4. Identification of System _ _ _S_..r:.._,;5_..o"'-+.._'1--=.I"'-'Z)':'+'e..,d:_._,~...c....o...______________________

7

- I

s. (al Applicable Construction Code B31. l 19§.L__Edltion,___;N;.;..:.;/A:.=.____ Addende, N-1, N-7 (bl Applicable Edition of Section XI Utilized forRepairs or Replacements 1980W80

6. Identification of Components Repaired or Repl11ced and Replacement Components

Name of Component Name of Manufacturer Manufacturer Serial No.

National Board No. Other Identification Year Built Repeired, Replaad, or Replacemant or Nol ASME Code Stamped cv.. l',.l\i.,.. Pi l.c>'c:o \"i' 3':J.(,*,_sf) .! N/A . '2 -SJ: - l\,1- U~I\MO,all 111:.Pl.J'IGb KO f\-&G, ~Gl~t<~ \.1.1" '"" PO'* cs.y N\JT :ff- ) ::CN! C.. b°:1-:5~ I N/A 31.1.f ~-.I (.-1 \ll\"\0 ~p IIICSti'S.\T ~o I snYDS Ut..lKN-OWl\l U/.JK~N I N/A 2-SI-Lfr 11~11~1'1 11.E:~l.l\C:Sb NO

         ~ Tl) t)5 CPl?..t'.>IN ftl :cNt> 1-\1" ~                                  I       N/A.

f>o-:\t cs y J9fr'! ~lhCt:1'1\lNT NO PRot>ucrs Z!Nc.. I? 9} "={4t 32. 'f O':f-3-2

7. Description of Work _ _..LR ...o/2~:.</..::::i<aruce"3C.~de1a_ __..(.......Q....o.._.)._S';;z..-t d~...s!.._..::4:!S....-'=(,,.,.1'-'t:;L?;,,,.>~.11.IO:.L.!:lUL...+,~c....--1.{~t....J')1...-_ _ _......

                                                                                                             .......u....                                                                                1

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

Other O Pressure _ _ _ _ _ psi Test Tamp. _ _ _ _ _* F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (11 size is 8% In. x 11 in., 12) lnforma-tion in items 1 through 6 on this repon is included on each sheet, and (31 each sheet 11 numbered and the number of 1heet1 is recorded at the top of this form .

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

FORM NIS-2 (Back)

9. Remarks _...,A. . .';,.=.,.M;__E..-"'-*_...c. 0.....1?&::=.........0.....Jt':>

                                                                             ......=S.__..,2...=--------------------------

Applicable Manufacturer's Cata Reports to be anached CERTIFICATE OF COMPLIANCE We cenify that the statam,ents made in the repon are correct and this E2§PUIC.WMT: conforms to the rules of the ASME Code, Section XI. repair or replacement Type Code Symbol Stamp __N_/_A---------------------------------

                                                           - - - - - - - - - - - - - - E x p i r a t i o n Date _ _                   N_/_A____________

orProvinceof Vir inia CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the Stete andemployadby HSBI&I Co. of _ _ _ _ _ _ _ _ __,_..a....::a..;..:.....i..........,o.:.......,_,_... c::.*-'-'-'-------~-----have inspected the components described in this Owner's Repon during the period _ _ _ _ _ _ _!,._-_-_./_-_9__Q..__to--5--...L ....O..._-_'[_c.f...______, and state thet to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Repon in accordance with the requirements of the ASME Code, Section XI. By signing this cenificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations* and corrective measures described in this Owner's Repart. Furthermore, neither the Inspector nor his employer shall be liable in any menner for any personal injury or propany damage or a loss of any kind arising from or connected with this inspection.

   -----~"-*--:---"'."'"'"::::--i_.~~--~~--Commission1 _ _                                                       V_A_54_3_ _ _ _ _ _ _ _ _ _ __

Inspector's Slgneture National Board, State, Province, and E ndorumenta Date ~-~] 19__..:f..._1_

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

1. Owner Virginia Electric Name and Power Co, Date Tr IL'{ I Lt! \ \ 9 C\.\

5000 Dominion Blvd., Glen Allen, VA Addrea 23060

2. Plant Surry Power Station Unit ---"-:1_=---------------

Name P.O. Box 315, Surry, VA 23883 Addrea R11p11Jr Org11nlz11tion P.O. No., Job No., etc.

3. Work Performed by __V_i_r_g...._i_n_i_a_P_o_w_e_r_ _ _ _ _ __ Type Code Symbol Stamp NIA Name Authorization No. _ _ _........,NL.J/ '...fl......__ _ _ _ _ __

P.O. Box 315, Surry, VA 23883 Expiration Date _ _ _ _ _N....,../~8._________ Addrea

4. Identification of System_*_ _... s...0....F...F_I........Y__J...Kl~J...E.....:c:t'-'-";ro..,.._~W-______________________

5. (al Applicable Construction Code B31. l 19§.l__Edition,_N ___/_A_ _ _ _ Addenda,N-l, N-7 Code Casa (bl Applicable Edition of Section XI Utilized for Repairs or Replacements 1980W80

6. Identification of Components Repaired or Replaced and Replacement Components

Name of Component Name of Manufacturer Manufacturer Serial No.

National Board No. Other Identification Year Built Repaired, Replaced, or Replacement or Nol ASME Code Stamped (Yes NIJiS Ul','.l~~Ou:>lv VNI kN C,-0, l's)_ I N/1\ ~-$I.-IW-;).gs35 Vl\ll(ltEml\l R'Ef'IACX: t> ~o Pi & q- ENC,IN~l'll~ 1-\1' ~ PO ,a N \Ji'S :J: ) :i: N) C.

f>.N'l"\-(;,~ I N/A o":>l.f..b1-i \~i~ t\E\l J.~CE:f<'II:l\rr ~o

          ~OL.,&               C\'l.,.OSSY                         Lll\lK~~                   II N/A                            ~-~1-~v-1i~e                  Vf\:11\~o~~         P.E~L.~CED              NO Co..rdl'(lo.,\ :\'..Y)c\ t\f~                                                                       re~

Ui O'L1"$ ~~u..c;\"S ~ . %%"51"3~ N/R 3\(.. ').U,'\-1 \°\'\O "'E Pl.f\ec~'\:;J\'\1 NO

7. Description of Work _ __,_1\.,,,eo'"'lf'""\°'-""'-'Cf;..,o\~_.,..lill..).........,Y\u.U..._:\:~s-....,&"'----:l=-;':\L.)L--..ePc.L:tlJ11UaJ..:::s.___,__(_5.!../'o~'*);_________

8. Tests Conducted: Hydrostatic O Pneumatic 0 Nominal Operating Pressure (3" Other O Pressure t,..IQ P psi Test Temp. A,.I\B\E+lr ° F NOTE: Supplemental sheets in form of lists, sketches, or drawings may ba used, provided (11 size is 8% in. x 11 in., (21 Informa-tion in items 1 through 6 on this report is included on each sheet, and (31 each sheet is numbered and the number of sheets is recorded at the top of this form .

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

FORM NIS-2 (Back)

9. Remarks _ A. . . .6.=...c..l"\.---=C.~~C=__c=D~E..=-~C-1-A~';';,-~-7-~---------------------

APPlicable Manufacturer's Data Reports to be attached CERTIFICATE OF COMPLIANCE We certify that the statements made in the report.are correct and this Re:a VEMfAtconforms to the rules of the ASME Code, Section x I. *

repair or replacement Type Code Symbol Stamp __N_/_A __________________________________

Certificate of Authorization No. _N--'-/_A_____________ Expiration Date _ _N-'/'-A _____________ Signed ~~___,

                 ~r                   Owner's Desi!Jf,ee, Title I5T &6,1n (FFtf CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State or Province of                   Vir inia                        and employed by HSBI&I Co*                                                                    of
  --------++-=~-~~~~-"-'"~-----------=----- ave                                                                          inspe ted the components described in this Owner's Report during .the period                                          q-_J'{- lP'I    to _ _,,.'-L*........-___,q........._ _ _ _ _ , and state that to the best of my knowledge and belief, the Owner has performed examina.tions and taken corrective measures described in this Owner's Report in accordance w_ith the requirements of the ASME Code, Section XI.

By signing this certificate neither the Inspector nor his employer makes.any warranty, expressed or implied, concerning the examinations and i:o'ri-ecitive measures described in this Owner's Rep~rt. 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 0 i_n_sp_e_c_t_i-~..,*~*-6*~ee~~w-* _*--:£_**-:::-*-*_. _~---------Commissions _ _V_A__5_4_3_________________ Inspector's Signature National Board, State, Province, and Endorsements Date_ _ _ _ _ 7_.__..,+(-=h_19 r,

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

1. Owner Virginia Electric and Power Co, Date feL'( / lo 1 19 9.. I N11m11 5000 Dominion Blvd., Glen Allen, VA Sheet _ _-=l.____ of _ _..:l=------------

Addrea 23060

2. Plant Surry Power Station Unit _ _.-..,___ _ _ _ _ _ _ _ _ _ _ _ __

Neme P.O. Box 315, Surry, VA AddrBSI 23883 Sc,\, No, .3Sia01es9tJei ~91-53 Repair Orgenlzetion P.O. No., Job No., etc.

3. Work Performed by_....:V:...;1.:..*r::....cgc::i:..:.n:..:i::.:a=--P::.....:::o..::w~e:..:r,...__ _ _ _ __ Type Code Symbol Stamp__.N~/oA_

Name Authorization No. _ _ _ _N~/c.i.A.,_________ P.O. Box 315, Surry, VA 23883 Expiration Date _ _ _ _...1N~/.i::.AL-------- Addrea

r. .

4. Identification of System _ ___,5,:::;.&.,f:1.... E_T.L-')'._ _:r:.-..;N"""J'-'\;=C......,T....:l'-.>O<...JN..,.___ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __

5. (a) Applicable Construction Code B31. l 19§1._Edition,_N.....:../..;;.A;;.__ _ _ Addenda, N-1, N-7. Code Case (bl Applicable Edition of Section XI Utilized tor Repairs or Replacements 1980W80

6. Identification of Components Repaired or Replaced and Replacement Components

Name of Component Name of Manufacturer Manufacturer Serial No.

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

         &OL..""t'S               ( R.0s.~y                                         ll~~N.0-W~                  !      N/A                              "V
                                                                                                                                             .:l - ';.1- *J.'i,~C   llN~ll\cto~ !\!:I> L1\ C.l:b      ~o c~rcl.i.nJ .1.J,                                       t\1' ~                                              PO-* c.s.y
         ~OL\$                p~..J.M.                                                   '6S'-q13~              I       N/A                      31 C. :Vt ~          IC\C\O REfJ.flCl:l'/\tNi        ~o NVT5               V"'~NOU.,N                                            l11'\)~ Neto.:> I'.)

I N/A .l-5!-P.\f-~~5~ C lJNlkll)ota ft..EPJ.IK~'b NO Koreo.. ~til.l S11.a, \,\'t ,:\\ po-\1 CS."/ NUTS ~-' ).:t~. \\,N l '+~;l N/A "5 :Sflo Oi" \°I~ l ~c:PL~ NO r..:1 [.<+1 l'I \ It.<>,) o* I\ (L!!"!~>>\

                                                                                                                                                 *~~i..L~---------------

7. Description of Work _ __..I\,..e4~r""!A"""""'~fJ..,__n,l..l,.l,u:o..:\.l..t;.~___:Oo,E,!_--!,P.L19.!.!..1.1.::,,S,...,_--1,l,:;t:..:;;,:J.LJ

8. Tests Conducted: Hydrostatic O Pneumatic 0 Nominal Operating Pressure Q------

Other O Pressure N:bP psi Test Temp. &v:e,IFb-IT: ° F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (11 size is 8% in. x 11 in., (21 informa-tion in items 1 through 6 on this repon is included on each sheet, and (31 each sheet is numbered and the number of sheets is recorded at the top of this form . (12/821 This Form (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017

FORM NIS-2 (Back) 1

9. Remarks _ _-4f\.i.S=--'-tv\.---'-"=E..=-___.,,C,,...D_,_Q.,,......E--==---__,_C_...1.A:S"""--......s...._-"'2....""'--------------------

Applicable Manufacturer's Data Reports to be attached CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this \;§ol.JK.E &,Et,]"[" conforms to the rules of the ASME Code, Section XI. repair *or replacement Type Code Symbol Stamp __N_/_A ____________________________________ Certificate of Authorization No __N_/_A_____________ Expiration Date _ _N_/_A_____________ Signed_,;t...L/n/)+L-.:...+~~=~.!::J"""""'---;-..:I=.,,,<,-1=--__.5'--'l.l-"/6,'-"'-'/(l"'-/l,::;'/¥L."2=, or Province of

                ~ ' r Owner's Designee, Title Virginia CERTIFICATE OF INSERVICE INSPECTION

_ _ _ Date _ _ _f]_,.. I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State and employed by HSBI&I Co* 1,,,.,'-"£"==""_ _,_J

                                                                                                                                      ?JI' 0 le---* 19 9/

of f{tJ.rT 'Ford ) Cf: have inspected the components described in this Owner'.s Report during_the period q.1q- gj

to {,-(r?-'l J , and state that to the best of my knowledge and belief, the Owner has performed examinations and_.taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section XI.

By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures desc.ribed in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or.a loss of any kind arising from or connected with this i_n_s;:,_e_c_t_io_n.J.~----.:.. _ _* __i-"--'".,...,.~~~"----'=--'=""-------Commissions _ _ V_A__5_4_3__________________ Inspector's Signature National Board, State, Province, and Endorsements Date _ _ _ _ _....,7,_-.....(~b-_19 q(

1. Owner FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS Virginia Electric As Required by the Provisions of the ASME Code Section XI and Power Co, Oat, Ant51p6T 2. l _I. I '1Cf. I Nam, 5000 Dominion Blvd., Glen Allen, Addr-VA 23060 Sh~ 2X of LJ l4Y!I:: ~P,l /q I

2. Plam Surry Power Station Unit _ ___.,....__ _ _ _ _ _ _ _ _ _ __

Nam, P.O. Box 315, Surry, VA 23883 'lokRepair Na ,3'$0e/@ 2 S9 z:: ?P qL-5:t. Organization P.O. No., Job No., etc.

3. Work Performed by Virginia Power Type Code Symbol St1mp_.,.N-/~A-N1m1 Authoriz1tion No. _____.N~,_.JP,....__ _ _ _ _ __

1 P.O. Box 315 7 Surry, VA 23883 Explmion Oate _ _ _ _.. N"#'/....B - - - - - - - Add~

4. Identification of System _ _ _./i.......e...t<. c. ...-fa

                                                                       ......c_ __.C:.
                                                                                     ...-.........,.~
                                                                                                  ...-...a.....,./,

5. (al ApplicableConstructionCode B31.l 19~Edition,_N""'/_A _ _ _ _ Addenda,N-l, N-7 0

(bl Applicable Edition of Section XI Utilized for Repain or Replacements 1980W80

6. Identification of Components Repaired or Replaced and ReplDCGment Components ASME Code National Repaired,* StamPld Name of Name of Manufacturer Board Other Year Replaced, (YII Component Manufacturer Serial No. No. ld1ntifi!=ltion Built or Replacement or Nol J" NIJfS (R..tJSt3/ t/lVk/iJt:Ja!/V I N/A 2. -P,,c.,-sv - 2~s-, c. ll~l\NOll)II ~Plftab. ~o cfl/?PIAlHL J:AJC, Hf'~ PO~

r' f\lcJ,~ fROP/!C75 .!Ne. f,/'iJ3 b '"t Ii N/A 31Cfo1fS"-J 1990 ~PU\CBl\11-\i ~o VNk:~N tJtvkNDWN I~" ('JVT> I N/A "l.-P.,C.*.SV-~lc. Ull}\(~)I ~I) l.t\<:l:b NO c11Ro1N1Jt Wl> wr" Po,\t I~ /I NUTS f/(.0/)/)C/) :rllJc~. "])~0631- I N/A. 31 r 51- If-/ /1 '/tJ ~~(~11\~NT NO

7. Description of Work _ __,£... /a. . .c....e....'lp""'---/-"'. . .&. ......../_k...t:_i_,_..[t:J"'"J

                                       'j"'2"""'"'....                                                               ........~__...{ ....1:..;:2..::;...<.\_.r.:4:M=41_*.e.M~.c..i.;:,s~*--==(~~:;.ff:....,::}:..,__ __

8. Tests Conducted: Hydrostatic O Pneumatic O Nominal Operating Pressure S--

Other O Pressure _ _ _ _ _ psi Test Temp. °F NOTE: Supplememal sheets in form of lists, sketches, or drawings may be used, provided (11 size is B% In. x 11 in., (21 lnformll-tion in items 1 through 6 on this report is included on each sheet, and (31 each sheet ii numbered and the number of sheeu is recorded at the top of this form .

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

_J

FORM NIS-2 (Back)

9. Remarks - ~.....As<-=~~,__.£.-=-_ _.(._..o....QE-.~'---"(_t,.,.A:::;,...___:::,..__--"-----------------------

Applicabla Manufacturer's Date R1pom to be 1ttechad CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this Rt,eL/:ICf-1\lE,JT confonns to the rules of the ASME Code, Section XI. repair or replacamant Type Code Symbol Stamp_*_N_/_A_ _ _ _ _ _ _ _ _ _ _ _ _- - - - - - - - - - - - - - - - - - - - - - - - - Certificate of Authorization No __N_/_A_ _ _ _ _ _ _ _ _ _ _ _ Expiration Date _ _N"'"/_A ____________ Signed 'Arn'1a.. .;..I6I

           ?wner or Owner's DeslgnN, Title or Province of     Virginia
                                                   &16,io/ff-?                      Date _ ___,°o-=;.=,r"-..:a2"-'-/___ , 19 CERTIFICATE OF INSERVICE INSPECTION 91 I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State and employed by HSBI&I Co*                                                          of ft~,. Tfo .. d ) C. T                                                have inspected the components described in this Owner's Report during the period                        5:-f-9D            to     S:-/o.-9'-/                  , and state that to the best of my knowledge and belief, the Owner has pertonned examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section XI.

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

   -*-*_*_--*--_*~+---:'""----:--=:-_f_._~----""---Commissions_...,.V_A              __5_4_3_________--::-------

1nspector's Signature National Board, State, Province, and Endorsamentl Oate_ _ _ _...... ~~~-d:. .b--._19

                                      .            q/

1. Owner FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS Vireinia Electric As Required by the Provisions of the ASME Code Section XI and Power Co, Date Av l>>v"t>, .2. l I I Cj q I Name*

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

2. Plant Surry Power Station Unit _ __..._ _ _ _ _ _ _ _ _ _ _ __

Name P.O. Box 315, Surry, VA 23883 1o'oRep*tr No, o?i0<o10sig1-§?;4::ct1-6:2-Organization P.O. No., Job No., eu:.

3. Work Perfonnect by Virginia Power Type Code Symbol Stamp bl/ A Name Authorization No. _ _ _..,,N ....,,-tfl..________

P.O. Box 315, Surry, VA 23883 Expiration Date _ _ ___.N~/.i:A.________ Addrea

4. Identification of System _ _ _.8:....._*e,..o.._.._(.b_.~---'&""""'~:;.,c""'""......,rz'-l:'-----------------------

N-7

 ... 5. (al Applicable Construction Code           B31. l                    19~Edition,_..;N;.;./:...;A:=...._ _ _ Addenda, N-1.

(bl Applicable Edition of Section XI Utilized for.Repairs or Replacements 1980W80

6. Identification of Components Repaired or Repleced end Replacement Components ASME Codi National 'Repair9d, Stlms,ad Name of Name of Manufacturer Board Other Year Replaced, (Yes Component Manufacturer Serial No. No. Identification Built or Replacement or Nol I" Rob5 Cf?<J58,Y t/N K/IJ.OU>Al I N/A l*R.<=f>V -,ssl c... U11)1\tlO,clf l\t.Pl.AGb i"O J ROJ)S CffRblJVIJ /.. .:t'tJ1:> W(-:f:I

                               />RODlkiS ;]}\Jc., $}0Cf /, ':f'/-0 I            N/A PO ..

s:uq11--3 /11D ~~ IJ\CSl\&.\'T ~o i

I\ Rob.t ONkrutJWrJ VNkl\)CJCA.JN I N/A 'l-R.<..-'S,V-2.~I~ IINll\ba:li,1 "1:~ ll\C:Sb r-JO c/lR.PIN!JJ.,J:l,J 't> H'(# Po-.\'11

         /%" RODS             f Rot>VC75 INc.. Ee9=!2"1'                         I             N/R                            -:,3 lf. 'f5if,~3_                 J?'//          ~laC'E:1'\lNT          NO 11

7. Description of Work. __.,_&~~.,;t>""'-"&""""c"°""""J:;.,c___./'--_..&;c:......,/'-k,..,_f_.........t:..,.~=..{'z.._.:.f...:.l_2...,1,)~"'a.,.i.:;4UiL~-t:.tzut,1.z..L.f.:a.s--.!{...:.i:..i't~)~----

8. Tests Conducted: Hydrostatic O Pneumatic O Nominal Operating Pressure W-Other O Prassura _ _ _ _ _ psi Test Temp. °F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided 111 size is 8% in. x 11 in., (21 lnfom,a.

tion in items 1 through 6 on this report is included on* each sheet, and (31 each sheet is numbered and the number of sheets is recorded at the top of this form .

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

FORM NIS-2 (Backl

9. Remarks _ _ _......._fr,sµ~..:.....:E-=-__..Cro-

                                                  ......*=-__.O.......,,f>,
                                                                        .....~;,S=-__,_I_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __

Applicable Manutacturer'1.0at11 Raportl to be auached CERTIFICATE OF COMPLIANCE We cenify that the statements made in the repon are correct and this ~ conforms to the rules of the ASME Code, Section XI. repair or r11p1acament Type Code Symbol Stamp __N_/_A_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ Cenificate of Authorization No,_N_/_A_ _ _ _ _ _ _ _ _ _ _ _ Expiration Date _ _N__/_A _ _ _ _ _ _ _ _ _ _ __ Signed ~L orProvinceof

                                 '     :;::t:5I wner or Owner's Oe1ignu, Title Virginia E'.votAJlfL CERTIFICATE OF INSERVICE INSPECTION andemployedby HSBI&I Co.

Date _ ___,_Q.......,µ:;;+..L.*_ 0 I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State

                                                                                                                                       ....;)a.a...../_ _ _ , 19 C/1

of f-/o..'f' T Ford. J Cf- have inspected the components described in this Owner's Repon during the period 5:-(-t/O to S-/0 -9'/ , and state that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Repon in accordance with the requirements of the ASME Code, Section XI.

By signing this cenificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures d~cribed in this Owner's Report. Funhermore, neither the Inspector nor his employer shall be liable 'in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this in~~io_n.~£-- ~ Commissions __V_A __5_4_3________________

I napec:tor'1 Signature National Board, State, Province, and Endorsements Oate_ _ _ _ ~g'._.._.a.. . .b_19 q/
1. Owner FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI Vir~inia Electric and Power Co, 011t1_...._4_u=P..."1.... s,""'_,2-;;....;..1__

q .... i Cf...."1.......( _ _ _ _ _ __ Name 5000 Dominion Blvd., Glen Allen, VA Sheet ,1., of _ _'5_..._,- - - - - - - - Addr.. 23060

2. Plant Surry Power Station Unit _ _ _ _ _ _ _ _ _ _ _ _ _ _ __

Name P.O. Box 315, Surry, VA 23883 1ak No 3'6001058:~'7 @?~q(-5'/

Addre11 Rep1lr Organization P.O. No., Job No., ate.

3. Work Perfonned by Virginia Power Type Code Symbol Stemp N/ A Name Authoriz1tion No. _ _ _...,N..,/...A"---------

P.O. Box 315, Surry, VA 23883 Expimion Oate _ _ _........,N_,../.... 8.......______ Addrea

4. Identification of System _ _..... B.~e...,*n,...c....:b,1..=11:::;;;......;C..........

o o....\,...&:o""""--'+/-,___ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __

s. (al ApplicableConstructionCode B31.l 19E_Edition,_N~/_A _ _ _ _ Addenda,N-l, N-7 lb) Applicable Edition of Section XI Utilized forRepeirs or Replice'rnmts 1980W80

6. Identification of Components Repeired or Replaced and Replacement Components

Name of Component Name of Manufacturer Manufacturer Serial No.

Netlonel Board No. Other ld1ntifie1tion Year Built Rep1ired, ReplllCld, or Repl11e1ment or Nol ASME Codi StamPld (Yes t" NVTS CRo~e,y urJ ~tn.t., ~. I . *N/A ~-R(-SV~';l.';SH3 U~~NOICII -PJ...ftGb ~o C~R't>\tlAL ~b' \-\'t~ PO .. csr 1". N lJT5 P~blb~ lNt B\ i o(/\ I I N/A 3l~ 0'-\S -1 \~~o ~PLI\Csr.~1' r-:io

       \3ih N\)TS              UN~~                                 UN1<..~ew~

I N/A :t-~-~\J-',2S$"H3 UN\t~ "1::~ J.I\CS]) NO l'*'s NU.TS (1\1\'t>\~J:\L ~l:,

                            ~Ro~c,i;. ~t. j)~r.,{,"3'::J.          "'~                                 I        N/A.

Po-.t C'>Y 3\15'4'-\-\ \'1'\ 0 ~~t'E:11\1:.NT NO D \ \ \ ~ \% ,,

7. Description of Work _ _,f\c..-e-r~...,_o...c='-"'e,....c\..,,___,_ _,~,.._....__,2.___'""J'\""M"'"t .......

( "\. \ l J~eo.:xa\::i:*:=<.1.---1f..!ie:.i.d,.:..:C,~1,,,(-1.I~l...,,)f------

                                                                                                                             ,_:i,,,;:)..::;:,l\...i1-l-

8. Tests Conducted: Hydrostatic O Pneumetic O Nominal Operating Pressure ~

Other O Pressure _ _ _ _ psi Test Temp, _ _ _ _ _°F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided 111 size is 8% In. x 11 in., (21 lnforme-tion in items 1 through 6 on this report is included on each sheet, end (31 each sheet Is numbered and the number of 1heet1 is recorded at the top of th is fonn .

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

FORM NIS-2 (Back)

9. Remarks --+~.._S..,M;~t,,=--(o"""'-'DE-=;;...._..,,(.....,..LA-5=.......c::,..__---'---'---------------------

Applicable Manufacturer', Data Repom to be attachec:t CERT! FICA TE OF COMPLIANCE We cenifv that the statements made in the repon are correct and thisgi¥>t.Af Mf'.NI conforms to the rules of the ASME Code, Section x I. ~epair or rep1acement Type Code Symbol Stamp __N_/_A _____________- - - - - ~ . , . . . . . . . - - - - - - - - - - - - - - - - _...;.._ _ _ _ _ _ _ _ _ _ _ _ Expiration Oate _ _ N_/_A____________ orProvinceof Virginia CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel lnsPectors and the State andemployedby HSBI&I Co. of Ha..r- T fa .. l d er have inspected the components described in this Owner's Repon during the period r:- J-Cf D to S::- / D -'ft../ , and state that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's_Repon_in accordance with the requirements of the ASME Code, Section XI. By signing this cenificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations_ ~nd corrective measures described in this Owner's Report. Funhermore, neither the Inspector 'nor his employer insPec~io_n.~ t (1k shall be liable in any manner for any personal injury or propeny damage or a loss of any kind arising from or connected with this Commissions __V_A_5_4_3 ________________ Inspector'1 Signature National Boara, State, Province, ana EndorHment1 Date_ _ _ _ _ R __-..._i,___t __19 q)

1._ o.ivner FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI Viriinia Electric and Power Co, o,t, Aue,L)sr z.., 1 l'\C\ \

Name 5000 Dominion Blvd., Glen Allen, VA Addr- 2)060 Sheat _ ___.l.__ o f * - - . e . . . - - - - - - - - -

2. Plant Surry Power Station Name Unit _ _ ....,,.L-------------

P.O. Box 315, Surry, VA 23883 Rilpelr Or;anlzetlon P.O. No., Job No., nc.

3. Wortt Performed by Virginia Power Type Coda Symbol Stamp J\I / A Nam*

Authorization No. _ _ _.a;Na.,/µA.~------- P.O. Box 315 1 Surry, VA 23883 Expiration Date _ _ _-iN'>>>f-/.. 8~------ Addrea

4. Identification of System _ _**... R. . . .e. .n. ...c_+......(J.....r _...r...e...o....\....c.... X)........+/-.,______________________

A....

5. (a) Applicable Construction Code B31. l 19~Edition,--'N""'/;..;A""-_ _ _ Addende, N-1, N-7 (bl Applicable Edition of Section XI Utilized for.Repairs or Replacements 1980W80

6. Identification of Components Repaired or Replaced and Replacement Components

                                                                                                                               . '                                                                           ASME Codi' Rep1irwd,            Stamped Name of               Name of                              Manufacturer National Board               Other*                 Year              RepllCld,               ,v..

Component Manufacturer Serial No. No, Identification Built or Replacement or No)

        'II   f<.OD5           c~oc;.e, y                              U~\(l\)O~N                         I          N/A              <:"RC.-SV-lSSi B          U~~II0\011           "t. p IJ'l(J:b           KO

( ROt:>S CP,i\t) I N"F\\.. It-)1) ~1~ l~WCl'S ~c.. &e9<;, "l~o I N/A PO. csy 3l2.1rri --& \~io ~PLI\CBI\B.\T ~o i

         \! ,, \\_C)bS        U~~N"~N                                 "~~Newt-:il                                        N/A          2.-P-<.-S.\f-)~SIS       111,lll~              ~1)1.1\C:Sb              NO
           ~

CP.l~b\NR-L~!> \.\'t'-'I Po°* l?lis P.-ot::,s l>P-Ot>vcti;; ~c. seiq12'\c.. I N/R 33i; ':J.S't-3 l'\'11 ~J.&C~ll\~NT NO

7. Description of Work _ _ _f\ l J'\.._...:f-t~...\ .,.A.,.t.._e-=cl"--__,__ \ ...~...._ %,,

                                                                                           ~ ...\__...~--..1.0,..IJa...J:~S_..;l..~'Ll.;::;..:'-t~JL-..!::~==-:..."".:;e,.:::O.:~$-.:::.:..\'t=-*:::;J*

I f '\ I I ( -=----

8. Tests Conducted: Hydrostatic O Pneumatic O Nominal Operating Pressure B-'

Other O Prassure _ _ _ _ psi Test Temp. °F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1 J size is 8% in. x 11 in., 121 lnfom,a. tion in items 1 through 6 on this repo" is included on each sheet, and (31 each sheet 11 numbered and the number of sheets is recorded at the top of this form .

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

FORM NIS-2 (Backl

                                                  -0'.'::IE-

9. Remarks _ __,_P._;":>:a...a,..~"""£_'"""-__...C..................._c. . . M"-W,.,6..__.._\- - - - - - - - - - - - - - - - - - - - - - -

                                                                           £....

Applicabl* Manutacturar's Data Reports to ba attachacl CERTIFICATE OF COMPLIANCE We cenify that the statements made in the repon are correct and this ~ T conforms to the rules of the ASME Code, Section XI. repair or rep1acamant Type Code Symbol Stamp __N_/_A_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ Cenificate of Authorization No._N_/_A_ _ _ _ _ _ _ _ _ _ _ _ Expiration Date _ _N_/_A _ _ _ _ _ _ _ _ _ _ __

           !LmL. :rsr.

Signed 7:Yo~ar or orProvinceof Owna'r's Oasignff, Titla Virginia bv6/tJ(pg Date CERTIFICATE OF INSERVICE INSPECTION

                                                                                                                         <1tJ       -?L I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel ln,pectors and the State andemployedby HSBI&I Co.
                                                                                                                                                  ,19't'/

of d<Lr:t f,:..- I d Cr have inspected the components described in this Owner's Repon during the period ~- I- 9D to ,S:-/e, - ?</ -, and state thet to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's .Repon. .in eccordance with the requirements of the ASME Code, Section XI. By signing this cenificate neither the Inspector nor his employer makes any warrantv, expressed or implied, concerning the examinations_ ~nd corrective measures described in this Owner's Report. Funhermore, neither the Inspector nor his employer shall be liable in any manner for eny personal injury or propeny damage or a loss of any kind arising from or connected with this in~ec~io_n*.-~ !.~

    -----~r-:;...:a.~c:.==.::-=:-d:._"-""'-~"""""'"=-;:;;..;;:.-._ _ commissions __V_A_S_4_3                        _ _ _ _ _ _ _ _ _ _ _ _ _ _ __

7 I napactor's Slgnatura National Board, Stata, Province, and EndorAments O_A l Date_ _ _ _ ___..(l'--"-"'"'---19 -i c.,

1. Owner FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS Vininia Electric As Required by the Provisions of the ASME Code Section XI and Power Co, Name 5000 Dominion Blvd., Glen Allen, VA ShHt 1, of ~

Addr- 23060 t/N:.r l..

2. Plant Surry Power Station Unit _ __,3~8~0=0...!.l:.:0~!!u$~'.1. .fi...,__......r::IZ-(2;:J::::..,i._9..1.\i;;.-.:::5::.:.0~

Neme P.O. Box 315, Surry, VA 23883 Repelr Organization P.O. No., Job No., etc.

3. Work Perfonned by_..;V..:i:..:r:.cg:a.:i:.:n~1::.:*a::...:P:.;o::.;w:::.;e:.r=-------- Type Code Symbol Stemp NIA Nam* '

Authorization No, _ _ _.1,;Na,1µ!&~---.....:.--- P.O. Box 315, Surry, VA 23883 Explmion Oate _ _ ___.hl~/.,1;;AL..-______ Add,_

4. Identification of System _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __

s. (al Applicable Construction Code B31. l 19§1._Edition,__;N;..;..:...;/A=-___ Addenda, N-1, N-7 (bl Applicable Edition of Section XI Utilizid for.Repein or Replacements 1980W80

6. Identification of Components Repaired or Replaced end Replacement Components

ASME Code National Repaired, Stamped Name of Name of Manufacturer Board Other Year Replaced, (Yes Component Menufac:tu rer Serial No. No, Identification Built or Replecement or Nol

        \" N\JT5                  (fl.OSRY                                   u~~~~
                                                                                                !         N/A                            l -R..C:- SV~ ~5"S" I ~               ll~~N010M                  ~PL.A<J:b                     l'\O (fi~t:,\~PI-\. ~~                               ~,~                                                        PO~                 <.SY l" N\Yi.S             ,~~,~~(.                                        l\W,3b~           I         N/A                               3 i.9 01.\'S'- I                      19~0 ~~1.1\CB'tilt..\T                                ~o i

t\ ~v,s IJN~l>)E>Wl\l VNl(t..lO~., N/A .2-Rt.-W-:tSSII\) 11~\t~t,I II.Ell ll\CSb t-.30 (',s ,, Cllll\b \NA\. ::I.l\lt::, ~.,." Po,\ll t~Y NVl.S \>fl.CbUliS :rNc;, l>LiOb:."l I N/R 311-5':J-J.t~ I \'\ ~ 0 ~lJK'E:mENT NO*

7. Description of Work. _ _...D ~ \ &

n....t'"'-t"~\....A...(......d:,,..__..i..._.:,e_..._...l:1.,., 11 l~'~...__..,_'!'><.fJf....,'A' ..aS'-l..C.1. L.=:,.*..!...,! I , '""'<J.~i:l~r:A~-*

                                                                                                                                                                  \                                      I\'-.
                                                                                                                                                                                                   ?,!a....,-.J.J~------
                                                                                                                                                                        .:...V\!!:u:~:rl..s;2....~(...

a. Tests Conducted: Hydrostatic O Pneumatic O Nominal Operating Pressure ~

Other O Pressure _ _ _ _ _ psi Ten Temp. _ _ _ _ _°F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (11 size i1 B% in. x 11 in., (21 lnforma-'. tion in items 1 through 6 on this report is included on each sheet, and (31 each sheet ii numbered and the number of 1hem i1 recorded at the top of this fonn .

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

FORM NIS-2 (Backl

9. Remarks _ _.... A....5...,fv\-=£_=-___..C....'.fl....D=--E--__C,t....,.....,a.,_s~s~_.....,\..._____________________

Applicable Manufacturer's Data Repom to be attached CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this l<'EPl,flcE,ME,NT confonns to the rules of the ASME Code, Section XI. **Pair or replacement Type Code Symbol Stamp __ N_/_A-------------------------------- Certificate of Authorization No._N_/_A_ _ _ _ _ _ _ _ _ _ _ _ Expiration Date _ _N....;/_A _ _ _ _ _ _ _ _ _ _ _ __

                /¥1L Signed      I 1cQ.;;:;r or Owner's O**lgnn, Title

rsr p,J6,r,,(£?

CERTIFICATE OF INSERVICE INSPECTION Date -r I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel lnsPectors and the State or Province of Virginia and employed by HSBI&I Co* e< l , 19 9/ of ft'!rtT fo 1 CT rd have inspected the components described in this Owner's Report during the period S:- f-90 to 3"-/U -'it./ , and state thet to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section XI. By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable *in any manner for any personal. injury or property damage or a loss of any kind arising from or connected with this inspec~i(\ .. t1 -/- _J)* ~

   ---..ii~c..:a..~-=-:-----;J":-'=:--~...---------Commissions __V_A__S_4_3________________

imi,.ctor'1 Slgn*ture Natlon*I Board, Stat*, Province, and Endorument1 Date_ _ ___,._8'..... -~._.6.._-_ _19 C//

1. Owner FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS Vininia Electric As Required by the Provisions of the ASME Code Section XI and Power Co, Date Aurnus-r 2.-l, l9"\. I Name 5000 Dominion Blvd., Glen Allen, VA . Sheet Addr- 23060

2. Plant Surry Power Station Unit:--_.....=.J,~------------

Name P.O. Box 315,- Surry, VA 23883 1,,\, Na .3&0010ss3 5 12e~t--s::, Repair Organization P.O. No., Job No., etc.

3. Work Perfonnedbv Virginia Power Type Code Symbol Stamp r,1 /A Name Authorization No. _ _ _.....N:a.,,,-i(&c;,..._ _ _ _ _ __

P.O. Box 315, Surry, VA 23883 Expimion Date _ _ _ _,.,N..,./.A..._______ Addraa 4, Identification of System _ __.B. . .mc

                                                   . ....*....to'"""""c-~C....rx"-'o~\1,1.0\1>,.0 -l-~------------------,----..--
 ... 5. (al ApplicableConstructionCode B31.l lbl Applicable Edition of Section XI Utilized for.Repein or Replacements 1980W80 19~Edition,_N_/'-'A~_ _ _ Addenda,N-l, N-7

6. Identification of Components Repaired or Replaced and Replacement Components ASME Code

                                                                                                                                                                   ' Repaired,       StamPad Name of                  Name of                         Manufacturer National Board                  Other              Year             Replaced,        ,v..

Component Manufacturer Serial No. No. Identification Built, or Replacement or Nol 1" ~ot)S C.Ro~i?Y UNK~eu:illl I N/A 2-ll.c.-~v.:. :>ss \1\ Ulll~t!Cv.,11 ~PIJ'Kl:b . ~o CP.f-1..~ ll*.l I\ l ~b \,\1~ PO'* CC,Y l" P..c t:> s iROWCT'i. I~t.. 80<:!f.+.a+O I i N/A 31i~:n.-~ 19~0 ~PIJ\CSl\&.\'T ~o

         \ ~ II  (:\.Cl t:> s   1/Nj,:l\lOLA!lN                        01'111:.t-lci\X\N I     N/A            H\t-~1/-lSS.I ~        ll~lt~t,1         11.1:~ J.f\~b       NO
              ,,              C~ru:>\N Pi L .I.t-:1:t) l-\1,t\                                                            Po,1       c.c,1
        ,:v~     &JDS           f'~~s ~c.. %8lA \:i~                                                  I    N/A.            .3:ll Cj l-'f - 5        li~o         1'a.LhC1::1'1\'=.NT    NO

(') \ \ \ I/ ~ \%/I b C " t ( \

7. Description of Work _ _.._l'\~e"'i"~-"g""r._.P...,d,....___;_L--~~;,--'--c..J.!!L----1.:C_..O_,..gl..i?~..:\~'2'-J'--...J~~"'-[A.J......JIQCl.\!.JJ.:.l+/-..!:S.__~1~L\-..:I....l-------

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

Other O Pressure _ _ _ _ _ psi Test Temp, °F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (11 size is 8% in. x 11 in., 121 lnfonN-tion in items 1 through 6 on this repon is included on each sheet, and (31 each sheet 11 numbered end the number of sheets is recorded at the top of this fonn .

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

FORM NIS-2 (Backl

9. Remarks ~s~ (;6pE:,. C1 .A:::;;/S I Applicable Manufacturer', Data Atpom to l>e attached CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this ~!-tnE.Nf: conforms to the rules of the ASME Code, Section XI. repair or reo1acament Type Code Symbol Stamp __N_/_A_________________________________

Certificate of Authorization No __N....;./_A_____________ Expiration Data _ _N....;/_A _____________ Signed orProvinceof

                     ~~1M1Jt.,c:             1 ::C.sT bvt;,M~
                    ~;,;.;orOwner'1 Deslgnu, Title Data _ ___.(2....,,.,..,.c}'l-'"'--<il_._.f~---* 19 CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State Virginia                    andemployedby HSBI&I Co.

9(

of Hct~T'Fo ... d J c+,' have inspected the components described in this Owner's Report during the period S:- / - '16 to 5-J O - '1 t/ , and state that to the best of my knowledge and belief, ttie Own.er has performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section XI. By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, *concerning the*, examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable 'in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this

                  ~         - ~<-*__,

i_n_sp_ec_*-~-io-1-n_._,*.. ..;...--:---:-f_,:=:-~=:-*-*---'c.-----Commissions __V_A_...;5_4....:.3________________ 7 I nspec:tor's Signature National Board, State, Province, and Endorument1 Date_ _ _ ____,~..._-__ i""'---l_19 Cf.,!

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

   , . Owner      Virginia Electric and Power Co, Nam*

5000 Dominion Blvd., Glen Allen. VA Sheet _ __.l..__ of _ _...:l=----------- Addrea

23060

2. Plant Surrv Power Station Unit _ _ _...._._ _ _ _ _ _ _ _ _ _ _ _ __

Name P.O. Box 315, Surrv, VA 23883 Addrea Repair Organization P.O. No., Job No., ate.

3. Work Performed by_...,;\....;ri;;..;ra.g=i-"'n;.;;i_aa.....;P;..o.;;;.w.;.;..;;:ec.::r'-------- Type Code Symbol Stamp _NUL.,t:/..1A1.-_______

N*m* Authorization No. _ _ __,_,NLt/~A;i...._______ P.O. Box 315, Surrv, Addrea VA 23883 Expil'llltion Date _ _ _ _.... N~;.a~-------

4. Identification of S y s t e m - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -

s. (al Applicable Construction Code B3 l. l 19~Edition,_N;.;..:_/.;:.;A:...__ _ _ Addenda){- l ~-7 (bl Applicable Edition of Section XI Utilized tor Repairs or Replacements 1980W80

6. Identification of Components Repaired or Replaced and Replacement .components

                        ...                                                                         .~ ' .

I Name of Component I Name of Manufacturer t

I Manufacturer I I Serial No. I I i National Board No. Other Identification .. Year Built Repaired, Replaced, i 1 ASME Code stamP9d (Yes or Replacementt or Nol I l I ! I

  '                          1* V~LR-N                                                                                                                                                        I
  '         sn.n:)s          I                                 I Ut-' l<t.Nb-U,l':l I                                N/A          c<. - C.I{-309            !ll 11.ll\NClllN   ~P~l:)         /   ~o    I
                             , ~t}\\.lf'IL. ~'t), 1-\"f ~                                                 I                   *1 PO~ CS)'

f'>P.cbocrc:. ::cNc.,1 8'6l\":\-2.~~ I N/A "5 '31.\. 't Slf-'2.

I ' I VN>KNOWN I Vt..:l\c.11.)e-t,.:,N Ii N/A I 1-C.I-\-?. 09 I1/NlC\,lo,lt.a 11.EH~Cl:b NO

   ;         ~UTS                                                                                                                                                                             I li                         I pct.~ BIJ9~~                           1-1 r.tfl                           )

N/A IPo,\1 csy I . ~PJJKE:1'\~l-t'rl NO I N UTs. ..,,- I ::C/JC- I RN t.:¥ 2. 32.~'2..~8' 19'1) i I i I I .i I

                                                  ....c..,e,,-...,;Jc:..........;C,...,la.:::'.l.,_\~n...1,,o:.}-t'

7. Description of Work _ _....,R...,,:e"\'~'""\o, ~~-&=--~c..1.1rL"-:')"--~s..l.t;~J~.;;:e:,~~(....3..:./.....!4-_'~')-----

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

Other O Pressura _ _ _ _ _ psi Test Temp. *F NOTE: Supplememal sheets in form of lists, sketches, or drawings mav be used, provided (1 l size is SY.. in. x 11 in., (21 informa-tion in items 1 through 6 on this report is included on each sheet, and 131 each sheet is numbered and the number of sheea is recorded at the top of this form . (12/821 This Form (E00030) mav be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017

FORM NIS-2 (Backl

9. Remarl~~E.::.,-==----'(,_,.1_£6'-'-""6...,__---<;L=-----------------------~~

Aoo1icao1e Manuracturer's Data Aeoorts to ce attachea CERTIFICATE OF COMPLIANCE We cemtv that the statements made in me recort are correct ana this ~ & I T : contemns to the rules of the ASME Code, Section x I. reoa,r or reou,cement NIA Type Code Symbol S t a m P - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Certificate of Authorization No __N_/_A ______________ Expiration Date _ _N_/_A______________
~~~ wneff' ~~~
~~Signed :;:r.,;r or Owner*s oJsignee, Title Date _ _a......,'fj'f-'-"--~~*~~----, 19 9/ CERTIFICATE OF INSERVICE INSPECTION~~
1. the undersigned. holding a valid commrssion issued by the National Board of Boiler ana Pressure Vessel Inspectors and the State orProvinceof Virginia andemo1oyedbv HSBI&I Co. of
_ _ _ _ _ _ _ _ __,fl.....,tl=t_T_,__.fe-=-_~_J=..1.__C=---'f'--'-,- - - - - - - - - : - - - - - - - ~ave i nsoectea the components descnbea in this Owner's Reoort during the ceriod _ _ _ _ _ _ _t;:.._-_._/_-__.Cf._D=---to_....... )~~_._/_0_---'"9_cf..._______, and statll that to the best of mv Knowledge ana belief, the Owner has perlomned examinations ana taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section XI. By signing this certificate neither the Inspector nor his employer makl!$ any warrantY. expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shalt be liable in any manner tor any personal injury or property damage or a loss of any kind arising from or connected with this insoec~£ ~ Commissions __V_A_5_4_3_________________ rnso~or'1 Signature National Boara, Stata, Province, and Endorsement* Date,_ _ _ _ i_-_j.~&'__19 q f
~~FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI~~
~~1. Owner Virginia Electric and Power Co, Date _ __,,Ti,1..1,..J.1,=L..:I./L--~k=-'-f.!...+l....._/9...,__Clul'-------~~
~~Nam* 5000 Dominion Blvd., Glen Allen, VA Sheet _ _.,,l,.__ of _ __,l=---------- Addrea 23060~~
2. Plant Surry Power Station Unit d ,.1,-.,1"' 1 0 9.';5Lf.6' ~
Name P.O. Box 315, Surry, VA 23883 Sak Na 32>00+/-§31-5:, /2-f2:P"Jl-'f1 Addrea Repair Organization P.O. No., Job No., etc.
3. Work Performed by Virginia Power Type Code Symbol Stamp N I A Name Authorization No. _ _ _.....,N..,/...e,......_______
~~P.O. Box 315, Surry, VA 23883 Expiration Date _ _ _ __.N,,...,_/....8.1...-_______ Addrea .~~
4. Identification of System _ ___,S=-ul:)... f 4f_T.._y+--_I.-:..N......_U~C"-:-f....a....L\=O..:.N-=---------------------

5. (al Applicable Construction Code B31. l 19~Edition,_....;N.:../.c.A;....._ _ _ Addenda, N-1, N-7 Code Case (bl Applicable Edition of Section XI Utilized for Repairs or Replacements 1980W80

6. Identification of Components Repaired or Replaced and Replacement Components
~~i I~~
Name of Component I Name of Manufacturer II Manufacturer Serial No. I I National Board No. Other Identification Year Built Repaired, Replaced, ASME Code Stamped or Replacement or Nol (Yes I 1:) liR lJ N" 6, I N/A )~'6 Iu ~o r I .l- SI- ~PIJ\Cl:b STUt:,S I UNKNoWN llll\NOlllN cs'f ,
8.
o~
STUDS .:n:.. -:L ~ C. 7 ~9~:2.5 I N/A 3 I 5o:s 2-~ 11 ~ ~ (J ~?~ct.\, ~o i
; *VN'tN~N II NO I /'J lJT)
CA-P.,PINft.L :tNb. I vN\.:roOWl\:I N/A .2.-SI-1~% V~lt"10.l:l1'1 P.EHf\CEl:) Hi-=il i Po,\'t cS.)-" li N01.) f'fl.O bVt:H ~Ne ei, ':f-53 I N/A. .316""033"-/ /'l'itJ ~P~tl::tt\~NT NO I I
~~7. Description of Work _ _ _ C\Ce="-"o\~_. .n.....!A:.u+/-.._s........,L=....,..;ll,"'---'\__&"-"-.......s!-+~k\!<:l..J,;Jl.!;s...::._.....:C~1..!::~:....Ji.1.-_ _ _ _ _ _ __~~
~~B.,.e"'fp'""l~~
8. Tests Conducted: Hydrostatic O Pneumatic O Nominal Operating Pressure g-Other O Pressure _ _ _ _ _ psi Test Temp. °F NOTE: Supplememat sheets in form of lists, sketches, or drawings may be used, provided (1 I size is 81.i in. x 11 in., (21 Informa-tion in items 1 through 6 on this repon is included on each sheet, and (31 each sheet is numbered and the number of sheets is recorded at the top of this form .
(12/921 This Form (E000301 may be obtained from the Order Dept.,ASME,345 E.47th St.,NewYork, N.Y.10017
FORM NIS-2 (Backl
~~9. Remarks ----=A~S"'-'M-'-'---f:_...,..._Q..,.-Ol?"""""...~~
rE.."--'fu=*'"-"SS=-_ _.__ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _-'-_ APPiicabie Manufacturer's Data Reports to oe attachea CERTIFICATE OF COMPLIANCE We certify that the statements made in the reoort are correct and this REf'.i.flC,fMEAl[ conforms to the rules of the ASME Code, Section XI. repair or rec1acement Type Code Symbol Stamp __N_/_A __________________________________ Certificate of Authorization No. - -N/A --------------Expiration Date N/A ---------------- Slgoed orProvinceof
~,';,3""'?:,s;f,,
~~CERTIFICATE OF INSERVICE INSPECTION Oate---.0fj,,..t:;:;::;;.,.;'"'--....-::0;.:...,..L/_,;_ _ _ ,~~
~~1. the undersigned, holding a valid commission issued by the National Board of Boiler ana Pressure Vessel Inspectors and the State~~
~~Virginia andemployedbv HSBI&I Co.~~
~~1.9 ?1 of~~
-------tfl-F4="~:-r~fu~"~o\=-:,,.....0=+"~-----------::=:---:--;;---:=---~ have inspected the components describeO in this Owner's Report during the oeriod _ _ _ _ _ _ _..,q,.__ ......._to_...6. . .-.. .l_.~ !'2 ..___/..,'.f. . . . . ...---'Cf'-'-(------., and state that to the best of mv knowledge and belief, the Owner has oerformea examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section XI.
By signing this certificate neither the Inspector nor his employer makes any warranty, expresse*d or impl.ied, concerning the examinations and corrective measures described in this Owner's Report .. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspectior0)_[ _J)* /,) /\
~~----~-"---""--'"-----'i.:.""-::7"""~~,CC.,'"-'"'-"~-----Commissions __V_A_5_4_3___________...,..._____~~
~~Inspector's Signature National Boera, State. Province, and End.orsem11nt1~~
*oate_ _ _ _ ~7~-j__4~_19 q(
~~FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI~~
1. Owner Virginia Electric and Power Co. Date :::r\ /LY .3D I IC{ q I Name 5000 Dominion Blvd., Glen Allen, VA Sheet _ _~_of \
~~Address 23060~~
~~2. Plant Surry Power Station Unit _ _ _ _Z.,, _ _ _ _ _ _ _ _ _ _ _ _ _ __~~
Name f::-12-,# Cl 1-4 ~ P.O. Box 315, Surry, VA 23883 wo~/Ds5la l I Ei~e..cro-370 1 -Pfi-()2, Address Repair Organization P.O. No., Job No., etc.
~~3. Work Performed by Virginia Power Type Code Symbol Stamp_-PL-'----------~~
~~Name Authorization No.-----'-"-'-""---------- P.O. Box 315, Surry, VA 23883 Expiration Date _ _ _ __ _ , ~ ~ - - - - - - - - Address~~
4. Identification of System S&e.-v1ce. l,J/\--T.£.12.._

5. (a) Applicable Construction Code B31. l 19~Edition,_N~/_A_ _ _ _ Addenda, N-1, N-7 Code Case (b) Applicable Edition of Section XI Utilized for Repairs or Replacements 1980W80

6. Identification of Components Repaired or Replaced and Replacement Components
~~Name of Component Name of Manufacturer Manufacturer Serial No.~~
~~National Board No. Other Identification Year Built Repaired, Replaced, or Replacement ASME Code Stamped (Yes or No)~~
~~/1 tt" ~ e," Lt,U..~~
~~Z-$1,./ PP-f>'l,f5c.. 0 (/µ.L,,lD 0 rJ U,v4JD IA.) ,.J AIIPr-~~
2 ~ -fP- ml'Sc.... 111, v.J(J ,I, I ~MP-"'r> N,0 z ..;;w -{>1,1>\I-I' 'i.l "'STIX::>=:, UA.flt.t..ll'>kJ,J UM,<NOI.JN Mfr 'U><-t fl. J /3, 0, p U~...J /2fi'~ }J.o
/J-U,,"- /.l-PO*- 3"5'7'0:L'1 JJ-19'1/ ,, 1 ,~'!> r2.0000S' \' '*
1
'STUDS iJOvA Bt: 6 1.....~ 11-rrJ. e11z~i.. /ll/A- 8Gipo"'- If /309L $q /'lf)7 ~~ /./o ,, j--StAi- (\,I w- \lLj I-it.XS 1 J, v- roc.)1,./ UtX-tJowoJ vl!t- ;).o<-1 />-,d..C,D 1/1,/tri!Dw,J f%PlAc.e_.p, IJO ~1.,;A{., CAIT' ~2-772'1 C.. -to"' ,t,,'l'i'i B {Y1'1B'I ,8/?>t;<'/
~~1t 1,.( 1'1 t.,tS IH./l;J .1¥, If( 7.J"/tJ(, AJ//1- /1-t,, -fr)"' 33 7/ 2. 7 Nn 1'1'1/ , m ~ ;Jo~~
~~7. Description of Work 'J?6efu1Zfn) rtvz!V/>> ! ~ A l !116 /3efm,7ll'{m 'WE#>lf:,t//,:.pe-P . ~ w , { I , tiJ¥',/qz_. lfk0~,1~~
~~~ [3r,Jsrr.u.f' [j,,.o] f\klr5 ' ,~~
8. Tests Conducted: Hydrostatic D Pneumatic W"Nominal Operating Pressure D Other D Pressure psi Test Temp. °F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is SY, in. x 11 in., (2) informa-tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form .
(12/82) This Form (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017
FORM NIS-2 (Back)
9. Remarks -+/}5..L.."1!.'-'-,f11.....cf;_.c.,::.._._a...c:"'"""a£'""--'-Q4"A5'--'--$,.___,,_3..___ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
Applicable Manufacturer's Data Reports to be attached CERTIFICATE OF COMPLIANCE /?ef'#? 177'.0 We certify that the statements made in the report are correct and this ~ conforms to the rules of the ASME Code, Section XI. repair or replacement Type Code Symbol Stamp __N..:/_A __________________________________ Certificate of Authorization No. _N....;../_A_____________ Expiration Date _ _N_/'--A_____________ Signed VmL,
~~)~Gr or Owner's Designee, Title ;TSL £#(?{Alf¥=?-~~
CERTIFICATE OF INSERVICE INSPECTION Date----,,;%;,__;;--....,d~/_ _ _ , 19 I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State 11 or Province of Virginia and employed by HSBI&I Co* of
-------1-H--<-=Ct"'-'-,t-'i......_f..,.<J'-"'-=d~.'--C"'-T'-------=---.....,,=-----"""have inspected the components described in this Owner's Report during th~ period 9:- f~- fc1 to 6 -( f-9 / , and state that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section XI.
By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspection. ( ) ~~ . /). 11)1 Af _____,'. .i.&. . ~~"'-~---J.- Inspector's Signature
*-~~-.,~~~~~~-Commissions _ _ V_A_._5_4_3_________________
~~National Board, State, Province, and Endorsements Date~~
~~--------='---=----- rp. . b- 19q f~~
~~FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI~~
~~1. Owner Virginia Electric and Power Co. Date -:::!71 b'{ .'.3c, 1 ) 9ct[~~
*Name 5000 Dominion Blvd., Glen Allen, VA Sheet _ _ ___._of__,_1_ _ _ _ _ _ _ _ _ _ __
~~Address 23060~~
~~2. Plant Surry Power Station Unit ;2__,~~
Name P5 - u:i. P.O. Box 315, Surry, VA 23883 c.w'2.-'1o*S>-n) Address Repair Organization P.O. No.,
~~3. Work Performed by Virginia Power Type Code Symbol StamP----f'J..J.t:!'-------~~
~~Name Authorization No. - - - - - - ~ . l i . - - - - - - P.O. Box 315, Surry, VA 23883 Expiration Date _ _ _ _ _ _....;.:~c::L._ _ _ _ __ Address~~
4. Identification of System si;;.i2-v IC S \;J ITT~~

5. (a) Applicable Construction Code B3 l
~~1 19§1_ Edition,_N-"-/_A_ _ _ _ Addenda, N-1 , N- 7 Code Case (b) Applicable Edition of Section XI Utilized for Repairs or Replacements 1980W80~~
~~6. Identification of Components Repaired or Replaced and Replacement Components~~
~~Name of Component Name of Manufacturer Manufacturer Serial No.~~
~~National Board No. Other Identification Year Built Repaired, Replaced, ASME Code Stamped (Yes or Replacement or No)~~
~~"C.." l.-11'1,E.~~
~~INA-t....- 51'1-1~~
%1'\.MJW~'-(
1112, Ut-&1~owr,.i 31/' -1...is-1.;i 3-0:i Hr#, poiL ' 1'2.," ur-S C 318'5"!1 -"l
~~7. Description of Work f1?e&PFe:P Firttbtr~{rnte.£cs10,,1 l(t& f'.tA&TJNbi, v.J&& Bt.1/l-DLP 1 CWZtl!c:P!M!> 1twft>2.. idi0011.,47!1Altr,,~~
~~~(ft~ L"I J 'c,'J1,tf'_;, / G'o] N LtS~~
8. Tests Conducted: Hydrostatic D Pneumatic D Nominal Operating Pressure g-Other D Pressure psi Test Temp. °F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is SY. in. x 11 in., (2) informa-tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form .
(12/82) This Form (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017
FORM NIS-2 (Back)
~~9. Remarks -........C--45'""""-'-fl'.l-"£=---a~oo~E.----'=C'-"'e,,45'-'-=-s"--.3 Applicable Manufacturer's Data Reports to be attached CERTIFICATE OF COMPLIANCE gcpn,.,e.... t9t<£>~~
We certify that the statements made in the report are correct and this gEP{NE/'1EtvT conforms to the rules of the ASME Code, Section XI. repair or replacement Type Code Symbol Stamp __N_/_A _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ Certificate of Authorization No;_N_/_A_ _ _ _ _ _ _ _ _ _ _ _ _ Expiration Date _ _N-'/_A _ _ _ _ _ _ _ _ _ _ _ __ Signed L;,{~Ac?ct'= ,
"'1t.,,;;,.;owner's Designee, Title £SL G/6,111£.EL CERTIFICATE OF INSERVICE INSPECTION , b---d--+/---, 19 Date--....;tJz;oJ...
c,==* I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State 9/ or Province of Virginia and empl~ed by HSBI&I Co* of H0. t 1( Ff> Y' d. ) C.. I*, have insi:1ected the components described in this Owner's Report during the period 'j~f'f-SJT to /,-f'J-C{/ , and state that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section XI. By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this
~~-,----:-!.-=-:'--~~--------Commissions_...,.,V_A__5_4_3 i-n-sp-ec-t-io_n..,G1Jd='--"'--~- __________________~~
~~Inspector's Signature National Board, State, Province, and Endorsements~~
~~FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI~~
~~1. Owner Virginia Electric and Power Co.~~
~~Name 5000 Dominion Blvd., Glen Allen, VA Sheet _ _ _. , _ _ o f _ ~ - - - - - - - - - - - Address 23060~~
~~2. Plant Surry Power Station Unit ----'2,..-"----------------~~
Name PL-1- P.O. Box 315, Surry, VA 23883 \,JD t+/-- IDS"9/e I I Ew'2.-C;D- ~1 D , WCft - 4'f Address Repair Organization P.O. No., Job No., etc.
~~3. Work Performed by Virginia Power Type Code Symbol Stamp_..i..:....:....:__ _ _ _ _ _ __~~
Name Authorization No. _ _ _ _.........___ _ _ _ _ _ __ P.O. Box 315, Surry, VA 23883 Expiration Date _______,_.__ _ _ _ _ _ _ __ Address
~~4. , Identification of System ?EevtcE.. b//l'rE?-~~
~~-~~~='-'~~~-----------------------------~~
5. (a) Applicable Construction Code B31.1 19~Edition,_N---'-/_A_ _ _ _ Addenda, N-1, N-7 Code Case (bl Applicable Edition of Section XI Utilized for Repairs or Replacements 1980W80

6. Identification of Components Repaired or Replaced and Replacement Components
~~Name of Component Name of Manufacturer Manufacturer Serial No.~~
National Board No. Other Identification Year Built Repaired, Replaced, ASME Code Stamped (Yes or Replacement or No) ( I "C-" WNE. uc.....11 L.{q, 7.L.,, r -PP- fYfl ~(!., UNl!No~,\ 1 l.,, ., _,_;., AIIA- ,~- .... ~ l),1v. o,,,./ '12Ep.41p.=-,. /Jo
~~7. Description of Work Pt:t:n,((,~~
~~I Ice, /2J?Q§IDN furuf?£d> WA: IJR o 13 ~ t 011e frN a tze-<Now It RNp/,,g.~~
~~µyo/U:>IA~ 1 StWPet.,/-;,(lf,:,.~~
8. Tests Conducted: Hydrostatic O Pneumatic O Nominal Operating Pressure 0 Other O Pressure _ _ _ _ _ psi Test Temp . ...,...._ _ _ _ _°F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is BY:. in. x 11 in., (2) informa-tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form *
(12/82) This Form (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017
FORM NIS-2 (Back)
~~9. Remarks _"""/ts--"=-M--'....£-"--~C=oo-E_ __,,_C....Jdt'S="'--'<<oos~_3=------------------------~~
Applicable Manufacturer's Data Reports to be attached CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this f2E.ep,g__ conforms to the rules of the ASME Code, Section XI. repair or replacement Type Code Symbol Stamp __N_/_A __________________________________ Certificate of Authorization No. _N_/_A_____________ Expiration Date _ _N_/_A_____________ Signed er).
~~~ , -.-~, '-+- u..L-wner'oOwner'~ Designee, Title f:::r.;h(NF,Q?~~
CERTIFICATE OF INSERVICE INSPECTION Date ---'~""'""°"~=,_...___.3......._.().,_____ , I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State 19 _9. . . .t.__ or Province of Virginia and employed by HSBI&I Co* of tfttrtFo"dJ ct, have in~7ted the components described in this Owner's Report during the period _ _ _ _ _ _ _~q.._-.......:../...,'1'"""-....~--Cf._to 6-/g- , and state that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section XI. By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this i_n_s_p-ec-t-io_w-ll*l-"'
~~.....;:_--:---'-*--:--=~~---------Commissions _ _ V_A__5_4_3__________________~~
~~Inspector's Signature National Board, State, Province, and Endorsements Date_ _ _ _ _..... P_---=d-..-'--_19 'f /~~
~~FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI~~
~~1. Owner Virginia Electric and Power Co, Date _ _ 7~,r/3~0-1/~9.,_._/_________~~
~~Name 5000 Dominion Blvd., Glen Allen, VA Sheet _ _ _~ _ o f _ ~ - - - - - - - - - - - Address 23060~~
~~2. Plant Surry Power Station Unit _ _ _~2...,~------:----------~~
Name p 2..-{),Z., P.O. Box 315, Surry, VA 23883 No-#105%1 *[)r!E. 90-Slo ~I-L/3 Address Repair Organization P.O. No., Job No., etc.
~~3. Work Performed by Virginia Power Type Code Symbol Stamp _ _. . . , , , . ~ - - - - - - -~~
~~Name Authorization No. - - - - - - - i . µ __ _ _ _ _ __ P.O. Box 315, Surry, VA 23883 Expiration Date _ _ _ _ ___,<>.1.1-P-------- Address~~
~~4. Identification of System __ '7~~
~~___[""l2..='-v,~c~E-~-lr...M~TE~/£-~~
5. (al Applicable Construction Code B3 l. 1 19§1__ Edition, __ N~/_A_____ Addenda, N-1, N- 7 Code Case (b) Applicable Edition of Section XI Utilized for Repairs or Replacements 1980W80

6. Identification of Components Repaired or Replaced and Replacement Components
~~Name of Component Name of Manufacturer Manufacturer Serial No.~~
~~National Board No. Other Identification Year Built Repaired, Replaced, ASME Code Stamped (Yes or Replacement or No)~~
/\I t-1011. Fv.,ea-. ,v,...,~~ -;ir. -ws-12---1-;o D /Jo,, Fv""-r. 1/ik.£ 11 3~ -1AIS-1Z/--tb ~ot,1 '!;°u,.a. 1/Al.vE..
~~3(.. "-\IIS-12.HD~~
~~8. Tests Conducted: Hydrostatic O Pneumatic O Nominal Operating Pressure ~~~
Other D Pressure _ _ _ _ _ psi Test Temp. _ _ _ _ _ _° F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is BY:, in. x 11 in., (2) informa-tion in items 1 through 6 on this repon is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this fonn . (12/82) This Form (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017
FORM NIS-2 (Back)
~~9. Remarks _P,i;.i...,.S""M..-'-"-'-£..=---'c""'J"J'-'""'l'>E'--"--___,_(;...+bJ:1A?:..<-S"---."":=i"'--------------------------~~
Applicable Manufacturer's Data Reports to be attached CERTIFICATE OF COMPLIANCE f2ePll11!- f}M) We certify that the statements made in the report are correct and this /?YlAC(;./11{3{'{( conforms to the rules of the ASME Code, Section XI. repair or replacement Type Code Symbol Stamp __N_/_A __________________________________ Certificate of Authorization No. _N_/_A_____________ Expiration Date _ _N_/'-A_____________ Signed (,;(cm}L r?wner or Owner'~ Designee, Title ISL bv6111!££?. Date---~,¥'""'7--,5)=..cc......_ _ _ , 19_9~/~-- CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State or Province of Virginia and employed by HSBI&I Co* of Ha.'r"T f'D r J c1, J have ins7ected the components described in this Owner's Report during the period _ _ _ _ _ _ _lj,_-__._J_.1""-_,,[/J_.._j__ to b-a- '1 ' and state that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section XI. By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or imp Iied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspection. n j__ _____(%..,.__~~':-----,-~-'....__*__ I nspector's Signature
~~~--=~---Commissions __V_A_5_4.,.3~---------------~~
~~National Board, State, Province, and Endorsements Date._ _ _ _ _ _ _ f_-_cl__ 19 'f /~~
~~FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI~~
1. Owner Virginia Electric and Power Co. Date --=r-uu{ 29, 19 ':l I Name 5000 Dominion Blvd., Glen Allen, VA Address 23060

2. Plant Surry Power Station Unit _ _~ L = - - - - - - - - - - - - - - -
~~Name~~
~~'f/* v~~~
P.O. Box 315, Surry, VA 23883 wo-t*- 1b 5 q le I Eld e.-tbql) - 3]D ?-1?*1'01-4 L Address Repair Organization P.O. No., Job No., etc.
~~3. Work Performed by Virginia Power Type Code Symbol Stamp _ __,.,._,.P...-------~~
~~Name Authorization No. - - - - - + > J - f ' - ' - - - - - - - - - P.O. Box 315, Surry, VA 23883 Expiration Date _ _ _ _ _-f'"'-;+-'-------- Address~~
4. Identification of System_-~""""=V..,i""C..."'E;.""--_,\'"'g.._.A-'-TEJ2..'-""CL...C----------------------------

5. (al Applicable Construction Code B31. 1 19§1__ Edition,_N-'-/_A_ _ _ _ Addenda, N-1, N-7 Code Case (bl Applicable Edition of Section XI Utilized for Repairs or Replacements 1980W80

6. Identification of Components Repaired or Replaced and Replacement Components
~~Name of Component Name of Manufacturer Manufacturer Serial No.~~
~~National Board No. Other Identification Year Built Repaired, Replaced, ASME Code Stamped (Yes or Replacement or No) 1vo~~
~~7. Description of Work 'f?Ee11illQ ftrrw6 lcoMtJ?Ja4/~~
7
~~/M WEtD ISt>>?iX!P &VP 6,e,JI/P!Nr:, ,&..,4K&'> f2rt Zs~ ~/~;z J.IYP/ZO/.AZ.1N'tri I SR11.P8t¢,TIJ6t ~~] /./,;/TS~~
~~8. Tests Conducted: Hydrostatic O Pneumatic O Nominal Operating Pressure ~~~
Other O Pressure _ _ _ _ _ psi Test Temp. _ _ _ _ _ _°F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is BY:. in. x 11 in., (2) informa-tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form . (12/82) This Form (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017
FORM NIS-2 (Back)
~~9. Remarks -~-.L..AL.-2<<.ifV/--=£-_ _,a=o=D:....fi-."'---+C,,.-1'""'--AfCL..L..S<<....-_3~------------------~~
Applicable Manufacturer's Data Reports to be attached CERTIFICATE OF COMPLIANCE)?6,P1we. A-f..tp We certify that the statements made in the report are correct and this ge-Pw,u;,"4£:N'r conforms to the rules of the ASME Code, Section XI. repair or replacement Type Code Symbol Stamp __N_/_A __________________________________ Certificate of Authorization No. _N-'-/_A_____________ Expiration Date _ _N_/_A_____________ I Signed ( _;) ~ (l?4.., IS T Date _ ___,_9...p,a~-==-,,'-----'--,:5,0...:...._ _ _ , 19 '.z I
~;;;.;;r Owner's D~ignee, Title CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State or Province of Virginia and employed by HSBI&I Co* of /-I a. rTfor Q l ( 1:, have inspected the components described in this Owner's Report during the period Cf~ /Cf-J'7 to lb~ I 8~ Cf I , and state that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section XI.
By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this
~~/ ___* --~---------Commissions _ _V_A__5_4_3__________________~~
i_n_s_p-ec-t-io__:,~<..::.=--=-:---'--.... Inspector's Signature National Board, State, Province, and Endorsements Date _ _ _ _ _ _ [_-_~ _ _19 q/ _J
~~FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI~~
1. Owner Virginia Electric and Power Co. Date -::Ti"":::< ?so , I Cf 91 Name 5000 Dominion Blvd., Glen Allen.
~~Addrea~~
~~23060 VA Sheet _ _ ...,,l.__ of _ _...,l=----------~~
~~2. Plam Surrv Power Station Name Unit _ _ ....;;;;t,=..--------------~~
~~P.O. Box 315, Surrv, VA 23883 Repair Organization P.O. No., Job No., ate. 7~~
3. Work Performed by __l.i:... 1.:.*r:.::,.g.:i~n:..:i:..:a:.......:P:...:o::..w::::.=e.:.r_ _ _ _ _ __ Type Code Symbol Stamp_tJL.14/...cA:i__ _ _ _ _ __
Nam* Authorization No. _ _ _.......,N._,~;Ac:L._ _ _ _ _ __ 1 P.O. Box 315 2 _ Surrv, VA 23883 Expiration Date _ _ _ __.N~/.._A._________ Addraa
4. Identification ot System_--"'d,:..:..,;.:i?.~..,,'14 ....L:-..... $.Lr..JE:,......6;'-L..-M:......_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __

s. (al Applicable Construction Code B3 l. l ,s§l_Edition,_N;..;..:./~A=-----Addenda, N-1, ~-7 (bl Applicable Edition of Section XI Utilized for Repairs or Replacements 1980W80

6. Identification of Components Repaired or Replaced and Replacement Components
~~Name of Component I I~~
Name of Manufacturer I Manufacturer I Serial No. I I i National Board No. Other Identification Year Built Repaired, Replaced, or Replacement or Nol ASME Code Stamped (Yes I s- . I C~N~ I V I-Jl4.lOWN i N/f\ J!"l'V\<!.- f ~ 1 ~Pl.JK;b :iO I S1lJb5 ~I
!\Jllll\NOIIJN I . c.f\~)NftL .!Nb I ~1" lit f'O ~ CSY % I \qq1 NO i
1'0bS 8' I PMblJ~ INC- &'O%tl.f.O I I N/A. 330~02.-S' ~p 1..l'ICEYti!t..\,. I I
! NU'i.S I l/1\lk"' 1)-(.A.JN I \)NKNo-ruN i i N/A .:2-M£- l'is2... Il.l~K'30i:lt,1 11.1:HI\CJ;b NO I c~~blMl\-1.... :!Nb 11-{T ~ ; Po-:\1 cs.y NUTS i"PRobll~ .!'1-)C., HIJ.\'+3f. I N/A. ,,t9 0 bC\ 3 -] I 19~0 ~P~C'E:t'l\~NT NO I I R....
7. Description of Work _ _.... e....\lt"'\""0,,.....<>..._euJ.a,..._~ro... cl. .s",;-.,_c.,,,.*.:-=-'6)...;.......__..&"t,,.--'XWlc=I.l....2.$-....:C::...,;l:....:l,:...JJ.....,..,_.i.L__~_9.::g:.....":....)_ _ _ _ _ _ __

8. Tests Conducted: Hydrostatic O Pneumatic O Nominal Operating Pressure ~
Other O Pressure _ _ _ _ _ psi Test Temp. °F NOTE: Supplememat sheets in form of lists, sketches, or drawings may be used, provided 11) size is 8% in. x 11 in., (21 lnfonna-tion in items 1 through 6 on this report is included on each sheet, and (31 each sheet Is numbered and the number of sheen is recorded at the top of th is form . (12/821 This Form (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017
FORM NIS-2 {Back)
~~9. RemarKs _ _ _.... A,.,S~M~E-~_..C.,,.......o""'D=E--=-___,,U=-,.,,~=-o-S~=3~--------------------~~
Aoolicaole ManuracYurers Data Aeoon:s to oe anached CERTIFICATE OF COMPLIANCE We cemfv that the statements made in tne reoort are correct ana this 'f;EPwCE.NcoTC conforms to the rules of the ASME Code, Section x I. reoa,r or reo1acement Type Code Symbol Stamp __~_/_A ____________________________________ Certificate of Authorization No __N_/_A_____________ Expiration Date _ _N_.;../_A_____________
~~~ff~~~
~~Signed~~
~~' ~ or Ownar*s Desig'nee, Title~~
~~J:s:E .bv/;1Wa,g_ Date _ _ _...,f)-§=""'."+-.~~
__ , $==---, 19 91 CERTIFICATE OF INSERVICE INSPECTION I, the undersigned. holding a valid commission issued by the National Board of Boiler ana Pressure Vessel Inspectors and the State orProvinceof Virginia andemptoyedbY HSBI&I Co. of
--------1~=*:...=l"...J..:"'L.-.::O:.._":..d,::_µ{!_=*'-ol..-------:---,,---,,,,,...,------have inspected the components described b- J 8-Cf/ . and state that to the best of my knowledge and belief, the Owner nas periormed examinations and taken corrective measures oescnbed in this Owner's Report in accordance with the reauirements of the ASME Code, Section XI.
By signing this certificate neither the Inspector nor his employer makes any warrantV, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind.arising from or connected with this inspection.
~~------+-'~---u~_f_e9z_* I nsi:iac:Yor1 Signature --~-Commissions_VA-.c..5-.c..43_ _ _ _ __~~
~~National Boara. Stata, Province, and Enaorumant1 Date_ _ _ _ _ 7_-_j_/_._19 tJ-/~~
~~FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI~~
, . Owner Virginia Electric and Power Co, Date _~..-..,0~L=-'(z.....<::2.....,4+,i....i.1....1.q_q'-"1_ _ _ _ _ _ __
Name 5000 Dominion Blvd., Glen Allen. VA Sheet _ _ ....,,l..__ of _ _ _l~--------- Addr1111 .UOGO
~~2. Plant Surrv Power Station Unit----""'---------------~~
Name P.O. Box 315, Surrv, VA 23883 :iok No 3800 toS':\:30 gg.:#jt-37 Addrea Repair Organization P.O. No., Job No., etc.
~~3. Work Performed by Virginia Power Type Code Svmool Stamp-bl~{....A2-._______~~
Name Authorization No. _ _ _........,N~/uA...________ P.O. Box 315, Surrv, VA 23883 Expiration Date _ _ _ _...1N;>>,.j./.i;;.A1.-_ _ _ _ _ __ Addrea
4. Identification of SYstem _ __...N\~fl.._\._.N_,,!_~S...T......,,:f-_._ft,._,M.__,.___ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __

s. (al Applicable Construction Code B31. l 19~Edition,_;;..;N..:../~A;;,..__ _ _ Addenda, N-1, N-7 (bl Applicable Edition of Section XI Utilized for Repairs or Replacements 1s80W80

6. Identification of Components Repaired or Replaced and Replacement Components
~~Name of Component I~~
~~I Name of Manufacturer I Manufacturer Serial No. I I I Ii i National Board No. Other~~
~~. Identification Year Built Repaired, R~laced, or Replacement ASME Code Stamped (Yes or Nol i ' STc>D~ I cr,t~I\)~ \~~
I Vl\lli:NOI.O~ ! N/f\ ..2..-Ms-n-s /1!1\l~MOlllN P.!:.PU\ab I :"\O I I(. i,, ~'t::,\ NJ,\_ :r.t.i):) I H 'T :ll I PO~ C.5, y STlJbS i>Ro°b'Jct<:. ~., '60'1',!f-~0 I i N/A
~~'li5 oio2.-s I I'l~ I ~P~!!,.\i NO I~~
~~I i~~
~V"CS I U~{:)Wfv I VNKl\lewrv I N/A ,'2-('i)S,- \'f-~ l11~1t~t,1 "1:Hf\ Cl:b NO !I NVfS I('\Rt> 11\iJ\'2. .J:N"b I k{f!,,\
i N/A. PO-.\\ csy j 1q qc, ~PJ.hC.!:'l'l'l~NT NO i i i'fl..o't:::,\) er& '.INC B r'i 'f3l I .1. 'l &b qt .:.1 I I I 1
~~7. Description of Work _ _ R""""""e"'~-\c...,c....~~
~~e.,,.. J+-,_n _ ... ....u......_k.........__..&,..__.....§,.,_+-'-'~=~$.-----1i?;:.f1..oLC--',?,.i.t:"'~-Gl.,.5~/8_',t..)_ _ _ _ _ _ __~~
~~8. Tests Conducted: Hydrostatic O Pneumatic O Nominal Operating Pressure ~~~
Other O Pressure _ _ _ _ _ psi Test Temp. °F NOTE: Supplememal sheets in form of lists, sketches, or drawings may be used, provided fl I size is SY.. in. x 11 in., (21 lnforma-tion in items 1 through 6 on this repon is included on each sheet, and (31 each sheet is numbered and the number of sheea is recorded at the top of this form . (12/821 This Form (E000301 may be obtained from the Order Dept., ASME, 345 E. 47th St., New Yorlc, N.Y. 10017
FORM NIS-2 (Backl 2=()1'----'-'£=-_,_C....c...WF"'"""",--1C,,....1....""'A5,_,_s...._...,3=------------------------
~~9. Remar1~~-i-;..,':f'--"""/£=-11_.l_."f-j.._.1'--------~~~~
~~5000 Dominion Blvd., Glen Allen. VA Addreu~~
~~23060 Sheet _ _ _..l'--- of _ _-=l=-----------~~
~~2. Plam Surrv Power Station Unit---'----------------~~
Name P.O. Box 315, Surry, VA 23883 Addreu Aepelr Organization P.O. No., Job No., etc.
~~3. Work Performed by __V_1.=-*r;;..,_.g..;;:i_n:..ci:..ca--'P'-o"-w~e""'r_______ Type Code Symbol Stamp ........N-/.cA~~~
Name Authorization No. _ _ __,N"'--f/""El"--------- P.O. Box 315, Sutrv, VA 23883 Expiration Date _ _ _ __.Na.+-/.._f\._________ Addrea
4. Identification of System _ _ _...,\'0...:.,'1J.;lu;\\',.,.\_,.;5I:.,.'f;~Piu.\'{\;:..,..._ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __

5. (a) Applicable Construction Code B31. l 19§l___Edition,-N;.;.:../.;.;A:.___ _ _ Addenda, N-1, N-7 Code Case (b) Applicable Edition of Section XI Utilized for Repairs or Replacements 1980W80

6. Identification of Components Repaired or Replaced and Replacement Components I
ASME Code National Repaired, Stamped Name of Name of Manufacturer I Board Other Year Replaced, (Yes i Component Manufacturer Serial No. I No. Identification Built or Replacement or No) I I (f>fi :I,\ I ~01,..,S CR!\~\: 3""G~ 11-'5"\\~l,..\ ! N/f\ 2-rns- \1-(, lu~~NOIUN ~Pl..f\C1'b ~o I I lcf\~\)1'N!Pil-- mti. j 1-\,.. :\1 f'O ~ c.5y
I
~O\..""(':) l'~\)C.,i':, ~l\lC., %b % +J.\.o ! N/A 3 "$ci<oo1~s I \'\" I ~?IJ\CS'til!:)..\j NO NV"TS V"Nl~'N I UNK~C>u)-N Ii N/A l-1'1\S-l~{, 11~\(\,l~),I "1::Hf\c.E:b NO C~~bll\\l"!L J'..Nl> Hi~ i f>o-!<< csy NUTS \>\\.tl\;:,l)tr<!, :i:~e.. ~'is' 1'-t'+?>t, I N/A ~°\ U-t,C\ ~-t IC\C\o ~PI.IKl::1'1\~N'T NO I
7. Description of Work _ _ _Ri..=;e~~\Cl,l,c.,...c.""e""_o\""'--...i.C~9,..1,\_... sr~u.""ct~S,,,._____;&l.:,l..._.l,,.c.l,llb2.....1.\--l.:n.l.l:Y\~~.l..;$L-_~~al:f:..l:S::--~l::-J.:M:...\..:.*------

8. Tests Conducted: Hydrostatic O Pneumatic 0 Nominal Operating Pressure W Other O Pressure ;JoP psi Test Temp. {tr>-,6tet,.;r'
F NOTE: Supplememal sheets in form of lists, sketches, or drawings may be used, provided (1) size is BY.. in. x 11 in., (21 lnforma-tion in items 1 through 6 on this repon is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form .
(12/821 This Form (E000301 mav be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017
FORM NIS-2 (Back)
~~9. Remarks -../A-"5""'-'-M::.!.ia=e.=..._.>..C..,ro""'""rp-=-_.,.C~kl..!.l+_,.S:.:S,....__&<-=-------------------------~~
Aoolicable Manufacturer's Data Reports to be anacned CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this fneWEJ\::1£NT conforms to the rules of the ASME Code, Section XI. , repair or reo1acement N/A
~~~:e~,~~~;,~~
~~Type Code Symbol S t a m P - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -~~
~~£r.t~~
~~____/l/l_~-----Expi:~::n_D_a_,~,,e::::N:_/__A_________~-(.~S:~~~~~~~-._ ____~~
~~-ig_N_e-~:1;;-:-it_:_____ __~~
0 1 61 19 11 1 CERTIFICATE OF INSERVICE INSPECTION 1 the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State
;rProvinceof Virginia andemployedby HSBI&I Co. of ------~t,_*..,.l.,t1.,...-_"T-'-fuL...>"-r-'d=-+l__;;c;..-r
_________:::---:=--..=--:---;:-have inspected the components described in this Owner's Report during the period _ _ _ _ _ _ _ _q.,__--'/'-'f.,__--=ff.__.'f_to b -( 'f' 'f f , and state that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section XI. By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor. his employer Q!0: !.* shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspection. I) (\ _ _ _ _..Juf---t~F-:-<-----::--::~'f-'---~-------Commissions _ _ V_A_S:......4..:3_________________ I nspec1:or's Signature National Board, State, Province, and Endorsement* Date _ _ _ _ _ _ ],...-__,_/-=S'c..-_19 -{/
~~FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI~~
~~1. Owner Virginia Electric and Power Co. Date _ _ ~h...._/7~-+/~9_/________~~
~~Name 5000 Dominion Blvd., Glen Allen, VA Address 23060~~
~~2. Plant Surry Power Station Unit-----'=--------------~~
~~Name P.O. Box 315, Surry, VA Address 23883 Wo# 11'6:I B 7 Repair Organization P.O. No., Job No., etc.~~
~~3. Work Performed by Virginia Power Type Code Symbol Stamp _ ___,M-t'IJ,.,_/J-_ _ _ _ __~~
~~Name Authorization No*------"-~"-f.-!.-,'------- P.O. Box 315, Surry, VA 23883 Expiration Date _ _ _ _ _ _f1di'--"'-"'"'fj-'--------- Address~~
4. Identification of System_--'-'..t?.@""""'."-'-"C~Tl2'"""'~=-__._{1-""2b=...,,,uh/C"-'-"~------------------------

5. (a) Applicable Construction Code B31.1 19§.l____Edition,_N""'/'-A
~~_ _ _ _ Addenda,N-l, N-7 Code Case (bl Applicable Edition of Section XI Utilized for Repairs or Replacements 1980W80~~
~~6. Identification of Components Repaired or Replaced and Replacement Components~~
Name of

Component Name of Manufacturer Manufacturer Serial No.
~~National Board No. Other Identification Year Built Repaired, Replaced, ASME or Replacement or No) Code Stamped (Yes~~
~~;./IW) I-lot.£ Chwe- 9tN 11f!tP cse:, ~1/?:IJ:.~~
~~Bo~S w,~ TIN 6.Hoo5E ~':3748.i.O 1<1/11- ,2.-,ic-£ - i:;... ut1~,1ow /2£?,' --* {}//RJll&)l,J~~
~~/IMIIOtl!- C~rce. /30t.-T'S U,J4//)l,)N &GI e>>fl 3# // AJ!tJ 2-Et!-£ - IC., {lfli~ /?~ lh.WlW\I~~
~~8. Tests Conducted: Hydrostatic D Pneumatic D Nominal Operating Pressure ~~~
Other D Pressure _ _ _ _ _ psi Test Temp. °F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is 8% in. x 11 in., (2) informa-tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form . (12/82) This Form (E00030) may be obtained from the Order*Dept., ASME, 345 E. 47th St., New York, N.Y. 10017
FORM NIS-2 (Back)
~~9. Remarks ~C-'.tlt"5c,...J-.o~6..:..._.7[:_~~
~~. ----+-P,-'<2""--#_---,..{!.a.NT-"-L-_-3""""3 .........1e'-,1'------------~~
___z._.2_2 Applicable Manufacturer's Data Reports to be attached CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this /?ifetl?(Ell,IEll{Cconforms to the rules of the ASME Code, Section XI. repair or replacement Type Code Symbol Stamp __N_/_A __________________________________ Certificate of Authorization No. _N--'-/_A_____________ Expiration Date _ _N--'/_A _____________ Signed L/~ L_ 7S.£ l)fwnir ~ s i g n e e , Title bv611r/EEe.. Date _ _ _tf:?,,___,,r-/;_.,_7_ _ _ _ , CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State 19~9~/- Virginia and employed by HSBI&I Co. of
~~----,-1,,'="--L...L.C"'-'--'--,1---"c'--t--'-_____________~~-----T"_ have ~sqec,ted the components described I * ** , and state that 0~~
in this .0wner's Report during the period _ _ _ _ _ _q_,__---'/'-'f_,_*__,,g:>..__'f,___t6 * - to the best. of. my knowledge and belief, the Owner has performed examinations and taken corrective .. . . measures described in this Owner's Report iri accordance with the requirements of the ASME Code, Section XI. By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspection.
~~-----~t-"~-~----f._. Inspector's Signature --~--~---Commissions _ _ V_A_5_4_3________________~~
~~National Board, State, Province, and Endorsements Date,_ _ _ _ __.,{,..,.* --~7___19 q {~~
~~FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI~~
~~1. Owner Virginia Electric and Power Co. Date_......f."'-..t1,1-/7-'--+/_,_9__.._{_ _ _ _ _ _ _ _ __~~
~~Name 5000 Dominion Blvd., Glen Allen, VA Address 23060~~
~~2. Plant Surry Power Station Unit _ _ _--<-2,_,=--------------~~
~~Name P.O. Box 315, Surry, VA 23883 Address Rep~lr Organization P.O. No., Job No., etc.~~
3. Work Performed by Virginia Power Type Code Symbol Stamp _ _,_Ni"'"'"//fr-:--------
Name Authorization No. -----'-'M"'-'0'!,W-';.-------- P.O. Box 315, Surry, VA 23883 Expiration Date _ _ _ _ _..,M-"'-'1,-'-_______ f/f _ Address
4. Identification of System_-l'W:::s.:~C:...:~~'fZ.=--_*-=l'.'.7oa::....:..:::..,Mrr'Ca:;u.LL----------------------------

5. (a) Applicable Construction Code B31. l 19~Edition,_N:..:.:../-=-A=--_ _ _ Addenda, N-1, N-7 Code Case (bl Applicable Edition of Section XI Utilized for Repairs or Replacements 1980W80

6. Identification of Components Repaired or Replaced and Replacement Components
~~Name of Component Name of Manufacturer Manufacturer Serial No.~~
National Board No. Other Identification Year Built Repaired, Replaced, or Replacement or No) ASME Code Stamped (Yes IM,v/)/1()1£- ~ ~/II No ,e(,P ptJt-r=> ~Ttfllb/HJV6e, Cf:>f.n l<;'T.I!,.,_ Ot..~ 748J.O ;//,4 J.-f?C,-£ -IA- /)f,/~OAJ/./ j!EPLl'f-E/lfEl,/I
/J~ /lf.WD;lot& (bvE,e, ~1-r-' (}tiJJbJowtJ r,15~?:>JI II M/fJ 2-12C,-£ -JI} Urv4JWIII f!Ht./lCE.D /N)b.ltJl,c),J
~~7. Description of Work [?ee!fiCEQ /.Jt;,.,o;lot£,~~
8, Tests Conducted: Hydrostatic D Pneumatic D Nominal Operating Pressure W' Other D Pressure _ _ _ _ _ psi Test Temp. _ _ _ _ _ _° F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is BY. in. x 11 in., (2) informa-tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form . (12/82) This Form (E00030) may be obtained from the Order-Dept., ASME, 345 E. 47th St., New York, N.Y. 10017
FORM NIS-2 (Back)
~~9. Remarks ~............C~~
...Z.46"'----'-"-6,___,7J;..,,,__--4--a___,o=----#'---4e..L.'AITlL.L~3=3"'-L..Z.,,,,2.2£,="-'I-------------
Applicable Manufacturer's Data Reports to be attached CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this* /?£eWEptf:AC conforms to the rules of the ASME Code, Section XI. repair or replacement Type Code Symbol Stamp __N_/_A _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ Certificate of Authorization No. _N_/_A_ _ _ _ _ _ _ _ _ _ _ _ _ Expiration Date _ _N_/_A_ _ _ _ _ _ _ _ _ _ _ __ Signed
~~~~ wr{er or Owner's ISI oes'ignee, Title lw6r11/£E,e_ Date _ _~~
~~CERTIFICATE OF INSERVICE INSPECTION~~
~~~&'----+-/~7_____ , 19 9/~~
I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State or Province of Virginia and employed by HSBI&I Co* of
, Ha.rT fo,. ~ 1 C't have inspected the components desbribed in thi~ Owner's Report during the period *'f- I c;- g q *to lo - (8-. q-, , and- state that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this 'Owner's R~port in'acco~dani:e with the r~quirements of the ASME Code', Section'* XI. .
By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspection. _ft~* U-o+/-<><---=-,-----_,,_f=-:--,--~==~-Commissions_VA_54_3- - - - - - 1nspector's Signature National Board, State, Province, and Endorsements Date,_ _ _ ____,,,b"---7_.__*_ _19 qf
~~FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI~~
~~1. Owner Virginia Electric and Power Co. Date _ _____._~olc'-4t-/z+-+/-'9-'_~~
~~/ _ _ _ _ __~~
~~Name r 7 5000 Dominion Blvd., Glen Allen, VA Address 23060~~
~~2. Plant Surry Power Station Unit _ _ _ _- = = - - - - - - - - - - - - -~~
Name P.O. Box 315, Surry, VA 23883 WO #-/0£ I 8 (p ;Ee.# 9lc;J'-f Address Repair Organization P.O. No., Job No., etc.
~~3. Work Performed by Virginia Power Type Code Symbol Stamp _ _~M,_'/l;--------~~
Name Authorization No. _ _ _ _ _"'l)_.,4.,,,_'ffl~------ P.O. Box 315, Surry, VA 23883 Expiration Date _ _ _ _ __,At1,,4;/Jr.L1/T..:....._ _ _ _ __ Address
4. Identification of System _ __.,f&tc.=-"-'-'<..L.lm..u.e:=-__.(J"'"""~"'t,::1'-"WWL"-'-'--"'-'-------------------------

5. (al Applicable Construction Code B3 l. 1 19§1___ Edition,_N_,_/_A_ _ _ _ Addenda, N-1 , N- 7 Code Cese (bl Applicable Edition of Section XI Utilized for Repairs or Replacements 1980W80

6. Identification of Components Repaired or Replaced and Replacement Components
~~Name of Component Name of Manufacturer Manufacturer Serial No.~~
~~National Board No. Other Identification Year Built Repaired, Replaced, or Replacement or Nol ASME Code Stamped (Yes~~
/1,tAP!la.£ &JIG/Z- '5,fJI/\) IFWt'SfJJ /3{X.T:;) 1/1?5TINt,. f/tJdGe- ~rt..tlu3$o µ/,4- 2-i?e-£-/B J.V.IA~l.' (2U't/KE/ll 41T l ! ~ /Hlfl/0Hd£. {'t,,-U. /3~1..rs {)t,//t/1)0 uJ nJ &5"/~9MII ,///t 2-ee..-e-18 /J.l/u/()ulrJ f21=:..PLl)C£. µ (),.J{Nt,{<),V
7. Description of Work /?Pt- J.l&.4?fJa£- /016£. .i':3t?R? [ 7]

8. Tests Conducted: Hydrostatic D Pneumatic O Nominal Operating Pressure [a-"
Other O Pressure _ _ _ _ _ psi TestTemp. _ _ _ _ _°F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is SY. in. x 11 in., (2) informa-tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form . (12/82) This Form (E00030) may be obtained from the Order*Dept., ASME, 345 E. 47th St., New York, N.Y. 10017
FORM NIS-2 (Back)
9. Remarks ~.b-Q."-"!tA?L...L..o<c....S=----Jt;--='~-_,_B.....,,c.?"'-----_.:#___,,,Crt/T=-><-_,_/_-3=3..<<...,.7=&<-4=:>.....L../_ _ _ _ _ _ _ _ _ _ __
Applicable Manufacturer's Data Reports to be attached CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this ~ conforms to the rules of the ASME Code, Section XI. repair or replacement Type Code Symbol Stamp __N....;/_A __________________________________ Certificate of Authorization No. _N-'-/_A_____________ Expiration Date _ _N-'/'--A _____________ Signed ~ ~ rs ( &a~
~Owner's Design6e, Title CERTIFICATE OF INSERVICE INSPECTION Date _ _-=k-1-,/:.....L...7_ _ _ _ _ , 19 I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State 9/
or Province of Virginia and employed by HSBI&I Co* of Ha.r"t?ot"'c:\, Ct have inspected the components described in this Owner's Report during the period q-, e;, 8'1 :, . , to ' '2-, K* q I , and state that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in'this Owner's-Report in'accordance with the requirements of the ASME Code', Section** XJ*.
By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer i
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 lo,pee<loo~ QWL Commissions __V_A_5_4_3________________ Inspector's Signature National Board, State, Province, and Endorsements Date_ _ _ _ ___...le,"-*-]..___19 qI
~~FORM NIS-2 OWNER'S. REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI~~
1. Owner Vir~inia Electric and Power Co, Date Av&u:sr 7..,.o 1 \ qq l Nam*
5000 Dominion Blvd., Glen Allen, VA Sheet _ _-=l..__of _ _-=l=----------- Addrea 23060
~~2. Plant Surrv Power Station Unit---""'---------------~~
Name P.O. Box 315, Surry, VA Addrea 23883 :S:Ok No 2:. '6 oo t9 <-i Repair Organization P.O. No., Job No., etc. si t,?f: @et'! 1-w
3. Work Performed by Virginia Power Type Code Symbol Stamp bl/ A Name Authorization No. _ _ _-1.JN..,/uPi:1-_______
~~P.O. Box 315, Surrv, VA 23883 Expiration Date _ _ _ _ ..,N.~/. . 8.1.-_______ Addrea~~
4. Identification of System_....;5""-"PrLff::.i'i=c-I..._..Y_=+N:f=:.,...oP"'-. .;;;C..:r-1.-1)...iO..u..N=-------------------------

s. (al Applicable Construction Code B31. l 19~Edition,_N-'-/_A_ _ _ _ Addenda, N-1, N-7 Code Case (bl Applicable Edition of Section XI Utilized for Repairs or Replacements 1980W80

6. Identification of Components Repaired or Replaced and Replacement Components
~~Name of Component I~~
Name of Manufacturer I Manufacturer Serial No. I I National Board No. Other Identification Year Built Repaired, Replaced, ASME or Replacement or Nol Code Stamped (Yes I };;' 'I P,.bt).$ [ VNKN~,u I \)"N~'l\\01..l!)N I
~~! N/A l. - ~I-Metr--;2.SI,~ \Jllll\NC\IJII ~PJ.J'\Gb ~o I rnR'l>)~F\L :r.\~~
A
~,~ . PO°* csy I J,:- ,1 ~ ~01:>'!:, . f!lo1>vc.::(S. .ui.c. &<H.'H;, °J I N/A :5 <:> ~~ r:i -l I I e, %1 ~p I..PiC&il:)..\j l'-)0 "5/Lf:" Nl.l"'f S UN'IC.~l'--l I \)1\lj,;.y...\t,u)~ i N/A !t-SL-MoV* mC\A 11"3\tN~i.a ~HI\Cl:b NO ~OT~
MAR'bWI\RJ:; I 1-\1~ i N/A t>o-:\11 c.s y l'l &J ~P~(c'lt\'=.NT NO "3/4; (* Sl't.<:11\LTY Lo. :ti-,c. P.> "" '60"3 I .:tbtii1t3-3
~~... _...£&e......:*'r~c,~~~'1_:(s:*c-l!..<..~0:..L_ _ _ _ _ _ _ _ _ _ __~~
7. Description of Work _ _.1:R~e~-\'~\1..!,:~:!a!.f&Ra!.,l.!l,...._J:{]J.U.!A::l.\-:.::s,.___1.,.(;1;l..!.Q!.,.,_}f_::-

8. Tests Conducted: Hydrostatic D Pneumatic D Nominal Operating Pressure ld------
Other D Pressure _ _ _ _ _ psi Test Temp. °F NOTE: Supplememal sheets in form of lists, sketches, or drawings may be used, provided (11 size is 8% in. x 11 in., (21 informa-tion in items 1 through 6 on this repon is included on each sheet, and (31 each sheet Is numbered and the number of sheets is recorded at the top of this form . (12/821 This Form (E000301 may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017
FORM NIS-2 (Backl
~~9. Remarks -~-"A:..S=...ME.:-=e=--~C.=""'.....,E=-........~~
C.a.J..,.A6~~=--"-&:=-*- - - - - - - - - - - - - - - - - - - - - - - - - APPiicabie Manufacturer's Data Reports to be attached CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this ? @ > , ~ conforms to the rules of the ASME Code, Section XI. repair or rec1acement Type Code Symbol Stamp __N_/_A ____________________________________ Certificate of Authorization No. _N_/_A_____________ Expiration Date _ _N_/;..._A_____________ Signed '<mfbowne~s £~e. orProvinceof Virginia i£r{m1n/fe{?- CERTIFICATE OF INSERVICE INSPECTION Date _ _ a,,""'""'-rt-*-~~~D____ , 19 I, the undersigned, holding a valid commission issued by the National Board of Boiler ana Pressure Vessel Inspectors and the State andemployedby HSBI&I Co.
?/
of Ha.r:Th>rtj ) ct have inspected the components described in this Owner's Report during the oeriod _ _ _ _ _ _ _._-=-...a..-..;;-,____ 5 -/- O Q to ~ _ r-_ /0 /:,n 7.::f.. ' and state thet to the best of my knowledge ana belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section XI. By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspectio~ !4 !. /I) /)
~~---..ll~~~::..~---:----"""."""~"-:-:::--~.;;....-.c------Commissions __V_A_S_4_3_________________~~
~~Inspector's Signatura National Boara. St11t11, Province, and Endorsament1 Date _ _ _ _........... ~,_-_J._7__19 q f~~
1. Owner FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI Virginia Electric and Power Co, Date :P,u6iuST Lo I lj 4, \
Nam* 5000 Dominion Blvd., Glen Allen, VA Sheet _ _ ..,.l.___ of _ _..:1=---------- Addr- . 2)060
~~2. Plam Surry Power Station Unit _...,a:....________________~~
N*m* P.O. Box 315, Surry, VA. 23883 ;:;bRap*lrb.)c, 38(l?0~95SJ.\.o ~L-1s Organization P.O. No., Job No., ate.
~~3. Wortc Performed t,y __V;...1;;.*raa.,;;ig.ai_n_i_a;;....P~~
~~....o.;;;.w.;,;,,;;e'-Cr;...__ _ _ _ __ Type Code Symbol Stamp--JN~/ziAl..-.~~
Name Authorization No. ---~Nl:A./-/;.i:81-_______ P.O. Box 315, Surry, VA 23883 Expiration Date _ _ _ __.N,>>+/...,A....__ _ _ _ _ __ Add,-
~~4. Identification of System _--'=,$d_"""":\.,..,_e_+._/.,_v_ _.:(=ll(':,.:~~ei;:..,.C_+.,_,,_1\,.;0:D;u,.Jo.......----------------------~~
5, (al Applicable Construction Code B31. l 19§l__Edition,-N:.:..:./.=:A=-----Addenda,N-l, N-7 Code Case (bl Applicable Edition of Section XI Utilized for Repairs or ReplacemeMS 1980W80
~~6. Identification of Components Repaired or Replaced and Replacement Components ASME Code~~
~~.Repaired, Stamped Name of Component Name of Manufacturer Manufacturer Serial No.~~
~~I National Board No. Other Identification Year Built Replaced, (Yea or Replacement or Nol I~~
~~,rs,op U"' \<Neto 1'J ll\Jlc;NOWI\> ! N/A 1-~I- "'1bV-28'SE ONkl\,cr.,~ ~Pl..FKcf:'> ~o ro ::M c.sy 11 l\ Rot)~~
~~A&G, fj\lq/~~111 Co , Jl. , r:,.Jc. \.\ 1 iqs-1t1 I N/A 315Q'32.-1 I 1'lo REt' I.P.CEM'EN T ~o i I~~
7. Description of Work _ _....R'-=e"\'p"-'\uo.... ce=J'\-.___;X:L.;o:4i.c;;~,.__;[::.;..1Lt..:).:..._ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __

8. Tests Conducted: Hydrostatic O Pneumatic O Nominal Operating Pressure ~
~~Other O Pressure _ _ _ _ _ psi Test Temp. _ _ _ _ _°F~~
NOTE: Supplememal sheets in form of lists, sketches, or drawings may be used, provided (11 size is 8% in. x 11 in., (21 Informa-tion in items 1 through 6 on this report is included on each sheet, and (31 each sheet is numbered and the number of sheeu is recorded at the top of this form *
* (12/821 This Form (E000301 may be obtained from the Order Dept., ASME, 345 E. 47th St., New Yortc, N.Y. 10017
~~c FORM NIS-2 (Backl~~
~
~~9. Remarks_..........................-==---~C,c""""o_'i;--=--.....cw~~~~
~~. . . . . . .~:L...._..........------------------------------------------~~
~~Applicable Manufacturer', Data Reports to be attached~~
~~- ~-*** - *,~~
CERTIFICATE OF COMPLIANCE We cenify that the statements made in the repon are correct and this ~ conforms to the rules of the ASME Code, Section XI. repair or replacement
~~Type Code Symbol Stamp __N_/_A _____________- - - - - - - - - - - - - - - - - - - - - - - -~~
~~- - - - - - - - - - - - - - - E x p i r a t i o n Oate ___N_/_A____________~~
or Province of Virginia CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State and employed by HSBI&I Co* of
~~----------,/f.f:-+_...4,,.,1"...:I.._...6.,,o~"'.;;;d~>...c=-..: c : : - - - - - - - - - - - h a v e inspected the components described in this Owner's A epon d urmg~~
t he peno

d --------"~..._ s1-9o...__...._..;;a..._to s~, . . -
~~_ u 0 1.1~~
.J..+ , and state thet to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's _Repon in accordance with the requirements of the ASME Code, Section XI.
By signing this cenificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Rep0rt. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or propeny damage or a loss of any kind arising from or connected with this inspection.
~~----*--'Rl-'*'-'-~-'f~.=--'~=-:~~;a;;..~~
~~I nspector'1 Signature~~
~~...*_______ commissions ....._V_A__ S_4_3________________~~
~~Netlonel Boera, State, Province, and EndorMmants Date_ _ _ _ _ rt~~~"-1_____19 'f (~~
~~FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI~~
,. Owner Virginia Electric Name and Power Co, Date Xu ~r &:fl /'Jq I 5000 Dominion Blvd., Glen Allen. VA Sheet _ __,,!.___ of _ _-=l~---------
~~Addrea~~
~~23060~~
~~2. Plam Surry Power Station Name Unit _ _ _ ...lC>.--------------~~
P.O. Box 315, Surry, VA 23883 1okRepetr Na, 3'8'0009691:t:ii ~#qHS-Organiz11tion P.O. No., Job No., etc. Addrea
3. Work Performed by Virginia Power Type Code Symbol Stamp bl / A Neme Authorization No. _ _ __,NULi'/u:Pi:1..-_ _ _ _ _ __
~~P.O. Box 315 2 Surry, VA 23883 Expiration Date _ _ _ _...... N.>>+/'-'Bi......._______ Addrea~~
4. Identification of System _ _--i;R,.,e.....,C\... CJu:OLJCi.:;....--'C..,e1.1coU-1Jlo..._.n...+-1--------------------------

s. (al Applicable Construction Code B31. l 19~Edition,_N __/_A_ _ _ _ Addenda, N-1, N-7 Code Case (b) Applicable Edition of Section XI Utilized for Repairs or Replacements 1980W80

6. Identification of Components Repaired or Replaced and Replacement Components
~~Name of Component i I~~
~~i I I Name of Manufacturer I I Manufacturer Serial No. I I National Board No. Other Identification Year Built Repaired, Replaced, or Replacement or No) ASME Code Stamped (Yes~~
~~!I I~~
I SiOt)S VELY-rN I Ut-iKNl:nJ.:>N i N/A J.-ll.c,l"Y\t,V-lS3(, I\Jl\\~NO\llN P.tP~Cl:b ~o I "f%-o5* "4.l% I I i"O"* csY *
! I CPtP-.t:>l~I\L IN\). N/A ~fl IJ'ICS'j\E:t..\'T NO Robs \ f?.Di:>Vcr:, INC. 3'i-oo!l..'l-ll 19°t\
i N\JTS I u".)KNOWN I \) \)\) ~~ 0-W 1(1 ! I N/A ~- RC..-Tt'IOV'-~'i.36 1/~K~N PJ:Ht\c.Eb NO I I\ a,l,i fNG,11\J~Rll\Y: f-\1' &, i f>o~ c.sy
~~.f\lVTS I -:n:-., :i:.s,l-c.. RI'\ DC\~ C\ I N/A 3 Xi4-l-\~i-l 1q91 Ri:PUKE:1'1\~NT NO i~~
I
7. Description of Work _ _.._R....e"fp""\C\C;c.=f'...c...,1,_ _\'\,_.,.,IA;,.,+/-....?.......__.&.,...._s'-'+/-....,""J""""',£>""-'pp.c;e-\1(':~-..:.R~,M~-...,,-,- - - - - - - - - - - - -

8. Tests Conducted: Hydrostatic O Pneumatic O Nominal Operating Pressure W Other O Pressure _ _ _ _ _ psi Test Temp. °F NOTE: Supplememal sheets in form of lists, sketches, or drawings may be used, provided (1) size is SY.. in. x 11 in., (21 informa-tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this fonn .
(12/821 This Form (E000301 may be obtained from tha Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017
FORM NIS-2 (Backl
~~9. RemarKs _.._.:.A...5,a=....~-=~-CD~-:D~E:~--'~=-=="'-=s=--~------------------------~~
AoPlicable Manufacturer's Data Reports to be attached CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct ana this la;;p1.4{El\:1Er.(t conforms to the rules of the ASME Code, Section XI. repair or reo111cement Type Code Symbol Stamp __N_/_A ____________________________________ Certificate of Authorization No. _N_/_A_____________ Expiration Date _ _N_/_A_____________
~~~~ -::z::s.r Signed or Province of wner or Owner's Designee, Title Virginia M6tAIE;E.e.. Date--9a~~-.._~._.t-/_,~~
CERTIFICATE OF INSERVICE INSPECTION 19 2 / I, the undersigned, holding a valid commission issued by the National Board of Boiler ana Pressure Vessel lnscectors and the State and employed by HSBI&I Co. of f/a..r*1'f¢>"0 I Ct: have inspected the components described in this Owner's Report during the period q..../q. 8't to 8 {;,-/ *'? ( , and state that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective meaSW'es described in this Owner's Report in accordance with the reauirements of the ASME Code, Section XI. By signing this certificate neither the Inspector nor his employer makes any warrantv, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or properly damage or a loss of any kind arising from or connected with this inspection.
~~---4..J~l.4,,,lu~~f....,__,. .~. . . . .~~
~~Inspector's Slgnatun~~
~~~~;::___Commissions_VA_5_43_ _ _ _ __~~
~~National Boara. Stata, Provinca, and Endorsementl Date_ _ _ _ __..7_-..1.=c..(....__19~~
~~. q/~~
1. Owner FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI Vininia Electric and Power Co, Data 4umU¢T 2/2 I / 'j q I Name 5000 Dominion Blvd., Glen Allen, VA Sheet _ _ !i__ of_ __.~=--------
~~Addl'W - 23060~~
~~2. Plant Surry Power Station Unit _ _ _ A._______________~~
~~Name P.O. Box 315, Surry, VA 23883 :S:o'a No 3 600 0 95 ;2 es e,eJ+q1-01 Rapalr Organization P.O. No., Job No., etc.~~
3. Wortt Perfonned by Virginia Power Type Code Symbol Stamp N /A Name Authorization No. _ _ _...N_,,-tfll ......._______
~~1 P.O. Box 315, Surry, VA 23883 Expiration Dat1 _ _ ___.N.__,./...,A.._______ Addrau~~
~~4. Identification of System _ _ _ _M_...a...,\..,.v1...._S+/--.......~~
~~ea..._vY\ 5_ (al Applicable Construction Code B3 l. l 19§1._ Edition,_N ..../__A_ _ _ _ Addenda, N-1, N- 7~~
~~.... (bl Applicable Edition of Section XI Utilized for.Repain or Replacements 1980W80~~
~~6. Identification of Components Repaired or Replaced and Replac:em11nt Components~~
~~Name of Component Name of Manufacturer Manufacturer Serial No.~~
National Board No. Other Identification Year Built Repairwd, Replaced, ASME Codi StlmPld IV* or Replacement or Nol I R.b t:)~ UN~NtfW'i\J l/11}kN{)1;,JN . I N/A l- /VIS-JJ1 U~l!.t!Oll:III l\t.PLA<ib ~o
\ II R!9D5 CFH,t>\~ f:\L ~'b P~t:.UCTS :tNc. \-\8'0~ . ,.~ '-1"'4-0 I N/A PO .. rsy 31~ Obl-'2. 1'1"70 ~1)1J\CSfiB.\T ~o l '; N 0,S tJN'l<N~A.J (IN/fr,JPWN I I
~~N/A 2.-{Y)s-,, r IINlt~i,1 11.J:f)Lf\Cl:b NO I r* NVj_s HRl\l>lOA-ftE 1,\1'~ 5f'tc.l~UY co,J:Nc, 1'i.tll!t~ /"tin. I N/fi. f>o-:\11 csy~~
i..~l?lt-~ 1~c;s~ ~lfKl::11\iNT NO

8. Tests Conducted: Hydrostatic O Pneumatic O Nominal Operating Pressure ~
Other O Pressure _ _ _ _ _ psi Test Temp. *F NOTE: Supplemental sheets in form of lists, sketches, or drawings ffl!IV be used, provided (1 I size is 8% in. x 11 in., (21 lnfonra* tion in items 1 through 6 on this repon is included on each sheet, and (31 each sheet II numbered and the *number of sheets is recorded at the top of this fonn *
* (12/B21 This Fonn (E000301 may be obtained from the Order Dept., ASME, 345 E. 47th St., New Yortc, N.Y. 10017
~~FORM NIS-2 (Backl~~
~~<1. . L_._______________________~~
~~9. Remarks -,&..AL..::s..::.:.µ_£=_.... oc,.~-"---"C"".J"",A..,.";,1""'-6...._...~~
Applicable Manufacturer', Data Fleporu to ba attachad CERTIFICATE OF COMPLIANCE We cenifv that the statements made in the repon are correct and t h i s ~ conforms to the rules of the ASME Code, Section XI. repair or r1101acament Type Code Symbol Stamp __N_/_A_ _ _ _ _ _ _ _ _ _ _ _- - ~ - - - - - - - - - - - - - - - - - - - - Cenificate of Authorization No __N.. .;. ./_A____________ Expiration Date _ _N...;./_A _____________ Signed_..,.ck_...,,.,..L or Province of
~~......=..._.....,a;r:~E,J...~----&--°'~'N-~=~--------Date _ _ _..... ~ or Owner', OeslgnN, Title CERTIFICATE OF INSERVICE INSPECTION o.....,Vf+-'-----d.......o___ , 19 ...2_1__~~
U I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel lnsPectors and the State Virginia and emplo)!_ed by HSBI&I Co* of fJa.rJ Fo "J 1 (;- I', have insPected the components described in this Owner's Repon during the period r S-1-q D to .!)"-/O -9'/ , and state thet to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Repon in accordance with the requirements of the ASME Code, Section XI. By signing this cenificate neither the InspectOT nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Funhermore, neither the Inspector nor his employer shall be liable 'in any manner for any personal ir:iiurv or propeny damage or a loss of any kind arising from or connected with this
~~""'fw===~-:::..~~
~~i_n_~_ec_~_io-*n-~-'1---~~
~~...*.=.. 1'::*-:-:*:::-:BA~ ....._-________ commissions _ _V_A_5_4_3_________________~~
~~Inspector's Slgnatura National eoara, State, Province, end Endorsament1 Date-_ _ _ _ _ f?_--~~7_19 'fJ~~
~~FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI~~
1. Owner Virginia Electric and Power Co, Date __"]"j...,__.t..,,,JL="{.,______,'1'-1i,........,l_'1.:......:"l..,_I_ _ _ _ _ _ __
Name 5000 Dominion Blvd., Glen Allen, VA Sheet _ _ i __ of __ 1__________ Address 23060
~~2. Plant Surry Power Station Unit -......:c.:~"----------------~~
Name P.O. Box 315, Surry, VA 23883 :Job )\)o. ..3%00105~1~ ee..~cH-89 Address Repair Organization P.O. No., Job No., etc.
~~3. Work Performed by Virginia Power Type Code Symbol Stamp _ __,_N~/.1..ft.______~~
Name Authorization No. _ _ _ __._N=-r/c....:Ac...:....._ _ _ _ __ 1 P.O. Box 315, Surry, VA 23883 Expiration Date _ _ _ _ _...cN...:-1,,/...18...1-_ _ _ __ Address
4. Identification of System _ _""C... om"""'l\?i"'c,""'n""'e""'V'\...._--t_,_----'CP:c...::o""\\,....n""~'t------------------------

5. (a) Applicable Construction Code B31.1 19§.l__Edition,__:N""/'-'A:.=....._ _ _ Addenda,N-1, N-7 Code Case (bl Applicable Edition of Section XI Utilized for Repairs or Replacements 1980W80

6. Identification of Components Repaired or Replaced and Replacement Components
~~Name of Component Name of Manufacturer Manufacturer Serial No.~~
National Board No. Other Identification Year Built Repaired, Replaced, or Replacement or No) ASME Code Stamped (Yes Nu.h CRJ\N'E:. 'l>F\~'f %I NJ A ~ -<X.-i li~K~OWN je~~~ -c~6'.: No A. & ~ ~tr1~a~- O~OIC\jO Po~ C~'f-tleJ< l\Jv.-\-s IN<;- CO, Jt ,lNt. e',~ '.l,G N/R .L9'i '{-oq-i \~91 Rep\o.ce~-l ~o St~s C~fll"l\)'t: UN\C~Ot.u"N N/A ~-<:.c...-1. Ot.lK\11011)~ R-;,\O\,C~ 'I\) 0 CAnti~ ~c\. y8'6QSIO \>O ~ CS'/- No S-ru.ds \>ro"**c..+.. Tue.. N/A 33oie~-5 lqo\\ R~\~-e..n-\:
7. Description of Work. _ _ ~'-=evrkc_e-'d__t:_10....:;')_N_w_rs_-'&,----'(_=-:..\O'-'):........:..;\o__:;o...:..\+..:...,'S,.___~.,,.e:..,._r_..::;.£....:.:W:...!P-....!......,;~::,R...:........--=5-~-'9'--_5....:.c/~=::.\-',
~~1>:::i,1!:!.,A-~~
~~8. Tests Conducted: Hydrostatic D Pneumatic D Nominal Operating Pressure B"'~~
Other D Pressure _ _ _ _ _ psi Test Temp. _ _ _ _ _° F NOTE: Supplemental sheets in form of lists, sketches, or drawings ~Y be used, provided (1) size is SY.a in. x 11 in., (2) informa-tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form . (12/82) This Form (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017
FORM NIS-2 (Back)
~~9. Remarks _......J./).L:a.S,:C..!...l"\!.,.£.-=-......,.Ll;>=bi;-='--'C"""'LA.,.=-~'--S,.___,,,,3""------------------------~~
Applicable Manufacturer's Data Reports to be attached CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this J?sa..A:C:MENt conforms to the rules of the ASME Code, Section XI. repair or replacement Type Code Symbol Stamp __N""/_A _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ Certificate of Authorization No,_N....;../_A_ _ _ _ _ _ _ _ _ _ _ _ Expiration Date _ _N""/_A _ _ _ _ _ _ _ _ _ _ __ Signed or Province of 0, ~~L 7)oC~'wnersr:leslgnee, Ti.tie Virginia 7:rSI El./tJ/Np&f:?- CERTIFICATE OF INSERVICE INSPECTION Date--~q<:>,<:=-1--.<..0~--* 19 I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State and employed by HSBI&I Co*
~~'.7/~~
~~of r{o.r--r:for-d) Ci have inspected the components described~~
. in th is .Owoer,'.s .Report 'during the period q ... M - It , ' to 6-1 V ...q, . . and state that to the best of my knowledge and belief, the 0)111ner has performed examinatjo11s and .taken.corrective measures described in this Owner's * '
Report' .in accordance I':* with the. requirements of the ASME Code, Section *x1. * , By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this* Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damag,e ~r a loss of anx kind arisirg from or connected with this 0
~~*_in_sp_e_i:_t_i_ - ~.).__*_*_*~~
~~I * . =_: ._~~
~~.*_* i....,,'--:c&A.-':"'""*~ >....... ......* __* _*_____ commissions-....,V-,-A_5_4_3_ _ _ _ _ _ _ _ _ _ _ _ _ _ __~~
Inspector's Signature National Board, St.ate, Province, and Endorsements Date . - -- . -*- .. . --- ~---. - -*- - * ' * - - - -* **** -- '.. - *-**-*---*---~-------***-* * - I - * - - - - - - - - ***
~~FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI~~
~~1. Owner Virginia Electric and Power Co, :Jate _.._:Il...._.H._'{ei--,2"'"'.~4..,.'_._/9'...,_C/....,_,/_ _ _ _ _ _ __~~
~~1 Nam* 5000 Dominion Blvd., Glen Allen. VA Sheet _ _ -=!.___ of _ _.-..__ _ _ _ _ _ __ Addrea~~
~~23060 Unit _ __..._ _ _ _ _ _ _ _ _ _ _ _ _ __~~
2. Plant Surrv Power Station Name P.O. Box 315, Surrv, VA 23883 Rai>alr Organization P.o*. No., Job No., ate.

3. Work Performed bv Virginia Power Type Code Symbol Stamp .........,,:,i,__/..cA'--------
Nam* Authorization No. _ _ _ _ N.....,.,tc..i.e~--'------- P.O. Box 315, Surrv, VA 2388j Expiration Date _ _ _ _.....,._µ;;;.1....-_ _ _ _ _ __ Addrea
4. Identification of System _ _ ....!f_.EE"""'t?~LJl'..l.lf,lu...f'E=?'i~----------------------------

5. (al Applicable Construction Code B31. l 19~Edition,_N.;..:./.;;.;A:.__ _ _ Addenda, N-1 N-7 (bl Applicable Edition of Section XI Utilized for Repairs or Replacements 1980W80
~~. 6. Identification of Components Repaired or Replaced and Replacement Components Name of ! Name of Manufacturer !~~
I I I National Board I Other Year Repaired, Aepl IIClld, ASME Code StamPlld (Yes Component i Manufacturer I Serial No. i No. . Identification Built or Replacement or Nol I I I I I i e.oL,S. i C.P.FI I\) E:. I UN\<l\'lcrwN I N/A f 2..-FU>-1~'3 iu~l\~(J\0111 ~Pl.l'lab ~o I Cf\~'t:>\lJ/H. ~b l-1 ,- :\' . PO~ C.!>Y
~~'BOL""f'°;) j ~~OMCT~ ~e.l '60%~0 N/A I ~:i..bs-c:11- 'l I 1q~o l~PI.PiCS4\i::).\T ~o i~~
tvl)T..S ! UN~fll<,Wl\l I UNKNew~ N/A l.-\::w-l"3:S 111~11\.IO&ltl 11.cHI\CE:b NO i H~AAE SfeC.IRi H1' .:\' jPo~ csy NUT5 .I C,ij l I.NC-, I 'TS(Wt A N/A I 1.3...I 3 ;l.1--~ I 191&, ~P~C.1:1'1\~NT NO l)\$C... u I',) I(~ 01-"-fV Ut'1K.~t,J l\l/fl l.-1'=1.u-,~3 ~f'l.f\CS~ No
~~8. Tests Conducted: Hydrostatic O Pneumatic 0 Nominal Operating Pressure 0""~~
Other O Pressure f.lC/P psi Test Temp. &@,e:ALT ° F NOTE: Supplemental sheets in form of lists, sketches. or drawings may be used, provided (1) size is 8% in. x 11 in., (21 lntorma-tion in items .1 through 6 on this repon is included on each sheet, and (31 each sheet is numbered and the number of sheeu is recorded at the top of this form . (12/821 This Form (E000301 may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017
FORM NIS-2 (Back)
~~9. RemarKs _ _,{is,-i-,.......a..tv\t-=-"'-----'-c-4~~=-->d.....a..4.A::..i....=SS=------'3=-----------------~~
Aoolicao1e Manuracturer's Data Aeooru to oe 11nacnea CERTIFICATE OF COMPLIANCE We cemtv that the statements made in tne reoort are correct ana this ?EebiVE ruuO: conforms to the rules at the reoasr or reo1acumen~ ASME Code. Section XI. Type Code Symool Stamp __N_/_A ____________________________________ Certificate at Authorization No. _N_/_A_____________ Expiration Date _ _N ___/_A____________ Signed L;/./V\~*'"= ;;::J::':SL EN61rJEti#-: Date--~~""='"-~ed~~r-'- - , 19 / /
~ n e r s 'bes1gnee, Title CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State or Province of Virginia and emo1oyed by HSBI&I Co* of ----------tfl.,.....a.....r_i.._-- ...f:J....o"-'-.--'J=-,.',-.-'c~t-------=---=---:::-=-----, have inSQected the componenu described in this Owner's Reoort during the period _ _ _ _ _ _ _ _Q....._-......_/..,'... 1-_.3...._.'f.___to l;-( 8'.- Cff , and state that to the best of my knowledge ana belief, the Owner nas performed examinations and taken corrective measures described in this Owner's Report in accordance with the reauirements of the ASME Code, Section.XI.
By signing this certificate neither the Inspector nor his employer makes any warrantV, expressed or implied, concerning tne examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his emolover shall be liable in any manner tor any personal injury or prooertV damage or a loss of any kind arising from or connected with this insoection~ ~ ~ ____,._.:,,ia,.___ """'"'."""'7~~'__,~-.,,.,_~-----Commissio.ns __ V_A __5_4_3________________
~~~Signature National Boera. State, Province, and Endorsemenu Date* _ _ _ _1-"---'~d:"-G"~_l 9 qJ~~
~~., ,I~~
~~FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI~~
1. Owner Virginia Electric and Power Co. Date _ _ :::C......._,_,_)(_j.,___....,2=4....i.+J..,.f_.9_-jL..,/'--------
~~Name 5000 Dominion Blvd., Glen Allen, VA Address 23060~~
~~2. Plant Surry Power Station Unit ---=.;2.._=----------------~~
Name P.O. Box 315, Surry, VA 23883 :So\:, No. "3'6ll0 I<l> b :i+/-i.h [?e+/-i4t-9 1 Address Repair Organization P.O. No., Job No., etc.
~~3. Work Performed by Virginia Power Type Code Symbol Stamp _ _ _~N~,,./'-"'fl'-+------~~
Name Authorization No. ------0-N;,"-l..1.A=------ P.O. Box 315, Surry, VA 23883 Expiration Date _ _ _ _ _ _ __,Nc..><.,,_/.,_A_,__ _ _ __ Address I
4. Identification of System _ _........i-_..'E....~......D..l""'J,).._._A.,_!....__..ELJB.....__ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __

5. (a) Applicable Construction Code B31. l 19~Edition,_N......:../_A_ _ _ _ Addenda, N-1 N-7 Code Case (bl Applicable Edition of Section XI Utilized for Repairs or Replacements 1980W80

6. Identification of Components Repaired or Replaced and Replacement Components
~~Name of Component Name of Manufacturer Manufacturer Serial No.~~
National Board No. Other Identification Year Built Repaired, Replaced, ASME Code Stamped (Yes or Replacement or No) CfV\l\lc Vf\tVl:: HT ~ ro~ - l&Y "DI Cz> c.. S.IB, &R'tPAII\ °'tl\V, P/fl) ~i'Fl-'\--Cl N/R l S'l"l. 0 b /Cf Be RI-PLflCEl"cJJT ~C)
7. Description of Work _ _ ~B~ef1-t\o.......c:...ec...l..___roo.:......,...,..\:e.....,..,n'"-,...&>o.\t~s--C......s'-"e""e-~b...,M""""1-.1;P;........~i..__),J.-...._
~~\ .s ___________~~
8. Tests Conducted: Hydrostatic D Pneumatic D Nominal Operating Pressure W Other D Pressure _ _ _ _ _ psi Test Temp. _ _ _ _ _ _° F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is SY:. in. x 11 in., (2) informa-tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form .
(12/82) This Form (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017
FORM NIS-2 (Back)
~~9. Remarks_.......,_A~2~~~e..~-~C~o=D~£..~_C._....,,....Af>~S~~~~----------------------~~
Applicable Manufacturer's Data Reports to*be attached CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this ? e e t ~ conforms to the rules of the ASME Code, Section XI. repair or replacement Type Code Symbol Stamp __N_/_A __________________________________ Certificate of Authorization No. _N_;_/_A_____________ Expiration Date _ _N_/_A_____________ or Province of Vir inia CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State and employed by HSBI&I Co* of C have inspected the components described in this Owner's to 6* 18-9 f , and state that to the best of my knowledge and belief, the Owner has performed exami~ations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section XI. By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspection.
~~-------~1----~---,---f._._~~~~-~-Commissions __V_A_5_4_3_________________~~
~~Inspector's Signature National Board, State, Province, and Endorsements Date _ _ _ _ _,7_-~d:~~--_ _19 C//~~
~~FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI~~
,. Owner Virginia Electric and Power Co. Date Aq6,l.l~T LO J I qq I Name 5000 Dominion Blvd., Glen Allen, VA Sheet _ __,l,,___ of _ _...c&::...:;:Z::._J,;;~=-..!:::le,/~.;i...:.1'-/q.L.;,:....--
~~Addresa 23060~~
~~2. Plant Surrv Power Station Unit---=::..'----------------~~
Name P.O. Box 315, Surry, VA 23883 1ok No, '380el (')BX35 ~#91-Cf:I-Addresa Repair Organization P.O. No., Job No., ate.
~~3. Work Performed by Virginia Power Type Code Symbol Stamp t,I / A Name Authorization No. ---.....uNy/c..LA;J..._______~~
P.O. Box 315 2 Surry, VA 23883 Expiration Oate _ _ _ _...11\l::.+/.i::f\L-------- Addraa s,!,;fL..L.AA:,LLY,7---------------------
4. Identification of System _ _...;\\'f:~(...,l.:.;R!,::,C..QUwbPi::L.LT...1...11u..<\:.,..'.\ci;q~...

5. (al Applicable Construction Code B31. l 19~Edition,_;.,;N.:../_A;;;...,,._ _ _ Addenda, N-1 N-7 Code Case (bl APPiicabie Edition of Section XI Utilized for Repairs or Replacements 1980W80

6. Identification of Components Repaired or Replaced and Replacement Components
~~Name of Component I~~
Name of Manufacturer i Manufacturer I Serial No. I I I I National Board No. Other Identification Year Built Repaired, Replaced, or Replacement or Nol ASME Code Stamped (Yes I l\)VTS I VN\l;.l'\l~N I UI\\ l<-)vOU,r\J l N/A l-P-S-f\'\O\f -:i.st.11 1111\l\\'NC~N ~PL.&;l:> ~o I I Cf\R'b\~FH. ~l> I r\'\" ,I.\ i PO~ csy NO N \J"TS f P.OW~ .INC. B~lO\ \ I N/A 3~\Jt()(,-'l{ I 1~9a ~?lJ'ICS'tiE:t..\i Sil)t::,5 tJN,C...NO't.uN I l)fl)~N~ II' N/A :l.-Rs-MoV-%1,R 1/~\(~1'1 "1::Hf\Cl:l) NO f'l~VA MkHINE ~,~ i Po~ csy
~~~\:)5 f P.-0.t>l>,~t':o (01\f' 1091t%1. I N/A 3:.'5!54-°\-3 Il\ C\ I R=Pl.lKE:1"\:.'tJT NO~~
1. ~ ~S.-ll\di-'2S£~ 111\l~DU'l~ NO

t,1sc.s l"cs1 .. s"E:fn.. UN~(llp',-i I t-yA "1:f'l..f-\C.&b
~~~~} ~/!Jq1 "~~
7. Description of Work e~e~ 62-) SlVDS I 6rj 1'\UTS -, 1'o I AM? -p,\ ~

8. Tests Conducted: Hydrostatic O Pneumatic O Nominal Operating Pressure G-Other O Pressure _ _ _ _ _ psi Test Temp. °F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is 8% in. x 11 in., (21 informa-tion in items 1 through 6 on this repon is included on each sheet, and (31 each sheet is numbered and the number of sheett is recorded at the top of this form .
(12/821 This Form (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017
1t'1.>-l_ FORM NIS-2 (Back)
~~9. Remarks _ _. 1.At.1. .2¥.c.,l\A....:.,,E=-__.(_...Q"""D...:E.-~___,_C=-4,.l..icA:?......._""..._;;:,--<=L"""-------------------~~
APPlicable Manufacturer's Data Reports to be attached CERTIFICATE OF COMPLIANCE We certify that the statements made in the reoort are correct and this \2EPl..tllEI\.Cf:NT conforms to the rules of the ASME Code. Section XI. repair or rep1acement NIA Type Code Symbol S t a m P - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Certificate of Authorization No. _N....;../_A_____________ Expiration Date _ _N....;../_A_____________
' .)LI - ,- _.O.....,.t}'-~*___d~D-* __, 19 Signed ~ I Set r;lll (.1/1Jf=1!-- Date _ _ 91 wder or Owner's besignee, Title CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State
~~or Province of Virginia and employed by HSBI&I Co* of~~
'-'c t. . . _______________ have --------~H.µoa. .r:cct.......,.A., o""r..,d=-..,)..... inspected the components described in this Owner's Report during the period _______£.,,_-_/.._--{L..;;.l>___ to _ _..,5":~-~l~D~--q_'_______f , and state that to the best of my knowledge and belief, the Owner has pertorm.ed examinations and taken corrective measures described in this Owner's Report in accordance with.the requirements of the ASME Code, Section XI.
By signing this certificate neither the Inspector nor his employer makes any warrant¥, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. F.urthermore, neither the Inspector nor his employer shall be liable in' any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspection. ,~* ?. ~~*
~~------l~f-1.<.,"'*~'---,------:--(:~-~L:4r,.._,.....,_~~------C.ommissions __V_A_5_4_3________________~~
Inspector's Signature *
~~National Boara, State, Province, .and Endor111m11nn Date _ _ _ ~7-1s 1, {~~
~~__.r{'-'-.....~~
~~FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI~~
~~1. Owner Virginia Electric and Power Co. Date _ _.flro~&.=-=u~';:>~T~....2~P=-i1~\~9~'f.....,_l______~~
~~Name 5000 Dominion Blvd., Glen Allen, VA Sheet Address 23060~~
~~2. Plant Surry Power Station Unit ___: ) . . . ~ - - - - - - - - - - - - - - -~~
Name P.O. Box 315, Surry, VA 23883 :S~\., ~ c;, 3'600 JO~~ 3 o e£141 -q4-Address Repelr Organization P.O. No., Job No., etc.
~~3. Worlc Performed by Virginia Power Type Code Symbol Stamp _ ___,N=-1-/'--A._,__ _ _ __~~
Name Authorization No. _ _ _ _ __,_N"-'-//fi-....c..a._ _ _ _ __ P.O. Box 315, Surry, VA 23883 Expiration Date _ _ _ _ _ _...,N-"'-.,._/...,_J:'[...,___ _ _ __ Address
4. Identification of System _ _~R:=);:_t~\~B.-c_u~*~l-l\[~_...tN:~GJ-~S~P~13.~l\:~Y________________________

5. (a) Applicable Construction Code B31.1 19§l__ Edition,_N~/_A_ _ _ _ Addenda, N-1, N- 7 Code Case (b) Applicable Edition of Section XI Utilized for Repairs or Replacements 1980W80

6. Identification of Components Repaired or Replaced and Replacement Components
~~Name of Component Name of Manufacturer Manufacturer Serial No.~~
~~National Board No. Other Identification Year Built Repaired, Replaced, or Replacement or No) ASME Code Stamped (Yes PO~ $ s 'I~~
t:, \ S, (_ f' o 51-- !>'E-IH.... 2\lo - ~o IlCJQ'-3oO N/r-t 2.SS' l':J 12. )~%~ R.\:;{' Lf\'\'t:f',I'r N-0

8. Tests Conducted: Hydrostatic D Pneumatic D Nominal Operating Pressure ~
Other D Pressure _ _ _ _ _ psi Test Temp. _ _ _ _ _ _° F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is SY.. in. x 11 in., (2) informa-tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form. (12/82) This Form (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017
),
~~FORM NIS-2 (Back)~~
~~9. Remarks -~--1-~...,_.-a.:===--L()--"-'D--'E..;;.__~C~~
~~...A:..i.J>,;'$u..:.....,_S_.___.2""-"'-'- - - - - - - - - - - - - - - - - - - - - - -~~
Applicable Manufacturer's Data Reports to be attached CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and t h i s ~ conforms to the rules of the ASME Code, Section XI. repair or replacement Type Code Symbol Stamp __N_/_A __________________________________ Certificate of Authorization No. _N-'-/_A_____________ Expiration Date _ _N..c/_A _____________ Signed t/~ XS T "9'wneror Owner's Designee, Title b/116,(AlffP CERTIFICATE OF INSERVICE INSPECTION Date _ _ __,{2-,....~..,.,...~~e?~D~--. 19 I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State CJ, or Province of Virginia and employed by HSBI&I Co* of
-------...H~d~r_T~l.'"~to~~~J.......,.,_c~r_*______________ have inspected the components described in this Owner's Report during the period _ _ _ _ _ _~S:--~l-~'?~O__ to_.__ 5:_-~/~0~--9~</~------, and state that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section XI.
By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this
~~. inspection. £. /I)~ ---~µ=--='--,-----'<-f'-'--c-"Ll__...,~.,_--=------Commissions __V_A_5_4_3________________~~
~~insi,e;tor's Signature National Board, State, Province, and Endorsements Date-------------- ro~ _,.r1" 7 19 q I~~
~~FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI~~
1. Owner Virginia Electric and Power Co, Date Ji !I '{ 9 1 14:CZ I Name 5000 Dominion Blvd., Glen Allen, VA Sheet _ _ i _ _ of _ _ 1 _ _ _ _ _ _ _ _ __
~~Addreu 23060~~
~~2. Plant Surry Power Station Unit _ _ _~ - - - - - - - - - - - - - - -~~
Name P.O. Box 315, Surry, VA 23883 -:l" .\, ~., 3lH,0i~.$~ e, e, f?.{?_=#= q/. 9£; Addreu Repair Organization P.O. No., Job No., etc.
~~3. Work Performed by Virginia Power Type Code Symbol Stamp _ _ _ _N=-./._fl:........__ _ __~~
Name Authorization No. -------1b:}"¥/..1ACJ....____ P.O. Box 315, Surry, VA Address 23883 Expiration Date N/ 7 a
4. Identification of System Con+c:mmer,.+/- >t1r~

5. (al Applicable Construction Code B31. 1 19§1___ Edition,_N--'-/_A_ _ _ _ Addenda, N-1 , N- 7 Code Case (bl Applicable Edition of Section XI Utilized for Repairs or Replacemsnts 1980W80

6. Identification of Components Repaired or Replaced and Replacement Components
~~Name of Component Name of Manufacturer Manufacturer Serial No.~~
National Board No. Other Identification Year Built Repaired, Replaced, ASME Code Stamped (Yes or Replacement or Nol I\) 11\.ts - Ul\lKNb\J.!ltv N/A ~-CS.-~'i-~til'c UN~cw,J
~~\'O ~ c.s'(-~~
~~R~\°'"c-=l No KereA.. ~o\-\-~~
"e)< NiAts 1.nc\. Co, L"*a_ o~Ol°tUo ~/A ~3(£3."f-;,l_ l~8 l ~\~-l- No ~-\-wls. - UN\C~O\OrJ N/A ~ -c.s-,~cr~\ ~ (.i,Ji::,,Jcw-J R~\~ No (C..~\1'.0\.\ ~ck. I\Tc\\~%'tq0 PO~ c;;y R..J. (hl)~a-,l\) \:>.-od\U.c,+~ 1.l-. N/A 3:iQioi-s t~~ I ~\w.e.rn~\: No 1
~~o.,.t_ __,C.-:9..,,_0_.__,+\<i""o..:..\t...,:%."-+/-(.,._9,.._\.,__-'-'\..J:,e.;lA::..>,;t....,s..__~(....54 /...j;gL....t.')...1,/;,laiA~*:..__ _ _ _ _ _ __~~
7. Description of Work _ _..._\3,,..:e""'l~~\r..r,...._=e....

8. Tests Conducted: Hydrostatic O Pneumatic O Nominal Operating Pressure 0 Other O Pressure _ _ _ _ _ psi Test Temp. °F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (11 size is 8% in. x 11 in., (21 informa-tion in items 1 through 6 on this report is included on each sheet, and (31 each sheet is numbered and the number of sheets is recorded at the top of this foni1 .
(12/821 This Form (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017
FORM NIS-2 (Back)
~~9. Remarks t\SM-t.- Cbt:E- (;J MS ~~~
Applicable Manufacturer's Data Reports to be attached Bo1.-,.S- PD-:! csY 33DBOL-5 CERTIFICATE OF COMPLIANCE we certify that the statements made in the report are correct and this /;l='Pqa;!"MT conforms to the rules of the ASME Code, Section XI. repair or replacement Type Code Symbol Stamp __N_/_A _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ Certificate of Authorization No._N-'-/_A_ _ _ _ _ _ _ _ _ _ _ _ Expiration Date _ _N_/_A _ _ _ _ _ _ _ _ _ _ __ Signed lA,,.._.,L_ , ;J;SI
~~~r or Province of or Owner's odslgnee, Title Virginia Gv'6rt.JE#?;~~
CERTIFICATE OF INSERVICE INSPECTION 1, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State and employed by HSBI&I Co* Date_-->,~"""""---2..._,,- - - , 19 9I of _ _ _ _ _.......Hµ..;o..=.:a,,.c...:t
........FPi...:::....(':.....::c\.::;_)r=c=--tc...;*c..-'- - - - - - - - - - - - ~ h a v e inspected the components described in this .Ovvner's _fleport during ,the peri~d _ _ _ _ _ q_,... ,....Jf...-....Jf..._'t',__....;..._to ' -, v-cr I . and state that to the best of my knowledge and belief, the O.wner has performed examinations and taken corrective measures described in this Ow11er's Report in accordance with .t~e. requirem~nts of the ASME Code, S~~ion XI. ., '
By signing this certificate neither.the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures* dj!Scribed in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage ~r a .loss of any kind arising from or connected with this inspection.
~~-----~.Ll-=-=*-*-=* -,-..,.f':--"._*~~~~
~~Inspector's Signature~~
~~... c<..>a-. .-..,,..,_ _ _ commissions __V_A __5_4_3________________~~
~~National Board, State, Province, and Endorsements Date* _ _ _ ____._7_-__,_ID~_19 Cf,.(~~
~~FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI~~
~~1. Owner Virginia' Electric and Power Co, Date -:fUL':( C\ \"\q \~~
Name 5000 Dominion Blvd., Glen Allen, VA Sheet _ __.!,.__ of _ _..:l,___ _ _ _ _ _ __ Address 23060
~~2. Plant Surry Power Station Unit_-"'~=---------------~~
Name P.O. Box 315, Surry, VA 23883 Job No. '6~~0i@5.3(}H ee_::tt.qr-91,, Address Repair Org11nlz11tion P.O. No., Job No., etc.
3. Work Performed by Virginia Power Type Code Symbol Stamp N/ A Name Authorization No. _ _ _..JNULf/.i:PsL--------
~~P.O. Box 315, Surry, VA 23883 Expiration Date _ _ _ _....N...,,-/Bu________ 1 Addrea~~
~~$...,~1-"c:R.....,>;j"'f-----------------------~~
4. Identification of System _--'c_""'t"l""'O....t....,n...,*,,..p_..o,.......,.f_.ll\u.+........__ _

5. (a) Applicable Construction Code B31. l 19~Edition,_N-'-/A _ _ _ _ Addenda,N-1, N-7 Code Casa (b) Applicable Edition of Section XI Utilized for Repairs or Replacements 1980W80

6. Identification of Components Repaired or Replaced and Replacement Components
~~Name of Component Name of Manufacturer Manufacturer Serial No.~~
National Board No. Other Identification Year Built Repaired, Replaced, or Replacement or Nol ASME Code Stamped (Yes (}AJIQI/C'u1',j STIJl) vN~OwDV I N/~ .2 -cs .. FNfi*!2.0IF ~ l\c:PL~~b ~o Roel ci'R.. , ~ I>,a.11
~~., Kor~ \lJoH~~
~~t.nd~~
~~lo L.-\:c\. (!)~()1~~30 N/A PO<\f C';,'/-~~
~~3"5oio2-5 - UN~J R'E:-~LP.Cl:M'tl\l1 NO NVTS - UI\J~l\let.c>N N/A i-lS-fl\'lq~O.OII') u,'l~otuJ~~
~L.Pra:D NO CCI..~'"°"\ fnd, t\,~ PD~ c~'(- UtJjU,(CW,J 1-'ce..l(. ~1.1-ts ~ l"O cll.\l."rS "!'n C , S0'3b~C I N/A 3:3 bb '3t--l - ~ l.FicB'fl1cf\)1 NO
8. Tests Conducted: Hydrostatic O Pneumatic O Nominal Operating Pressure 0 Other O Pressure _ _ _ _ _ psi Test Temp. °F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is 8% in. x 11 in., (21 informa-tion in items 1 through 6 on this report is included on each sheet, and (31 each sheet is numbered and the number of sheets is recorded at the top of this form .
(12/82) This Form (E00030) may be obtained from the Order Dept.,*ASME, 345 E. 47th St., New York, N.Y. 10017
FORM NIS-2 (Back)
~~9. Remarks -oLJ-A'-=S'-'-M-"E-=-~C=od=---e..,__,__,C_j=c.,.,""-S-.5-....c.L-"'--_~p~o-~_~&c.=us"-'-_-~C-~S-'f_-_3_"3_b~8_o_L_-_5_ _ _ _ _ __~~
Applicable Manufacturer's Data Reports to be attached pc:tt. N\Jf~ - csv - 33t..t,.37-x.. CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this ~l.E.ME.IJ°T' conforms to the rules of the ASME Code, Section XI. repair o~ _replacement Type Code Symbol Stamp __N_/_A __________________________________ Certificate of Authorization No. _N_/_A_____________ Expiration Date _ _N-'/_A _____________ Signed / fi., ~/ 1 ) ~ e ! e s i g n e e , Title or Province of Virginia
-:I""GI £,,!6.tAlf£.IL CERTIFICATE OF INSERVICE INSPECTION and employed by HSBI&I Co*
Date _ __,~=.,,j,...,.__..,,.7____ , 19 9/ I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State of ti"'"'"1"P:o \. <> ) c. r have inspected the components described in this Owner's Report during the period 'f- £1-tf to C. -( f-'t I , and state that to the best ot"my knowledge a'na beli~f. the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirem*ents of the ASME Cqde, Section XI.
'. By signing this certificate neither th~ Inspector nor his employer ma*k~s ~ny warranty, expressed o~ implied, con~rning the examinations and corrective measures .described in this Owner's Report. Furthermore, neither the Inspector nor his .
employer shall be liable in any manner tor*any person'al injury or property damage or a loss of anv. kind arising from or connected with this inspection. /,) ~ _____*~ -=-*-:-----:---::*:-"£,:....:...'
~~\-- _ _ _ _ commissions __V_A_...;:5_4_3 --~--......c.....: ________________~~
~~Inspector's Signature National Board, State, Province, and Endorsemenu Oate,_ _ _ _ _ 7____-,.-t-(_tD_ _19 q I~~
~~FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI~~
1. Owner Virginia Electric and Power Co, Date ----'~=L)=L:'-'-'{_....,IB~I__,l_'l.,_9....,__._f_ _ _ _ __
~~Name 5000 Dominion Blvd., Glen Allen, VA Sheet _ _-=l.___af _ _- " l = - - - - - - - - - - - Addraa~~
~~23060~~
~~2. Plant Surrv Power Station Unit _ _ __...........__ _ _ _ _ _ _ _ _ _ _ __~~
Name P.O. Box 315, Surry, VA 23883 Address Rapalr Organization P.O. No., Job No., ate.
3. Work Performed by Virginia Power Type Code Symbol Stamp N/ A Name Authorization No. _ _ __,_,N..,/ue,:J.-_______
~~P.O. Box 315, Surrv, VA 23883 Expiration Date _ _ _ _......N""+/..1..P.......__ _ _ _ _ __ Addrea~~
4. Identification of System _ __,Sa<lB.JJrwE....I....X4---l"'-'N~:S:. .E . ...c..;-Y'-'\'-"O"'-'N-=--------------------------

5. (a) Applicable Construction Code B3 l. 1 1 9 ~ Edition,_N--'-/_A_ _ _ _ Addenda, N-1 N- 7 Code Case (b) Applicable Edition of Section XI Utilized for Repairs or Replacements 1980W80

6. Identification of Components Repaired or Replaced and Replacement Components ASME Code National Repaired, Stamped Name of Manufacturer I Board Other Year Replaced, (Yes Name of Component I
Manufacturer Serial No. I No. Identification Built or Replacement or Nol I I I 60L1S I l.)1--.:)',<.l\)('9-l,.ll\.l Ul\j\<;_~D(J)N \ N/F\ ;2.-SI.- )..Ur3, I U"ll\NO\ll)I ~P~b 1'110
-Cf\\:\,t,\~Pt:L Il';)\)l~T ~ PO~ S'j P.>Cl L1S \ ?~bocrs XNc., 13.?..':l.. IC\\ I N/A 3!,+ DC\H i ,~ <) l ~?~!:~, NO I '
NUIS \JEl..i;N VNK~k)I\.S ! N/A :i-1:,1..- ;;l.J-\s \vt-lKNOul'I "1::\:> LI, C.El) NO I {flP.b\NA\..... :I.Nt), l*f'f~ i f>o~ csy '
~UTS PRot:lllc...1 s. ~ C 2. l-i- ')__°i I I N/R :t'S!S"qu._1-1.. 1qi4 ~P~c.r:l'l\l:.>>T NO 1
7. Description of Work _ _ _ R,..._e-i~!--'\""'="":e""""c\"'-----'l"""l:::::i;)""---'-'Xl""M""::\::..;;s,....__~&,..___..i,\i~aui~..:::s,,__<,,~\"2=-.')!.,._...J.(e--1.l.:..VLJ.1....,),.2-_________

8. Tests Conducted: Hydrostatic O Pneumatic 0 Nominal Operating Pressure G-Other O Pressure NOP psi Test Temp. NOT O I:'
NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is 8% in. x 11 in., (2) Informa-tion in items 1 through 6 on this repon is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form * (12/82) This Form (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017
1 FORM NIS-2 !Backl
~~9. Remarl<s _ ..........f=------1C~0...D""'f-~...,C-"""r""'j--=-+$5=---'----------------------~~
_,_A,....S=-.:.M APPlicable Manufacturer's Data Reports to ca attached CERTIFICATE OF COMPLIANCE We cemtv that the statements made in the reoort are correct ana this f<E.f'LACEMEl\,l"T conforms to the rules of the ASME Code, Section XI. rep1ur or reo1acement Type Code Symbol Stamp __N_/_A ____________________________________ Certificate of Authorization No __N_/_A_____________ Expiration Date _ _N....;../_A_____________ 9 __~~...,,.-1,---,,..../~8--.- Signed ~~(gnee~~ or Province of Virginia Date _ _ CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler ana Pressure Vessel lnsoectors and the State and employed by HSBI&I Co* 1 __, 19 q I of
--------tH-+'a=--"~T . . . . .fu.=.,_r_d=----;)--' . c_1: ..._______=s--:-:::-=~--have insp;;=ted the components described in this Owner's Report during the period q-/'1-[{'7 to 6- /f?- 'f/ , and state that to the best of my knowledge and belief, the Owner has performed examinations and ta1<en corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section XL By signing this certificate neither the Inspector nor his employer! makes any warranrv, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner tor any personal injury or property damage or a loss of any kind arising from or connected with this inspection(;~~ J_ f) /) ----~lf-'=->.1~-~--'-'::- --:::rd:--_ '-~-------Commissions _ _ V_A_S'--4_3_________________
~~I nsi,ector's Signature National Boara. State, Province, and Endorsemanu Date 7-11 19,_C/~/-~~
~~FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI~~
~~1. Owner Virginia Electric and Power Co, Date _~::U......,u=~==-j.._~/'-'o"-J1--l...'......~~
~~.:1 9....I.___ _ _ __~~
Name 5000 Dominion Blvd., Glen Allen, VA Sheet _ _~!'--- of _ _..,l=------------ Addrea 23060
~~2. Plant Surry Power Station Unit ---')..=---------------~~
Name P.O. Box 315, Surry, VA 23883 Addrea Repair Organization P.O. No., Job No., etc.
~~3. Work Performed by Virginia Power Type Code Symbol Stamp N / A Name Authorization No. ---~Nu..;/c....Pt.,_________~~
~~P.O. Box 315 1 Surry, VA 23883 Expiration Date _ _ _ _....N~/.L;f\..________ Address_~~
t~--=s""'i'\)'-'C.::0...C"-')'f-----------------------

4. Identification of System _ _..:C,..o"'n...,t,...;,,...\n...._.ro......,e...uo...

5. (a) Applicable Construction Code B3 l. l 19§.l__ Edition,_N_..:.../_A;;;...._ _ _ Addenda, N-1, N-7 Code Case (bl Applicable Edition of Section XI Utilized for Repairs or Replacements 1980W80

6. Identification of Components Repaired or Replaced and Replacement Components
~~Name of Component Name of Manufacturer Manufacturer Serial No.~~
National Board No. Other Identification Year Built Repaired, Replaced, ASME or Replacement or No) Code Stamped (Yes Bol\-s l~* q"5~ Ul\ll<I\JCIWN I N/~ ~ -e..'l.~ F'Nq ..\0'3 OlllKNOlOt,\ Ri.fl.ACI;D ~o I eo.t'cr,niJ. ::r."'c\. S<&<;>'l 13'3 N/A PO~ l°tl:\\ ~fl'FtC.~~~T N!O Bol+~ 1>reduc\-s. ::I.nc.. .31.\0~'t-D-J Nu.-r lJNk~eu5N N/A !l..-c.&*FN~~lti?> U~KtOo~~ R't.~ L~ C.t. NO
~~- '"*~ ~~~
~~I \I I~~
~~" -' ,.._,_(" f()~~~
I-I-ex ~u.-t l%*9 _,. -\ i~S:::6- " N/A :2.~0t~l-';)... tC\i~ ~PL'tC.T:~f NO C-re: l(A~ '&,i_,.. I..OT : j : J Co. '51 &5'&
7. Description of Work_...,R-"e"'tw~~=ceo\=_..,,C.:..:l!l...:::..~~~~('J~~t~s____;&=-..--=.(~~~...!.\.l...-~:....::..:::lA:~A..:s_ _ _ _ _ _ _ _ _ _ __

8. Tests Conducted: Hydrostatic O Pneumatic O Nominal Operating Pressure 0 Other 0 Pressure psi Test Temp. °F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is 8% in. x 11 in., (2) informa-tion in items 1 through 6 on this report is included on each sheet, and (31 each sheet is numbered and the number of sheets is recorded at the top of this form .
(12/821 This Form (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.V. 10017
FORM NIS-2 (Back)
~~9. Remarks f\ S iV\E. Cot::>E, CL:A-SS &-~~
Applicable Manufacturer's Data Reports to be attached Nu-r Cs'-/. - 340116 - CERTIFICATE OF COMPLIANCE We certify that the statements made in the reoort are correct and this ~lAfEJ':'8{[ conforms to the rules of the ASME Code, Section XI. repair or replacement N/A Type Code Symbol S t a m P - - - ' - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Certificate of Authorization No. _N_/;..A_ _ _ _ _ _ _ _ _ _ _ _ _ Expiration Date _ _ N..;./_A Signed 7
~~~~ ~r or Province of T6X or Owner's oJsignee, Title Virginia &6rll(ff,e. Date_-7'59,....~'-'+--~li~~---, 19 9/~~
CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State and employed by HSBI&I Co* of
/iAv-!Fe.I'~ ) Cf- have inspected the components described in this Owner's Report during the ,Period 'i- I T-'t,. to ,_, a-<i I . and . state that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section XI.
By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations .and .corrective mf!asures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable 'in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspection.
~~,~Ji~'~ Jnspect~ture Commissions_VA-c--54_3- - - - - - -~~
~~National Board, State, Province, and Endorsements Date* _ _ _ _ _ 7.L.--..../-=D0-_19_q_/~-~~
~~FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI~~
, . Owner Virginia Electric and Power Co, Date t\u(nLlST 2 8 , Ic:rct. I Nama 5000 Dominion Blvd., Glen Allen, VA Sheet _ _..i,1..___ of _ _,..1.,,...__ _ _ _ _ _ __
~~Addr- 23060~~
~~2. Plant Surry Power Station Unit----~-------------~~
Name P.O. Box 315, Surry, VA 23883 1n b fvp ':5 800 / 0S--f?'.;5 't P:e,..:lt-cu-t.p_ Repair Organization P.O. No., Job No., etc.
~~3. Work Performed 1,y __V_1._*r.. .,. g._i....n""i""a--"P-o-w"'"""e..;;r_______ Type Code Symbol Stamp ___.t,f_/.aA'--~~
Neme Authorization No. _____ N.. _,.../ A-._______ P.O. Box 315, Surry, VA 23883 Expimlon Date _ _ _ _.....b\;i,i.,1-f.1JA1--_ _ _ _ _ __ Addrea II* n r r
~~4. identification of System _ _......... u"-"'u. ,r71CLJ,._ _,,1-rc.l.....U,az"-'-'u;/-..<Loj------------------------~~
~~v..,,,z...,...~~
5. (al Applicable Construction Code B3 l. 1 1 9 ~ Edition,_N;;.;..:./..;;.A;...._ _ _ Addenda, N-1, N-7 Cod*Cue (bl Applicable Edition of Section XI Utilized for Repairs or Replaeemlfflts 1980W80

6. Identification of Components Repaired or Replaced and Replacement Components ASME "Code National Repaired, Stamped Name of Name of Manufacturer Board Other Year Replaced, (Y" Component Manufacturer Serial No. No. Identification Built or Replacement or Nol
& ,,. c.led u/ve VNfrNf!W II.I v/l/ler.><7l,P Ill I N/A ,-vP-/Q VtJ!CfJDa,,v Rkl'l.PICE ~ ~o -i: re..... :J:!> PcJ .if /JS_,Y t"'dJ. (/a£e ,_ I N/A R.1:?I.MM'tNT NO T"'C... :a::60 p, ,c;-o :;11, 7-16 o-s> lC\q \
~~i II I~~
~~8. Tests Conducted: Hydrostatic O Pneumatic O Nominal Operating P r e s s u ~~~
Other O Pressure _ _ _ _ _ psi Test Temp. _ _ _ _ _° F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (11 size is 8% in. x 11 in., (21 lnforma-tion in items 1 through 6 on this report is included on each sheet, and (31 each sheet Is numbered and the number of 1heeu is recorded at the top of this form *
~~(12/821 This Form (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017~~
~~FORM NIS-2 (Back)~~
~~9. Rema[ks - - - . ; . . . . - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -~~
~~Applicabla Manufacturar'1 Data Repom to be attached~~
~~....--~-- . '~~
CERTIFICATE OF COMPLIANCE We cenify that the statements made in the repon are correct and this /?~>>c 4-c1e,,f..1Y conforms to the rules of the ASME Code, Section XI. repeir or rei:uacement Type Code Symbol Stamp __ N_/_A________________________________ Cenificate of Authorization No. _N.....;../_A____________ Expiration Date _ _N-'/_A...;...___________ Signed (]£~---< Owner or owri'.,:, ci:'sislin-: Title rs_r ?vt(,wE-E~ CERTIFICATE OF INSERVICE INSPECTION Date _ _ 4...,u.=""'n.--:1....G._____, 19 I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State orProvinceof Virginia andemployedby HSBI&I Co. 9( of tlo.t For c:i . 1 er: ~ l have inspected the components described in thi~ Owner's Repon during the.period I
- - 't() to S -/5 -<ju :y . , and state that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's _Report in accordance with the requirements of the ASME Code, Section XI.
By signing this cenificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be li~ble 'in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspection. f){)-#--!
~~/D..._...... '-:-..;...---:~rL~-L.._..,JJ~ *- l ~ f - = : : .._,,9+..;:.;;;;....._Commissions __V_A_...;5_4_3________________~~
~~lnsp~or', Signature Netlonel B0arc1, State, Province, and Endorsamentl Oate_ _ _ _.....,8._-....:)'-__ 0 19 q/~~
1. ONner Vir~inia FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS Electric As Required by the Provisions of the ASME Code Section XI and Power Co, Nama 5000 Dominion Blvd., Glen Allen, VA Addr.. 23060 Sheet ____ l..__ of_.......'-',=,,:--------
~~2. Plam Surry Power Station Unit---=-------------~~
Nama P.O. Box 315, Surry, VA 23883 4QbRapalr 3 8: e>@tee.as 3 'i;J{R:#-'JH/b NnOrganlzatlon P.O. No., JOb No., etc. 3, Work Performed by_..;V..:i:.:r:..<g.i::.::n;:.;1_*a;;;...;P;..o:;..;w::..;e::.;r=-------- Type Code Symbol Stamp__,fJ ...~{aA_ Nam* Authorization No. ----"Na,,,-i(AC1.-_ _ _...;.;.._ __ P.O. Box 315, Surry, VA 23883 Expimion Oata _ _ ____.N~/... 8i.....______ Addrna I/ £)' I
4. Identification of System _ _ _ _... *v.&1."-QLJ;Co.1<Lfa.l/~na:i--__.rc~...,,a:zu:11.t:..:;01t..~~---------------.....:..---

5. (al Applicable Construction Code B31. l 19~Edition,_N ___
~~/ A;;...._ _ _ Addenda, N-1, N-7 .... (bl Applicable Edition of Section XI Utilized forRepain or Replace'inenu 1980W80~~
6. Identification of Components Repaired or Replecec:t and Replec:emt!nt Components ASME Coda Repaired, Stamped Name of Name of Manufacturer National Board Other Year Replacad, ,v..
Component Manufacturer Serial No. No. ldtntification Built or Replacamtnt or Nol s-ruD5 f'O(,(.)£LL (ll':Jkf\)(JV/1.) ! N/A 2.-IIP-/2 U~~IIOIOII kt. p L.fK.1:l> ~o 51VT:>.s (:. /;l(r:,1N/lfL
~~,,fp()f/CJY-lll/C~~
~~IN!:> H't~~~
~~8'0 l;j +- 2..cu; I N/A PO .. csy~~
"'J o/'~ ~ 2. '1--1 l?f/1 ~p LI\CSl\!1-\j ~o i ~ u-r~ 11/IJkA}Cr(,vN 11N1<rvcrwN I N/A 2-VP-/f).. U~lt~t,1 ~fllf\~!) NO f\}V15 Jt&, t., 8Ji,1tfllt4!! 11-ru- -:JI:. J :au(._ 1W I 'rb2.
~~I N/F\ Po,. CS)/ 3 2~2Y,8'-2 19°!/ ~~C~ll\lNT NO~~
~~8. Tesu Conducted: Hydrostatic D Pneumatic D Nominal Operating Pressure ~~~
Other O Pressure _ _ _ _ psi Test Temp, °F NOTE: Supplememal sheets in form of lists, sketches, or drawings may be used, provided (11 size is BY.. In. x 11 in., (2) Informa-tion in items 1 through 6 on this report is included on each 1heat, and (31 each sheet is numbered and the number of sheet1 is recorded at the top of this form .
* (12/82) This Form (E000301 may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.'Y. 10017
~~FORM NIS-2 (Backl C ...~~
~~9. Remarks -,1--Asl""""'M'"'""""£""'._ .... ~a.1.or£~~
~~....."--.,..C....L.%""""'""s.__.,,.2...-=-----------------------~~
~~Applicabla Manutacturar'1 Data Reports to be attached CERTIFICATE OF COMPLIANCE .~~
We cenify that the statements made in the repon are correct and this ge:.R.ltc.Efl-§)11 conforms to the rules of the ASME Code, Section XI. repair or rep1acamant
-~ Type Code Symbol Stamp __N_/_A_ _ _ _ _ _ _ _ _ _ _ _ ----------------------- Cenificate of Authorization No __N.....;../_A____________ Expiration Date _ _N....;/_A _____________ Signed~~ O w n ~ 1 Daslgnff, Title or Province of ZLS::Z::: .Ja./hlA~ Date _ _....._.~....,.-t-'-*""c;,1......,./_ _ _ _ _ , 19 CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State Virginia and pmployed by HSBI&I Co* qt of f/a.tTfo ... d J Cf, have inspec~ t_he components described in this Owner's Repon during the period 5'-/-90 to S:-/0 -9'f_ , and state thet to the best of my knowledge and belief, tile Owner has performed examinations and taken corrective measures described in this Owner's _Repon_in accordance with the requirements of the ASME Code, Section XI. By signing this cenificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Rep0rt. Funhermore, neither the Inspector nor his employer
;;:~~~~~bin any ~anner; a ; ~na~njury or propeny damage or a loss of any kind arising from or connected with this ~d-- ~ --------ll-"'c.,,o.:-1n-1P-act--:-o-:r'-,-::s-;-1g"'"n-at:-u-r-*-=-------
~~Commissions VA 543 National Board, Stata. Province, and Endorumant1 Date_ _ _ _ ~_-_'J_J_,/:C/~~
,. Owner FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI Virginia Electric and Power Co, Date fat; , l~. /99/
~~Nama 5000 Dominion Blvd., Glen Allen, VA Addr- 2JQ6Q Sheot _ __.1..__ of_ _...,.,_-=---------~~
~~2. Plant Surry Power Station, Unit _ ___,.;,:l..:...._ _ _ _ _ _ _ _ _ _ _ __~~
Name *
~~P.O. Box 315, Surry, VA 23883 Repelr Organization P.O. No., Job No., nc:..~~
3. Work Performed by Virginia Power Type Code Symbol Stamp N I A Nam*
Authorization No. ---....uNLi/"'E\;i,.________ P.O. Box 315, Surry, VA 23883 Explmlon Date _ _ _ __."1:a.+/.... A~------- Addrea
~~4. Identification of System _ __.LJ ....~<r,_.em~~
.......,'6~...e.../...__...,tko::...._(/,,"'""81_..b,,..'ef-"":1}?;<L.l'e_ _._.~~~ 6..r.lef-"'T-------------------
~~5. (al Applicable Construction Code B3 l. 1 19§.l._ Edition,_N--'-/_A_____ Addenda, N-1, N- 7~~
~~...., (bl Applicable Edition of Section XI Utilized for Repairs or ReplacemlffltS 1980W80~~
~~6. Identification of Components Repaired or Replaced and Replacement Components r~~
- ASME Code National Repaired, Stamped Name of Name of Manufacturer Board Other Year Replaced, (Vn Component Manufacturer Serial No. No. Identification Built or Replacement or Nol ,,,-1r,,m l'IS5!1>1PlY (tJPE:5- lltlLCfW UN kfi)O"WAJ '! N/A 2.-Cfl*LcV- 'Wr"/1 V IJ l<Nt:rvl'. Rk'P~cE~ 1-\0 COPGS- t/VlCIJIIJ H1" ~ pp:#
~~11W'1 /l5S/1?8Lf ~/II! ~t,E CIT)! ci l9j I N/A ;.'3 'I 21'/-I ,qa~ R.l:V'L.F\QM"iNT ~o i I I~~
~~8. Tests Conducted: Hydrostatic O Pneumatic O Nominal Opeming Pressure ,~~
Other O Pressure psi Test Temp. °F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1 I size is 8% in. x 11 in., (21 Informa-tion in items 1 through 6 on this repon is included on each sheet, and (31 each sheet Is numbered and the number of sheets is recorded at the top of this form .
* (12/821 This Form (E000301 may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017
~~Data Repom to be attached 1.~~
~~. . CERTIFICATE OF COMPLIANCE .~~
we ce"ify that the statements made in the repo" are correct and this £t!->u¢c&.,,4vl: conforms to the rules of the repair or ra111acamant ASME Code, Section XI. Type Code Symbol Stamp __N..;./_A_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ Ce"ificate of Authorization No._N-'-/_A_ _ _ _ _ _ _ _ _ _ _ _ Expiration Date _ _N..;./_A_ _ _ _ _ _ _.,..._ _ __ Signed tl ~o r/ ~ AL/
~~~~ner orProvinceof Virginia .:zJ.:Z:- ~v4~4~~~
DetlgnH, Titla Date ___A""'""'"~'"'d,.._*.....,..f...._:,Z CERTIFICATE OF INSERVICE INSPECTION _ _ _ _ _ , 19 I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel lnsPectors and the State andemployedby HSBI&I Co. tel of Ha..r-1: Far d . er: have inSQected the components described in this Owner's Repo" during the period r 5-/- O to S:-IO ~ 9 q ' and state that to the best of my knowledge and belief, tile Owner has performed examinations and taken corrective measures described in this Owner's _Repo"_in accordance with the requirements of the ASME Code, Section XI. By signing this ce"ificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations_ ~nd corrective measures described in this Owner's Repon. Fu"hermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or propeny damage or a loss of any kind arising from or connected with this
~~,,-;on._~ I ~~~
~~Commissions __V_A __5_4_3"----------------- IMpector'tSlgnatu re National Board, Stata, Province, and EndorMmentl Oate*_ _ _ _ _ .g_~_"3_c)_ _19 q /~~
1. Owner FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI Vininia 1n~s:tx:is: and fQl!l~I: ~a. Date A4'.t fo,12V Name I 5000 Dominion Blvd., Glen Allen, VA Sheet l of 2.,
~~Addr- 23060~~
~~2. Plant Surry Power Station Name Unit _ _ ......li.::.....-------------~~
~~P.O. Box 315, Surry, VA 23883 :tnb t-.\,,_ 3R00J@?;£f63. R1fq1-'=fo Repelr Organization P.O. No., Job No., ate.~~
~~3. Work Parformedbv Virginia Power Type Coda Symbol Stamp-..,N~/..,,A'--~~
Nam* Authorization No. _ _ __,N.a-,./.1af\L.-_ _ _..;;..._ __ P.O. Box 315, Surry, VA 23883 Expiration Date _ _ _ _,i:itJ.11.;/1.JB~------- Addraa
4. Identification of System (hem ;cJ <& l/~e Lhrzf,.,d

5. (al Applicable Construction Coda B3 l. 1 19§.l__ Edition,___;N;.;./:...;A:,:;__ _ _ Addanda, N-1, N- 7 (bl Applicable Edition of Section XI Utilized forRapairs or Replicements 1980W80

6. Identification of Components Repaint? or Replaced and Replacement Components ASME Codi Natlonal Repaired, StamPed Name of Name of Manufac:tuntr Board Other Year Replaced, (VII Component Manufoc:tuntr Serial No. No. Identification Bullt or Replacement or Nol
*7i Roi> s VN/cflJDWN VNk.t,;~/tJ ! N/A 2.-CH- L{,J/-.2//Sf} U~l\'NOICII 11.t.PIJ\Gb ~o c/ffll)(NHL ;:{'Nb wr-:# PO-. ~,, Ro-t> 5 PH.o overs :f}\.}c, t9e<i6"ffo I i
~~N/A 330.s-ciu /?')/ ~t>I.PICBti~T ~o~~
~" l.)tJrS rJNkNC7i.ut\J II f\J If(\)OW I\J ' N/A ').- Cl-I- LC//-2/I.S-/I VN\t~N J,J:!) 1.1\CSb NO A>-, EVr;/NlfflJN~ 111"-:# Po~ ~" fv{J1"'S ::P- J :r;.N C fiN Jr6Z I N/R 3 H631-z l'l9/ ~!hC.1:11\~ NO
7. Description of W o r k * - - - - - - - - - - - - - - - - - - - - - - - , - - - - - - - - - - - - - -

8. Tests Conducted: Hydrostatlc O Pneumatic O Nominal Operating Pressure ~
Other O Pressure _ _ _ _ _ psi Test Temp. °F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided 111 size is 8% in. x 11 in., (2) informa-tion in items 1 through 6 on this repon is included on each sheet, and (31 each sheet is numbered and the number of sheets i1 recorded at the top of this form .
* (12/821 This Form (E000301 may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017
~~FORM NIS-2 (Backl~~
~~9. R e m a r k s _ - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -~~
~~Applicable Manufacturer', Data Repom to be attachad~~
CERTIFICATE OF COMPLIANCE We cenify that the statements made in the repon are correct and this ~"'idtMhC conforms to the rules of the ASME Code, Section XI. repair or ri,p1acament Type Code Symbol Stamp __ N_/_A_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
~~Cenificate of Authorization No._N_/_A_ _ _ _ _ _ _ _ _ _ _ _ Expiration Date _ _N __/_A~~
~~-t / * ,--~~4";~~ ~~~
Signed or Province of () Owner or O ~ n u , Title Virginia 4 / Date CERTIFICATE OF INSERVICE INSPECTION and employed by HSBI&I Co*
,64 -~"""...." " ' - - - - - - - - , 19 9./,.
I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel lnsPectors and the State of tfgrTFord,, Cf, have insp~ the components described in this Owner's Repon during the period 3'- / -'7Z) to S-/0. 'l ~ , and state that to the best of my knowledge and belief, t!ie Owner has performed examinations and taken corrective measures described in this Owner's Repon in accordance with the requirements of the ASME Code, Section XI. By signing this cenificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Funhermore, neither the Inspector nor his emi>loyer shall be liable in any manner for any personal injury or propeny damage or a loss of any kind arising from or connected with this i_n_sp_ec_t-io-n._._*-ltQ~~..-.-.. U...____.~.-l._._j_~ ____ commissions __ V_A_5_4_3_ _ _ _ _ _ _ _ _ _ _ _ _ __ lmpectOr'ISignnure National Boara, State, Province, and Endonamenu Date*_ _ _ _ _ _ o_..., o 0_*~---19 q;
~~FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI Virginia Electric and Power Co.~~
~~1. Owner Name Dete __3_-_.;_UJ __-~q~'--------------------~~
~~5000 Dominion Blvd., Glen Allen, VA Sheet _ __,..__of _ _...;__ _ _ _ _ _ _ __ Addr- 23060~~
~~2. Plant Surry Power Station Unit _ _ T_W~~
~~__o___________________ Nam* P.O. Box 315, Surry, VA 23883 WO* 3SOO 073755 Repair Organization P.O. No., Job No., ate.~~
~~3. Work Perfonned by Virginia Power Type Code Symbol Stemp__..N....{~A...________~~
~~Name Authorization No. _ _ N_/~A~--------- P.O. Box 315, Surry, VA 23883 Expiration Date _ _.:.:N..,/..._A.,___ _ _ _ _ _ _ __ Addrea~~
4. Identification of System CHEMICAL ANO VOLUME C.ONTROL.

5. (al Applicable Construction Code 831.1 19_§.l_Edition,-~N...../~A......____ Addend11,N-l, N-7 Code Case (bl Applicable Edition of Section XI Utilized for Repairs or Replacements 19 80W80

6. Identification of Components Repaired or Replaced and Replacement Components
~~Name of Component Name of Manufacturer Manufacturar Serial No.~~
National Board No, Other Identification Year Built Repaired, Replaced, or Replacement ASME Code Stamped (Yes or Nol VALVE.; PIPE.j £LL UNK/JOWN *. UN~~OI.\JN N/A 01. - CH - :1-56 U/IJl<HO~ RE:PI..AC.ED Ui.l~WN VALVE, 2." ROC.KWELL 83617'#F316RTtf. N/A 02-c.H-1-56 /'i~S REPU\CC:MelT utJKI\JOWIJ PIPE,').." FRISCHKORN 2616'f8 N/A 02. -CJ,j - 256 1'189 Re.PLACE.l'/lal1 UN/OJoWN E.LL, 2, qo" FRISCH KOR/I! /bO'l-31 N/A 02--C.H-2$ 1<137 RePLACEMEAIT UN~~,J
7. Description of Work REPLAcE CHE.CK VALVE.

8. Tests Conducted: Hydrostatic O Pneumatic 0 Nominal Operating Pressure ~
Other O Pressure 6/0P psi Test Temp, Nor *F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (11 size is SY.. in. x 11 in., 121 informa-tion in items 1 through 6 on this report is included on each sheet, and (31 each sheet is numberad and the number of sheets is recorded at the top of this fonn .
* (12/82) This Form (E000301 may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017
~~FORM NIS-2 (Backl~~
~~9. Remarks _\f.__'A_LV_E._ _~........o. .;#_. . ___. .c~~
~~. S"'--Y.,....-_o..;:;......;..9....;:;.6,._/4:.__-.....J _ _ _ _ ____,_A6_//1.. . .'.E . . . .1..A?. h~-----~~
____6_..... Applicable Manufacturer', Data Reporu to be attached PIPE. P.o. "IF- C3Y- 2.513'+7- I P.o. # SSY - l:Z.'855S .... J.. CERTIFICATE OF COMPLIANCE We certify that the statements made in the report a~ correct and this fii:E:f>L.ACE.ME.NT* conforms to the rules of the ASME Code, Section XI. repair or replacement Type Code Symbol Stamp _ _........,_.....__ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ Certificate of Authorization ri!o. _ _N-'-/_A___________ Expiration Date __N ....../_A____________
~~JJ Signed_++J'--14-=-""~=c.-===---------------Date _ __,,~..,,....,.q-'-"'-'--------. 19 ~ wna or Owner's Designee, Title or Province of VA CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State and employed by HS BI &I Co ,
34?/.P CJ/ of _ _ _ _ __,_t/..i..:::a:,..,.._TLL..6.>?..,,._cl=,~*.,.C,...._f:_________________,....have inspected the components described in this Owner's Report durin; the period_'_ _ _ _ _ _Cf.._-.,_/..,_'f_--=~-'1.__to 6- l'f?- q I , and state that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective.measures described in this Owne~'s Report.in accordance with the requirements of the ASME Code, Section XI. ' _.. By signing this certificate neither the Inspector nor his employer makes any warranty,.expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property ,damage or a loss of any kind arising from or connected with th_is
*=-._µ i_n_sp_ec_t-io_n£ .... ____~£~.
~~Inspector', Signature~~
~~--"~"--"--=--'------Commissions YA 543 National Board, State, Province, 11nd Endorsement, Date,_ _ _'---~--.=..~_7...._____19 qI~~
~~FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI~~
~~. I N.....,I..,.A..._.E....T.,,,.E~C~T....R.._I......C.__.A,..N....P.._.P...a....WE~~
1. Owner __V., _,.I. ._R.,G,.. .......R.._...r..._n..___ Date-----=--J--<-)_;1?:---=--)q----=:..._o _ __
Name 5000 DOMINION BLVD,. GLEN ALLEN, VA 23060 Sheet _ _..:./_ _ of _ _- - - ' ' - - - - - - - - - - - Address
~~2. Plant SURRY POWER STATION Unit _ _ _ _f___;__W_..=b:....___________~~
Name P.O. BOX 315. SURRY. VA 23883 3~ooo D'(s fl- 1.,( Address Repair Organization P.O. No., Job No., etc.
3. Work Perfonned by VIRGINIA POWER Type Code Symbol Stamp_----'-N,.,/c..,AC'-,._ _ _ _ _ __
Neme Authorization No. --'N"-L../.,A~---------- P.O. BOX 315. SURRY, VA 23683 Expiration Date_..,N"'--"A~----------- Address
4. Identification of System _ _ _ _C_,_k\~"'-'f"'..--'l..,,C'-'C\"-'l'---~~'-----'u-'(.... ) _/vv,.,-.-'--_e_<(f'......_-"O""/\....,~_r_o'--'-/_ _ _ _ _ _ _ _ _ _ _ _ _ __

5. (a) Applicable Construction Code 831. l 19...fi.2._Edition,--'N.,,,.._/.cA~_ _ _ Addenda, N-l
N-7 Code Case (b) Applicable Edition of Section XI Utilized for Repairs or Replacements 19 _ _ __

6. Identification of Components Repaired or Replaced and Replacement Components Name of Name of Manufacturer National Board Other Year Repaired, Replaced, ASME Code Stamped (Yes Component Manufacturer Serial No. No. Identification Built or Replacement or No)
~~)_ f\ r~ o-e. i'j.lj.~~
~~ff'~.:.clhr/\ ~i~ss,) JJ/lt )._-Lrl-eo-cf'3 ;V)A f,,; ~C'fj ))t; J~~
, p-;oe. 'voe ct J"'UJ'..>,; ~v,.~ 3'6"?55 00 µ/A I . ~-\.I.
ReJ1o1.cvJ 73 11
~~\'f ,~J,h: "' ~&0507 I ,,A)/A .N\~r,,~,__...,__ }lo'-"~~
~~J.-tl-l-Ra -cf 1, L/~f1J ~ ,Al/A J ,u~~
~u
7. D=,;pdoo of won< ~ ep Iq? C),._ / -t e £

8. Tests Conducted: Hydrostatic 0' Pneumatic O Nominal Operating Pressure 0 Other O Pressure .2. '/6"£ psi Test Temp. <,/CJ() °F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is 8~ in. x 11 in., (2) informa-tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form .
(12/82) This Fonn (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017
FORM NIS-2 (Back)
~~9. Remarks ,}._ ' P:p.e_ Po tr 5Y-9oJ5 o I c:i 'P~~
~~..),~p-t Po* SY-fJ5 /?3 r r~~
~~P~ ~~~
~~/ ' Reports to be attached /~~
ir--e d (f x-3 f( srp~i?ble 9 a{facturer's Data CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this ASME Code, Section XI. Kf k Cr't::'el\ rape* or replacement t conforms to the rules of the Type Code Symbol Stamp _ _ _N ~ . e A ~ - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Certificate of Authorization No. --=<....<.~----------Expiration Date -~N~/~A~------------ Signed ~ 0
; t;~tle Date ~cf/: 9 , 19 J'lo CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State or Province of and employed by HSBI & I CO* of HARTFORD, CT have inspected the components described in this Owner's Report during the period _ _ _ __..(..,~ ..-~'.).=--_.S-"2"----to 9-1-{- er . and state that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section XI.
By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspection. n /l ..a... /;) I)
~~----~-1---=--...><....=..=-i...__,i'--,-~_c) _____ commissions_-,----'J_~ _ _!J,::,.--'--L{-3__________~~
Inspector's Signature National Board, State, Province, and Endorsements Date_ _ _ _--='J_-_,9'--_19 '10 J
FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI
~~1. Owner __V., __.I...R,.,G"'I..._N...,.I.,.A......,E..,L ......R..._.._c..,n...__~~
.......""""'P....au~ .....E.,.C._.T~R,,._I.._c.._""A""ND Date-..:Jc.L.../;:......;/tJ"--L.!&c.....:0:.__ _ _ _ __
~~Name 5000 DOMINION BLVD ** GLEN ALLEN, VA 23060 Sheet _ __,/~_of _ _/ _ _ _ _ _ _ _ _ __ Address~~
2. Plant SURRY POWER STATION Name Unit /wo P.O. BOX 315. SURRY, VA 23883 Address Repair Organization P.O. No., Job No., etc.

3. Work Performed by VIRGINIA POWER Type Code Symbol Stamp _ ___.N,../'-'A...__ _ _ _ _ __
Name Authorization No.--'N"'-L../...,A.___ _ _ _ _ _ _ _ __ P.O. BOX 315, SURRY, VA 23883 Expiration Date _ _.,Nu:/_.A:o....._ _ _ _ _ _ _ _ _ __
~~. ,_ .. ~ddress ,~~
4, Identification of System du~ /Z:.ee.~t:>w,9r,:!£, 5, (al Applicable Construction Code B3l, l 19..6.2.._Edition,---'N...,,1-(.c,A~---Addenda, N l
N-7 Code Case (bl Applicable Edition of Section XI Utilized for Repairs or Replacements 19 _ _ __

6. Identification of Components Repaired or Replaced and Replacement Components Name of Name of Manufacturer National Board Other Year Repaired, Replaced, ASME Code Stamped (Yes Component Manufacturer Serial No. No, Identification Built or Replacement or Nol
~~';);,Sf._ r'~~,vt£- J>(j ?i6ff - 2-/w-1?~ ~,.e;,w9ecJ 11/i)~~
7. Description of Work. __(}=--c)_(!;_c,e_M_W.-'-'~c.....-t.""'/._.:et=.::.,,t/'-.5=---------------------------

8. Tests Conducted: Hydrostatic O Pneumatic 0 Nominal Operating Pressure @
Other O Pressure NtJ;:,. psi Test Temp. 11/0r: °F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1 I size is SY.a in. x 11 in., (21 informa-tion in items 1 through 6 on this report is included on each sheet, and (31 each sheet is numbered and the number of sheets is recorded at the top of this form . (12/821 This Form (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y, 10017
FORM NIS-2 (Back)
~~9. Remarks _v=.--1 _,_~c.~~!1-t:1_.:#_cs--,<y'-----'-/'-'~"-;l'--2---'o~z~C_I"~)_ _ _ _ _ _ _ _ _ _ __~~
Applicable Manufacturer's Data Reports to be attached CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this ~).:-Jll'l~dvrconforms to the rules of the ASME Code, Section XI. . repair or r~placement Type Code Symbol Stamp _ _- - - ' N s u . . " " A ' - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Certificate of Authorization No*--==-----------Expiration Date __N=/~A~------------ Signed Q 't( /I_ ~--,k: __:z-s_z- ~q. Owner or Ow~;signee, Title CERTIFICATE OF INSERVICE INSPECTION Date _ _./Z,--=v.i-'-'4.0l=:.:........:/_,6"'-----, 19 20
I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State or Province of and employed by HSBI & I CO* of
__.H....,A.._R..T~F~P~R~P"-",_C~T-------------=------,,.--------have inspected the components described in this Owner's Report during the period _ _ _ _Cj_,_-_,_/_.'t_-___,.~"--11'-----to b- S'- 9/ f , and state that to the best*of my knowledge and belief,the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section XI. By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this i-nspect--+-ion.~~W~i _
~~_/1)--:::,,b'--'~~Commissions~Ja----=Si=--'-lf 5_ __~~
~~Inspector's S i g n a t u ~ National Board, State, Province, and Endorsements Date _ _ _ ~J.__-~/~l_19 C/ 0~~
~~.. ~~ ~ **-~~
~~FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI~~
~~1. Owner __V:i...,/,Iu!:R>!,Gl..,I._N~I""A......_.E..,I1.1.,.. auWE E._C...,T,..R.,_I.._c...__-"A,..ND....,......i::P.....~~
~~Name~~
~~......Bo......>-C...a.___ Date~,.... J_,_)_/f~;;~f_6_*- - - - - - - -~~
~~5000 DOMINION BLVD., GLEN ALLEN, VA 23060 Sheet _ _/,___of____.,___ _ _ _ _ _ _ _ __ Address~~
2. Plant SURRY POWER STATTON Unit J;jo Name P.O. BOX 315, SURRY, VA Address 23883 w& # 3Y"tJJiJ0¥6?/2 Repair Organization P.O. No., Job No., etc.

3. Work Performed by VIRGINIA POWER Type Code Symbol Stamp_....,_N,.,/..,A....__ _ _ _ _ __
Name Authorization No. __,N,.,_._/,,..,A,..__ _ _ _ _ _ _ _ __ P.O. BOX 315. SURRY. VA 23883 Expiration Date_~N,../~A=------------ Address
4. Identification of System ~4EtfT{ T,~nc.r,,o>J

5. (a) Applicable Construction Code B31.] 19...6.1...._Edition,__.N...,,,_(.,A_ _ _ _ Addenda, N-1. N-7 Code Casa (b) Applicable Editioi:i of Sectjon XI ptilized for Repairs or Replacements 19 f"'O W91J
6. Identification of Components Repaired or Replaced and Replacement Components Name of Name of Manufacturer National Board Other Year Repaired, Replaced, ASME Code Stamped (Yes Component Manufacturer Serial No. *No.* Identification Built or Replacement or Nol
/Z.. S"r.:><<..l> 5' - - - 2-5".Z:'?'l - .RJ?e44fj A/0 /2. drs - - - 2-s.:r->1 - ~.t!>.t-,,;di) /Tl()
~~7. Description of Work __/2,--="...!+h..,,&=.,1-"'4=---""L,"'i?-..<.&~k=l'.:.;I/Ja.....:,§,___,0c...'/9.'-<-<..c,..,/, ...'d!..,_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __~~
7
8. Tests Conducted: Hydrostatic ~Pneumatic 0 Nominal Operating Pressure 0 Other O Pressure .Z.JJ,r psi Test Temp, ,S:,,/ 2 °F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (11 size is SY. in. x 11 in., (21 informa-tion in items 1 through 6 on this report is included on each sheet, and (31 each sheet is numbered and the number of sheets is recorded at the top of th is form .
(12/82) This Form (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017
FORM NIS-2 (Back)
~~>'--'-)--'o=--#-c.=sc....,cj,__-=2=.j--"".J~'9"-'2.=l'---'G'-'~'-,7"-)_ _ _ _ _ _ _ _ _ _ __~~
~~9. Remarks _s;c..L.'tt.=u=-i>.....~~
~~. '-. .,,J. Applicable Manufacturer'sDfta Reports to be attached &a *aJ µ est/- 26,.r.2-rf'C! L I~~
CERTIFICATE OF COMPLIANCE We certify that the statements ~ade in the report are correct and this A?c/>4,?c&-,,,..e,N';l!onforms to the rules of the ASME Code, Section XI. repair or replacement Type Code Symbol Stamp _ _--'SJ.L""A'----------------------------------- Certificate of Authorization No. _ _,.,._..._ _ _ _ _ _ _ _ _ _ _ Expiration Date __N=/~A~------------ Signed ~2 .t:JL_~< Owner o ~ l g n a e , fJ".f~CVt;l'UG~~ Title Date _ _.d,..__,_:;.,~,::1.41:.::C"'//c...../.,_,L.,__ _ _ _ , 19 90 CERTIFICATE OF INSERVICE INSPECTION 1,* i:he undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and.the State or Province of and employed by HSB I & I CO* of HARTFORD I CT have inspected the components described in this Owner's Report during the period _ _ _ _ _ _q-1-*.c.,__,/....t/.,_-_..3...._.q<--_to I, - I 8 - Cf/ , and state that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section XI. By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspection.
~~- - ~ ~ - - ':l-,--i.:...__. ' ~--"----'-* Commissions_-i...::{a_'-=--'S,=--~:...::....)_ __~~
Inspector's Signature National Board, State, Province, and Endorsements Date_ _ _ _ J_-_/_[_19 q ()
FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI
~~1. Owner __V:.:...i.I...,R.,,G,.,I,...N.i.I.....,A......,.E..,r..._,E....,.C....T~R._I._C...__.ct1u.ND C ac-.._~~
~~......._P"'"'"'D"'WR"""B"---'......~~
~~Name 5000 DOMINION BLVD ** GLEN ALLEN, VA 23060 Sheet _ _....J.~of_.,___ _ _ _ _ _ _ _ __ Address~~
2. Plant SURRY POWER STATION Name Unit ko P.O. BOX 315, SURRY, YA 23883 ulo # Yoe?() r¥2..ry Address Repair Organization P.O. No., Job No., etc.

3. Work Performed by VIRGINIA POWER Type Code Symbol Stamp _ __.N..._./'--'A...___ _ _ _ _ __
Name Authorization No._N=,../.,_A,___ _ _ _ _ _ _ _ __ P.O. BOX 315, SURRY, VA 23663 Expiration Date_-"N,.,/....,A"'------------- Address
4. Identification of System* . .-Mt!5o/ z;;/.rlc.7/i?#

5. (a) Applicable Construction Code B31. l 19....6.1._Edition, N/A Addenda, N-1, N-7 Code Case (b) Applicable Edition of Section XI Utilized for Repairs or Replacements 19 8'"~ w,J'O
6. Identification of Components Repaired or Replaced and Replacement Components Name of t '*
Name of Manufacturer National Board Other Year Repaired, Replaced, ASME Code Stamped (Yes Component Manufacturer Serial No. No. Identification Built or Replacement or No)
)> IJ C- 0~"'1/V fv~. i)~-1,f6"(j-~J) - 2-.5.r-? 7 - ~>~.{,,,,I.Lh"' /VO
7. Description of Work_..1.i2,..,,,~..,.t':..L..,...t'it':..;..c;&..,A,....___.s;.,L.J"""'""""""',;..___)~,CJ~wC'-"'.".~ - - - - - - - - - - - - - - - - - - - - - - -

8. Tests Conducted: Hydrostatic@" Pneumatic O Nominal Operating Pressure 0 Other ~essure 2 ~ 'i ..S: psi Test Temp. ,f( 2 °F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is 811. in. x 11 in., (2) informa-tion in items 1 through 6 on this repo" is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form .
(12/82) This Form (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017
FORM NIS-2 (Backl CERTIFICATE OF COMPLIANCE We certify that the statements made in the report. are correct and this ;.Ut1~r conforms to the rules of the ASME Code, Section X J. repair or replacement Type Code Symbol Stamp _ _~N.,.,__..A.__________________________________ Certificate of Authorization No*--=~-----------Expiration Date __N=/~A~------------ Signed CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State or Province of and employed by HSBI & I CO* of HARTFORD , CT have inspected the components described
in. this Owner's Report during the pe'riod ( a,.*-*'.).,- 'lfl*' to'

Cf .-(9.:: 'fl) , and state that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section XI.
By signing this certificate neither th_e Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspection.
~~---+=~~~':-:-:--:* __,JL~_ _ ::'"""""p insi,,ctor's S1gnat~~~
~~commissions _ _ t/6-_j=--l/_3_ _ __ National Board, State, Province, and Endorsements Date,_ _ _ _ ~;F_-_B___19 10~~
=**.-***-*
~~FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI~~
~~1. Owner __V I"'R..,,G..,I.,.N......,I.._A......,E..L.,..E....,.C....T...R...,I.._c.._.._A...N,..DL-P.......~~
~~........ D"'W......~~
~~E R...._c~~
~~.......a..__ Date_---""'.fi__,_6~6'L..-=..o_ _ _ _ __~~
~~Name 5000 DOMINION BLVD ** GLEN ALLEN, VA 23060 Sheet _ __.'--_of _ _,__ _ _ _ _ _ _ _ __ Address~~
~~2. Plant SURRY POWER STATION Unit _~...:../__:"<<-'c...J<'----------------~~
Name P.O. BOX 315, SURRY. VA 23883 Address Repair Organization P._.O. N_o., Job No., etc.
~~3. Work Performed by VIRGINIA POWER~~
~~Type Code Symbol Stamp_~NS>.L./-"A'--------~~
Name Authorization No. _N.,,.,_/coA.._*_ _ _ _ _ _ _ _ _ _ __ P.O. BOX 315. SURRY, VA 23663 ExpirationDate _ _..N,_,._,A....__ _ _ _ _ _ _ _ _ _ __ Address
4. Identification of System 07",f~,c*d& ; !'be. H-'t'.<< G ('(T,e,,, C..

5. (a) Applicable Construction Code B3l,] 19..Ji:Z_Edition,__.N._,,,._/.,.ll_ _ _ _ Addenda, N-], N-7 Code Case (b) Applicable Edition of Section XI Utilized for Repairs or Replacements 19 :P-11 {,(/~
6. Identification of Components Repaired or Replaced and Replacement Components Name of Name of Manufacturer National Board Other Year Repaired, Replaced, ASME Code Stamped (Yes Component Manufacturer Serial No. No, Identification Built or Replacement or No)
~~2-C/f*,.o-c/>~~
~~- 2-~~
7. Description of Work _ __.4~'1.J."""',;"'&zcC-..,,,..f~__..tf.:...&='>_,.fAd~---'~='-' ""~..,"'"-"-' °'"""'*.,.,_ _,{J=~=".c.e=.r~c.~.£~----------------

8. Tests Conducted: Hydrostatic O Pneumatic 0 Nominal Operating Pressure 0 Other E3" Pressure Alo? psi Test Temp. NQ C °F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is BY. in. x 11 in., (2) informa-tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form .
(12/82) This Form (E00030) may be obtained from the Order Dept,, ASME, 345 E. 47th St., New York, N,Y, 10017
FORM NIS-2 (Back)
~~9. Remarks l'.!?,e , ,.i:, c r! s ,y-e:fL-- e.t12s-2 0 ) ;;,~~
~~Applicable Manufacturer' Data Reports to be attached~~
.od CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this .te>~&<<'.C conforms to the rules of the ASME Code, Section XI. . . repair or *replacement Type Code Symbol Stamp, _ _ _..,N'-'--'A"'-----------------------------------
~~Certificate of Authorization N o * - - = = - - - - - - - - - - - Expiration Date _....e;N,../c.,A,..______________ Signed Qt: / Owner or O ~ e e , Title~~
*. -: : Date ~!' 7
19 211 CERTIFICATE OF INSERVICE INSPECTION I the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel *1n.spectors and the State i/Provirice*ot .

andemployedby HSBI & I CO. *. . ,. , * * ..... * ' * ** * ** of HARTFORD , CT li~e insp~ted the components described in this Owner's Report during the pe~iod /'}.- ~.:_Ff b . to 9- /-f.:. k'.:f° .. . , *and state that to the best of my knowledge _and belief, the Owner has performed examinations ar:id taken ~orrective me!!sures described in this Owner's Report in accordance with the requirements of the ASME Code, Section Xi.
~~By signing this certificate '*neither the Inspector nor his employer: makes any v.iarr~nty,~~
~~~ . . .. . .~~
~~e*xpressed or.implied;. . concerning~~
~~. the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer inspectio~. e~--.*_ *,~~
~~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 1nspector's Signature~~
~~.,Lf a -c-tf .3 ---"i-=c:c..-=----=----4'""---',.__,,=-=;..:....:.ccc-.----Commissions _______]=-----------------~~
National Board, State, Province, and Endorsements Date_ _ _ _ 6_-_-_g____1/f 0
FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI
1. Owner nRGINI8 ELECTRIC llND EQWER CD Date Name 5000 DOMINION Bl,VD,, GLEN ALLEN, Yll 23060 Address Sheet /"-.*- o f _ " " - - - - - - - - - - - -

2. Plant SURRY POWER STATION Name Unit ¥ P.O. BOX 315, SURRY, Yll 23883 Address Repair Organization P.O. No., Job No., etc.

3. Work Performed by VIRGINill EQWER Type Code Symbol Stamp _ ___,_N,_,/'-'A"'--------
Name Authorization No. ~N,.,_,._/.e,A,___ _ _ _ _ _ _ _ __ 315. Expiration Date_-"N,.,__.A..___ _ _ _ _ _ _ _ _ __ P.O. BOX SURRY, Yll 23883 Address
~~4. Identification of System '~~
~~c.)~/ctTV'~~
/
~~_L v..r,:!'4t7t1,t/~~
5. (a) Applicable Construction Code Bjl, l 19....6.2_Edition, N/ll Addenda, N-1, N 7 Code Case (b) Applicable Edition of Section XI Utilized for Repairs or Replacements 19 ?o tu,?'1)
6. Identification of Components Repaired or Replaced and Replacement Components Name of Name of Manufacturer National Board Other Year Repaired, Replaced, ASME Code Stamped (Yes Component Manufacturer Serial No. No. Identification Built or Replacement or Nol (tZ.t!A)
,i ~ §;uaS -- ,<-5'.r-. 91 Ph~c,r.,.,.t;,,.. /(/ () , ~ 4 ))wT"J(,LcA / \ - - - ,-sr-91 - R,f):,, ~t:.!,v,!#J '"'A/0 I / ." ~ .. !\,.,;
8. Tests Conducted: Hydrostatic ~umatic 0 Nominal Operating Pressure D Other O Pressure 23J£ psi Test Temp, f'f/2 °F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is 8% in. x 11 in., (2) informa-tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form .
(12/82) This Form (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New Y!)rk, N.Y. 10017
FORM NIS-2 (Back)
~~9. Remarks -~;::.....!To_:e-t:,__.:.,b'---"c......:,:'----C=.5:..+-;l--_2_S:_"5"'_'7~2,4 /_t-(-~...,,.?')----------------~~
~~APPllcable Manufacturer's Oat Reports to be attached~~
~~-2 .5-~-12.~~
CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this h,VA"U...-tAn:::: conforms to the rules of the ASME Code, Section XI. repair or replacement Type Code Symbol Stamp _ _ _N ~ ~ A ~ - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Certificate of Authorization No. Signed_W----~~L~-~=~~F-:'-~~,,....,V::::~-.IJ_J'._:..t.._--~t!',,~,.,6~----Date _ _ Owner or O ~ i t l e Expiration Date --"'N..( . , A ~ - - - - - - - - - - - - X_..,_....,y,___3~----, 19 9o CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State or Province of and employed by HSBI & I CO* of H)\RTFORD , CT have inspected the components described in this Owner's Report during the period _ _ _ _ _.,./... l--~~-*~£>~*_(,~-to q-( 'i- Sit; , and state'~hat to -th~ best of my knowledg~ and belief, the Owner has performed examinations and taken corrective ~easures described in this Owner's Report in accordance with the requirements of the ASME Code, Section XI. By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a Joss of any kind arising from or connected with this inspectionr A * ~ .J)* //) /I _ _ __,._\/__,~--:----:---:J-=::-~~~~~----Commissions _ ___,t)"-"a_=-_,,5.._~-=--:J:::.___________ Inspector's Signature National Board, State, Province, and Endorsements Date_ _ _ _ _ _ 7_-_3__19 'l 0 _J
FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI
\
~~1. Owner lJB. e,[t,7/n'c,, a..!'?Name '.f fv.J..t-1 Date _ _-4--7_~--={,.__f_-_9-'--0_ _ _ _ __~~
~~~lnru 1?wi-i i"' ,o~ B{Addrl,ss vq! 0* I~~~~
~~(" 1 , ( '{ ..._/ ,() ,n. f .k(' Cl -t-,'J)' CVI~~
2. Plant _ _ _.::::::,-'1.A'-'---r7_ __,f"---'-u--"--YV*,...,....-~>'---------- Unit __ P--.
~~T Name p, o , B £1 .X 3if,,, r wo~ 38?rn &b ~ 2 Repair Organization P.O. No., Job No., etc.~~
~~3. Work Performed by _ _ _l/'."-=/o_._._P_a_}~J*_...e.,i_-, _ _ _ _ _ __ Type Code Symbol Stamp~-/./~*_,9 _ _ _ _ _ _ __~~
~~Name Authorization No. _ _t,l'-'--i_,.,_ _ _ _ _ _ _ _ __ Expiration Date _ _...,,..~/;~'4~----------~~
~~'Address~~
4. Identification of System__.~~,,,..~-"~'-+-__.1 1-~='---~Yl___(_(.£'--,;,.--'p;J'--~*'.>:---,,c.)_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __

5. (a) Applicable Construction Code /k&t;. i'I 1sl::il__Edition, Ci,/,W Addenda, _ _ ~/./J~tfl____ Code Case (b) Applicable Edition of Section XI Utilized for Repairs or Replacements 19 /(o 4/f?'(J

6. Identification of Components Repaired or Replaced and Replacement Components
~~Name of Component Name of Manufacturer Manufacturer Serial No.~~
~~National Board No. Other Identification Year Built Repaired, Replaced, ASME Code Stamped (Yes or Replacement or No) st'.(r ; "'~i~~
~~~ *- - .--- ) -s'J, --p~ 1n - - -~~
~~( '2-t.1)~~
7. Description of Work ~(ult.J J1) 5:k-J $

8. Tests Conducted: Hydrostatic D Pneumatic D Nominal Operating Pressure D Other D Pressure _ _ _ _ _ psi Test Temp. _ _ _ _ _° F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is 8% in. x 11 in., (2) informa-tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form .
~~(12/82) This Form (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017~~
~~FORM NIS-2 (Back)~~
~~9. Remarks _....,,,fil&"----".,_.f.,,____....-_f.......:...1_-_6_{.,_2_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __~~
Applicable Manufacturer's Data Reports to be attached CERTIFICATE OF COMPLIANCE 1?1'- . J.r,-- We certify that the statements made in the report are correct and this UL<,lVl\~f conforms to the rules of the ASME Code, Section XI. repair or replacement Type Code Symbol S t a m P - - ~ ~ v 1 ~ 1 ~ - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Certificate of Authorization No. _ _ _#'----'-~-".&7------------ Expiration Date __# - - ' ~ - ' - - - - - - - - - - - - - - - Signed 0./., h'-/ Owner~ wner's Designee, Title
~~..fS°'..Z: &t;,~~~ -~~
Date __J_.,.._=;c,.t_ _,_l.._(Y _ _ _ _ _ _ , 19 'JO CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State or Province of t/ A. and employed by H S (3 '];"+I Cd. of tf Cl.r-Tf Ot' d ) e+. have inspected the components described in this Owner's Report during the period q _, q * $'I to 1-r f 8* Cf I , and state that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section XI. By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspection.
----1~---'-"u=:c-=-------=------' ---------'-J""--'..... .,___.e.JJ _ _ 4..==-S'i=---'L/:'--=3'-------------- '-"-......P--:t""""oe__---Commissions _ _National U_*
1nspector's Signature Board, State, Province, and Endorsements Date_ _ _ 7F----~/~e~_19 10
FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI
1. Owner __V:L.1.I"'Rl,l,Gl..IkaNLL.1.I.1:.Ai.....JE..,I'-',.,E~C...,T,..R,.I..:C.._,,:Au;N,..DL-P~Q""WEu:...cR'--'C~aL....._ Date _ __..3',::....,)'-'/_,,'.$"-/-'-/j~;J'-'(J"---------
~~Name 5000 DOMINION BLVD., GLEN ALT.EN, VA 23060 Sheet Address~~
~~..... ""~ -rwo~~
~~2. Plant SURRY POWER STATION Unit_....<./_'--'=--------------~~
Name P.O. BOX 315, SURRY, VA 23883 Address Repair Organization P.O. No., Job No., etc.
3. Work Performed by VIRGINIA POWER Type Code Symbol Stamp_.....,N,..lwA...__ _ _ _ _ __
Name Authorization No. """"'N,.,_,_/.,,..,A.___ _ _ _ _ _ _ _ __ P.O. BOX 315, SURRY, VA 23883 Expiration Date_..,N,.,_,A"'------------ Address
~~4. Identification of System _~s:""~"'"-"'.Z,""'d......c.T-+'/__..h, __..v-"_q"'-'"c::~z-..,,,C...Jl;)""*-".,.'--'V";___ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __~~
l
5. (a) Applicable Construction Code B31, l 19....6..2.._Edition,__.N"-l-/,,A_ _ _ _ Addenda, N-] , N-7 Code Case (b) Applicable Edition of Section XI Utilized for Repairs or Replacements 1 ;J'V u/)[/)
6. Identification of Components Repaired or Replaced and Replacement Components Name of Name of Manufacturer National Board Other Year Repaired, Replaced, ASME Code Stamped (Yes Component Manufacturer Serial No. No. Identification Built or Replacement or No)
~~- -- 2..-.Sf*Lo/'I RL.~~
0
---- - 2.-sf-2 ) ,v., ,v 0
7. Description of Work _ __,@[."','pc:....,,6"'-W _.,,_,,"",,_,~1..,,::?:c...,;,£:c:.,c::...,<.?--,,,...,,..&""--'"-'";,z,C.,.):.."'1:LL.;.r.s4c._..,().='P,1~c.-=t/.:...!'6e=..._ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
~~"7 77 7 '~~
8. Tests Conducted: Hydrostatic ~ Pneumatic 0 Nominal Operating Pressure 0 Other O Pressure 2.J IS: psi Test Temp. J" t'.) °F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is BY:. in. x 11 in., (2) informa-tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form .
(12/82) This Form (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017
FORM NIS-2 (Back)
~~9. Remarks ____,5~7"u=)=-_,_~.....,,C)"--#-C=-=S:.+-y_-,e,,2'-""6=L.,,_.,.4'"""'L...,.5"--C,>....!/--,,*..,:.)_ _ _ _ _ _ _ _ _ _ __~~
~ Ap61icable Manufacturer's oz:a ZR ports to be attached 11lctr: eo!/ C.5 Iv - 26.f'~xf"-----
CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this* #c'?)M~C-mM1/r'conforms to the rules of the ASME Code, Section XI. repafr or replacement Type Code Symbol Stamp _ _ _N,.,_,_.._A..___ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ Certificate of Authorization No. _ _......,=-----------Expiration Date_....,N'""/..:.A~------------ Signed Q ~J.f:~4= G ~ Owner or o ~ eslgnee, rt1e
~~< Date ddo '19 9 c)~~
CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State or Province of and employed by HSBI & I CO* of c... __.H...._A,....R..T..,F.....,O...R.,.D...._...... T..________________=-.....,=--,,,-----,-have inspected the coinpone.nts described in this Owner's Report during the period Cf- /Cj -8'.Cf to /,, - ($- q { , and state that to the best- of my knowledge and belief, the Owner has performed-examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section XI. By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be.liable in any manner for any personal injury or property damage or a loss of any kind.arising from or connected with this i_n_sp_e-ct-i-on_....:~,_-:c..lo<'--"'--* -'----'----* 1nspector's Signature
~
~~-:f_.________ commissions _ _ _ _J_* _tt.=*_$_:{~*~'J~*-----------~~
National Boarc;l, State, Province, and Endorsements Date_ _ _ --=8;_-_._/..:;;.l__,9 CJ 0
FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI
~~1. Owner //,,;6,',y.,4 /da*~,e,4µJ Name duf4'4 C. Date __5?""--l'~'----"""J""---l-hc..,L.lti~---------~~
.~ac,,, Qcw.-,0w 13.lv~ Ad ress ~ ..,~.#~ ~ 2,l~6b Sheet _ _ - - - _ o f - " ' - - - - - - - - - - - -
~~2. Plant , )u..e,ef ~y/e"L bo~ Name~~
~~Unit _ _.,__/ui.=we..JL~~
~~"?.'o. dox 3;,f ~~,I.~~~
~~Adclfes's mrJ Repair Organization P.O. No., Job No., etc.~~
~~3. Work Performed by d.d",;,h4' ~uld Type Code Symbol Stamp---"P::....~:..:.W..:....__ _ _ _ _ _ __~~
~~~ame Authorization No.-P=...M=----------- >.o. dox.?1.r 7 L-M~ t!4. z.;rr?~~
~~Addfess Expiration Date-,a,V"'-~"-'-------------~~
4. Identification of System C'wAtddt: I: t1J~ a,,£oL ,

5. (al Applicable Construction Code tf,J/. / 19-'.2_Edition, ,v4 Addenda, l'V-/ #- ::> Code Case (bl Applicable Edition of Section XI Utilized for Repairs or Replacements 19 ff'(') lVJ'IJ

6. Identification of Components Repaired or Replaced and Replacement Components
~~Name of Component Name of Manufacturer Manufacturer Serial No.~~
National Board No. Other Identification Year Built Repaired, Replaced, or Replacement or No) ASME Code Stamped (Yes f b. 11~.~,,. ...s;.).. - - ,v~ z. -~P-P-/lf - JZL':S, . - 4 NI'> S".,crl';N ~4,,/f'v,£ S'rw)~ - r ~,A "1>,.sce.,,~6~ ~
~~-- -- .....~ 2.-C//-P-/4 - I/~~
~~l pit)~~
~JJt: -r.t-9. - - JJLt .2. -t!,H-A-IA - - .J /II()
~~7. Description of Work. _ _,_~-=~,..,>....,,~c.L..<.'.=..d=c....___,,e--"-,1<--'S"-'-'N::....,o/C_ _,L.....,,:!', ...: . . . : c * = - - - - - - - - - - - - - - - - - - - - - - - - - -~~
~~....."A~~
8. Tests Conducted: Hydrostatic D Pneumatic D Nominal Qperating Pressure D Other D Pressure _ _ _ _ _ psi Test Temp. _ _ _ _ _*° F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1 I size is 8% in. x 11 in., (2) informa-tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form .
~~(12/82) This Form (E00030) may be obtained from the Order Dept., ASME,.345 E. 47th St., New York, N.Y. 10017.~~
~~FORM NIS-2 (Back)~~
~~9. Remarks ~C..,. . . .A. .,r~,41~*"-~S.~r._u)~_)_"_#_~_C.=s_y,__...~2~'~2.~3~4_,Y~0~1,,_)____________~~
~------')::....c..,,=~H.'-=.=--"'-__:_~=u;....___!..>o<----'--'d>--'1----'-~==~~I--E.~~'---L.><~~~JP,L,~-=+--L..,~r.di}v~J CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this tc1.(A:Ac4~onforms to the rules of the ASME Code, Section XI. repair or replacement Type Code Symbol S t a m p ~ Q ~ ~ ~ ' h 1 ~ - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -~t:4~4~------------
~~Certificate of Authorization No. _,f;....,_h-'~"------------Expiration Date Signed (2 t:.~!b Owner ~ner's Designee, Title~~
...LS Z .f':e&M:?,f~ Date _ _ rJ~-4,_.a.~~-------, 19 .?o CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State or Province of i/a.. and employed by 1./S (3 :I: ~ :Z: CO of
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ have inspected the components aescribed in* i:his o*wner's Report during the period 9 31 to b - I 'fl- 'f I , and st.ate that_* t<l the best of my knowledge and belief, the _Owner has pe~forryied examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section XI. By signing this ,certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a Joss of any kind arising from or connected with this inspection.
~~---'~~--!._. 1nspector's Signature -=...c~'----Commissions_--=-Vi-==--a..-=-S___:_::Lfj ' - - - - - - -~~
~~National Board, State, Province, and Endorsements~~
~~~- A iJ &/'~~~
Date_ _ _ _ _ _ _ _ _ d.._"1'---_19 I U
FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI
~~1. Owner Virginia Electric and Power Co. Date _....<.A.!.u""--'"'6""1,/c...,5,Li'.--"'6:>.....L?,,_I-l-'-7--'?--'tJ::___ _ _ __~~
~~Name Sheet _ _..c..,/ __ of_/" _ _ _ _ _ _ _ _ _ _ __ 5000 Dominion Blvd., Glen Allen 1 VA Address 23060-~~
~~2. Plant Surry Power Station Unit --.L..OW=-i.t....._ _ _ _ _ _ _ _ _ _ _ _ __~~
~~Name P.O. Box 315 1 Surry 1 VA 23883 Address Repair Organization P.O. No., Job No., etc.~~
~~3. Work Performed by Virginia Power Type Code Symbol Stamp__,N~/.,_,A,___ _ _ _ _ _ __~~
Name Authorization No. _ __.N.,_,_/A.._,___ _ _ _ _ _ _ _ __ P.O. Box 315, Surry, VA 23883 Expiration Date _ __.N~A,_,__ _ _ _ _ _ _ _ __ Address
~~4. Identification of System __Lo-='--'"'t'-L-'J))"""'0-"11"'1,fc=).l_,r'-----C.,__...._.".,_.,t.""&,=--~,___-----------------------~~
I
5. (a) Applicable Construction Code B31. 1 19..QL._Edition, _ __,N'-'--L-/.,_A,___ _ _ Addenda,N- l N- 7 Code Case (b) Applicable Edition of Section XI Utilized for Repairs or Replacements 19 80W80

6. Identification of Components Repaired or Replaced and Replacement Components
~~Name of Component Name of Manufacturer Manufacturer Serial No.~~
~~National Board No. Other Identification Year Built Repaired, Replaced, or Replacement or No) ASME Code Stamped (Yes 2.-c...C.- d~~
7. Description of Work __~~r,~=C~A~!'.:'.:=~~~:;r;~altl"'<'---~c~?~&.=w~tS=e'--,.,~=a=~'-"z::;-=;r----------------------

8. Tests Conducted: Hydrostatic D Pneumatic D Nominal Operating Pressure D Other D Pressure _ _ _ _ _ psi Test Temp. °F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is 8Y:z in. x 11 in., (2) informa-tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form .
(12/82) This Form (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017
CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this conforms to the rules of the ASME Code, Section XI. repair or replacement Type Code Symbol Stamp _ _. . . . u . f - . I : . " - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Certificate of Authorization No. ___N~/_A ____________ Expiration Date ----=-N'-'/'-A:....:....____________ Signed_...,.~---~%."---*~,/=-----;~~~ o\ivneror O w ~ l e J - - - - - - - - - - Date~A~~='Q~-d.~Y-----, 19 CERTIFICATE OF INSERVICE INSPECTION 7tJ I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State orProvinceof VA andemployedby HSBI&I Co. of ____t/,.u..,a=r~T~'Fo~~'"~d,,_._J_C=br--L------------=---=----=--,----------: have inqected the components described in this Owner's.Report during the period _ _ _ _ _ _ _Cf.--~'~q~-~1~1-to ~ -/8* / * * , and state that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in ..accordance with the requirements of the ASME Code, Section XI. By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or imp Iied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this i_n_s_p-ec-t-io-n--'~--'*><---=--*-*--'--t __ i_.---'~=--* ___*_____ Commissions VA 543 Inspector's Signature National Board, State, Province, and Endorsements Date _ _ _ ~P~*__..ct~~~7 _19 Cf o
~~FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI~~
~~1. Owner Virginia Electric and Power Co. Date_,9'-'-l~/.:.._'1:..._h-<-90=----------~~
~~Name 5000 Dominion Blvd., Glen Allen, VA Sheet _ _-'~--of_/ _ _ _ _ _ _ _ _ _ __ Address 23060~~
~~2. Plant Surry Power Station Unit - - " ' ' - - " ' " - 0 = - - - - - - - - - - - - - - - - -~~
~~Name P.O. Box 315, Surry, VA 23883 Address Repair Organization P.O. No., Job No., etc.~~
~~3. Work Performed by Virginia Power Type Code Symbol Stamp__,_N.,__/'--'A,._,__ _ _ _ _ _ __~~
~~Name Authorization No. _ __,_N.,.../'--'A'-'------------ P.O. Box 315, Surry, VA 23883 Expiration Date _ _~N~/~A~---------- Address~~
4. Identification of System /t:"Ac.rl')L Coo .e. ...?.M""""

5. (a) Applicable Construction Code B31. l 19..QL__Edition,-~N...._._/~A~---Addenda,N-l N- 7 Code Case (b) Applicable Edition of Section XI Utilized for Repairs or Replacements 19 80W80

6. Identification of Components Repaired or Replaced and Replacement Components
~~Name of Component Name of Manufacturer Manufacturer Serial No.~~
~~National Board No. Other Identification Year Built Repaired, Replaced, ASME Code Stamped (Yes or Replacement or No)~~
7. Description of Work O,;,r/(.d,fd? AL?t/E i/&t'.r/?c 8, Tests Conducted: Hydrostatic ~ Pneumatic D Nominal Operating Pressure D Other D Pressure 2.J,) r psi TestTemp . .:5-7'7 °F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is SY. in. x 11 in., (2) informa-tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form .
(12/82) This Form (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017
FORM NIS-2 (Back)
~~9. Remarks s;..qf) ~cl ,l:t- - CS ,C/ - 2 £:f( 2 2 If!/ ( .Z )~~
~~Applicable Manufacturer's ata Reports to be attached~~
'0# - JS-CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this l f E ~ µ r conforms to the rules of the ASME Code, Section XI. repa{r or replacement Type Code Symbol Stamp _ _~........~ - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
~~Certificate of Authorization No. _ _N_/_A_ _ _ _ _ _ _ _ _ _ _ Expiration Date __N....;.,_/.c.A.:....._ _ _ _ _ _ _ _ _ __ Signed _ _ a~~C2-<A~-~~~-z!.~. Owner~Owner's ~ l e~~
~~~----'---,<~---- _*-__ _ J_.f_f_~.C.~~#~4'~*___ Date _ _S"._~~~~A_r._/~/_____ , 19_~_9__~~
CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State orProvinceof VA andemployedby HSBI&I Co. of ffctrTFt,Jrci) C-f, have inspected the components described in this Owner's Report duri.ng the period / d- * ;f-J.- <?'? to I '.1.- 2 ~ -9' ~ * , and state that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section XI. By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore; neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspection. _ _Q........,,..,_)£'"""--W-~I._.~(!~~~'02-l'-~__ Commissions VA 543 Inspector's Signature National Board, State, Province, and Endorsements Date,_ _ _ _ _q.,___---'-/--'-_ f _19 {j () L *r*,;,,,,,:.J
~~FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI~~
1. Owner Virginia Electric and Power Co. Date _ _q'-4/_l,._.7-4-/_CJ'---D Name r I 5000 Dominion Blvd., Glen Allen, VA Address 23060

2. Plant Surry Power Station Unit TvJD Name P.O. Box 315, Surry, VA 23883 *WO'# J ~Oob ~ 1 l 7~
~~Address Repair Organization P.O. No., Job No., etc.~~
~~3. Work Performed by Virginia Power Type Code Symbol Stamp__,_N.,__/,_,A'-'-----------~~
~~Name Authorization No. _ __,_N"'""/,_,A~---------- P.O. Box 315, Surry, VA 23883 Expiration Date _ _~ N ~ A ~ - - - - - - - - - -~~
~~;(;_ddress~~
4. Identification of System b?uo,e ~,:;;l!fl,vr:

5. (a) Applicable Construction Code 831.1 19....Q.L__Edition,-~N'-'--'-/A~_ _ _ Addenda,N-1 N- 7 Code Case (bl Applicable Edition of Section XI Utilized for Repairs or Replacements 19 80W80

6. Identification of Components Repaired or Replaced and Replacement Components
~~Name of Component Name of Manufacturer Manufacturer Serial No.~~
~~National Board No. Other Identification Year Built Repaired, Replaced, ASME Code Stamped (Yes or Replacement or No) J ~ 0 2.0~~
7. Description of Work tJrl..64 d@t; kb/,// VA.c e/cE 8, Tests Conducted: Hydrostatic if Pneumatic D Nominal Operating Pressure D Other D Pressure...2. '.i ,1,, psi Test Temp, C:,I 2 °F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1} size is 8Y:, in. x 11 in., (2) informa-tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form .
(12/82) This Form (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017
FORM NIS-2 (Back)
~~9. Remarks ---=~c....n...,u"-')'---'-/t-'():::...._#_-_C=5~t/~2...=-f~,j'---"'2""2""'¢'--'--6___.__,.G--------------------~~
~~r . Applicable Manufa turer's Data Reports to be attached~~
~~/, ~- J r _.~~
CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and th is A?..f1)~.&v.;,-" conforms to the rules of the ASME Code, Section XI. . repai{ or replacement Type Code Symbol Stamp _ __.....,'-1--'-_..__ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ Certificate of Authorization No. ___N..c/_A ____________ Expiration Date _ _N;.,./..:A'-'-------------- Signed 0%:"~-- OwnerorOner'sDesignee, Title
..L.>.Z- Date _.,.,2:~~-"~.2~-------, 19 CERTIFICATE OF INSERVICE INSPECTION 90 I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State or Province of VA and employed by HSBI&I Co. of HtJ,,v-:t Fd 1--d 1
et n ~a 1 have inspected the components described in th is Owner's Report during the period 1- I 'f- GLJ to '2 - ( K* Cf I , and state that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Own.er's Report in accordance with the requirements of the ASME Code, Section XI. By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspecti~!. A) () .
-----1~i-=-=-----~L .......~,---~---------Commissions VA 543 Inspector's Signature National Board, State, Province, and Endorsements Date._____q_,_--+/~[~_19 f 0 I
~~FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI~~
~~1. Owner Virginia Electric and Power Co. Date _ _ 9~~~2.~"-h~'J_t)____________~~
~~Name 5000 Dominion Blvd., Glen Allen, VA Sheet _ _ ~;r__ of__/_ _ _ _ _ _ _ _ _ _~~~
~~2. Plant Address Surry Power Station Name 23060 Unit_"--">~<-----------------~~
~~P.O. Box 315, Surry, VA 23883 Address Repair Organization P.O. No., Job No., etc.~~
~~3. Work Performed by Virginia Power Type Code Symbol Stamp~N~/A~--------~~
~~Name Authorization No. -~N.,./~A~---------- P.O. Box 31S, Surry, VA 23883 Expiration Date _ _~N~/~A~---------- Address~~
4. Identification of System s~r1,~~ aJ,,,.,-e?-£..

5. (a) Applicable Construction Code B31.1 19...QL__ Edition,_~N'-'-'-'/A~_ _ _ Addenda,N-1 N- 7 Code Case (b) Applicable Edition of Section XI Utilized for Repairs or Replacements 19 80W80

6. Identification of Components Repaired or Replaced and Replacement Components
~~Name of Component Name of Manufacturer Manufacturer Serial No.~~
National Board No. Other Identification Year Built Repaired, Replaced, ASME Code Stamped (Yes or Replacement or No) i>&r,yJ; s.,-:, ....,.,,~-r - \ hi~ dh 1-,;.-.1. >-/oA I ""kfl"'"' ,i1,!,->.4,A!I;, l ;vo
~~.\ ' I~~
~~7. Description of Work_~R:~$.~C-4~,~L~__.,,..>:u~<",)~~
~~7 --,~~
~~.....~~~~..,..,t?_e;_L_r~~
8. Tests Conducted: Hydrostatic D Pneumatic D Nominal Operating Pressure D Other D Pressure _ _ _ _ _ psi Test Temp. _ _ _ _ _°F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is 8% in. x 11 in., (2) informa-tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form .
~~(12/82) This Form (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017~~
~~FORM NIS-2 (Back)~~
~~?o .#2 ?'('6?? !z. )~~
CERTIFICATE OF COMPLIANCE , We certify that the statements made in the report are correct and this .!'2J7'>A/4:, conforms to the rules of the ASME Code, Section ~I. repair or replacement Type Code Symbol S t a m P - - ~ + - > - ~ - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Certificate of Authorization No. ___N....:c/_A ____________ Expiration Date _ _N_,_/_A---'----------------- Signed_---"_/.1~~_.d:~*~...._,./!_'-=-AA".=--"/' ow¥or O w n e ~ , Title F"- "------=_cj;c...._S'_-=:Z-,-=~=.?~'-'ff.,_,.L.__ _ _ Date _ _.s::=---..~,,,.,e,.,,2>'--",C-L-'~2..~a....._ __ , 19 CERTIFICATE OF INSERVICE INSPECTION 7 I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State
~~? lJ or Province of VA and employed by HSB I &I Co. of~~

~H~a.~i..-_,_r-~-_o_r-~J'--,.....,e~~""'-------------~----~----have inspected the components described in this Owner's Report during the period q _ / 'f- P'J to fu ~ I ~ Cf 1 8 , and state that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section XI.

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

~~1~~c~.__-=e----~~"-------'~~ ......=-------Commissions _ _,V'-'-A_,__,,,Sc...4..,3"-----------------~~

~~I nspector's Signature National Board, State, Province, and Endorsements o-~O Date,_ _ _ _ __,l._____19 '1 n 0~~
~~FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI~~
~~1. Owner Virginia Electric and Power Co.~~
~~Nam,e Date _--l'l~Z--.L~z~ftL~t!_______ 5000 Dominion Blvd., Glen Allen, VA Address 23060~~
~~2. Plant Surry Power Station Name Unit bl)~~
~~P.O. Box 315, Surry, VA 23883 Address Repair Organization P.O. No., Job No., ate.~~
~~3. Work Performed by Virginia Power Type Code Symbol Stamp__,_N.,../'--'A'-"----------~~
Name Authorization No. _....,_N_,_,/'--'Ac.e..._ _ _ _ _ _ _ _ __ P.O. Box 315, Surry, VA 23883 Expiration Date _ _~N~/'--'A~---------- Address
~~4. Identification of System <?<<b,a dC.~~
~~d,0}~~
5. (al Applicable Construction Code B31.1 19_QL__Edition,-~N....._/~A~_ _ _ Addenda,N-1 N-7 Code Case (bl Applicable Edition of Section XI Utilized for Repairs or Replacements 19 80W80

6. Identification of Components Repaired or Replaced and Replacement Components
~~Name of Component Name of Manufacturer Manufacturer Serial No.~~
~~National Board No. Other Identification Year Built Repaired, Replaced, or Replacement or No) ASME Code Stamped (Yes~~
~~.(r,1de-~ eN? /j,,,JSCo ,L) ,,, _ _~~
~~( 'Jo,, - ,?- ,# A-A~~
*..,,,,:,o , , _, .k...vn nld //~ 2-C#---E-S'Afl V,.,,~,J(kq~ It!. G") - ,A~ A,) ,'(/ It t;., .. (ic.L- 0 ,,c.
~~r-.,,_,,.?4_ S)t:!c@ tu,11,.f,.,v,.,,,J,V ,,v />> .z-CAl....d*<A- 19!'~ .,4/&Hcb,bcl;:"' ,,vl')~~
7. Description of Work _ _L,_.;::~:.,t.,,__J_~=L.-'c.~c-t~/.._,,U..._,'(j""'-'tf:"--"-O"-t'-'~"'------Ca"'-<,""(f)""°'?"""¢""-"',e,,,=-------------------

8. Tests Conducted: Hydrostatic O Pneumatic O Nominal Operating Pressure ~
Other O Pressure _ _ _ _ _ psi Test Temp. °F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is 811, in. x 11 in., (2l informa-tion in items 1 through 6 on this report is included on each sheet, and (3l each sheet is numbered and the number of sheets is recorded at the top of this form . (12/82) This Form (E00030) may be obtained from the Order Dept., ASM , 345 E. 47th St., New York, N.Y. 10017
FORM NIS-2 (Back)
9. Remarks A.1,u/c~ rt? ('.C eo(!)~M..,, ; 0 ;p ..5 y- LO 9 /bl C) - c..4-SS° d C c...,)t,,,,,,bf/r Applicable Manufacturer's Data Reports to be attached CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are co.rrect and thi~<(.>, ¢6,c,h:V',rconforms to the rules of the ASME Code, Section XI. repair or'replacement Type Code Symbol Stamp _ __ . _ , ~ _ . . . . _ - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
Certificate of Authorization No. ___ N..c/_A____________ Expiration Date __N__,_/_A_____________ Date CERTIFICATE OF INSERVICE INSPECTION _---=}~Gc....."'"C"""'-'-'--/--"-2_____ , 19 .Pa I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State orProvinceof VA andemployedby HSBI&I Co. of _______,/-l,__._,A. ......c_i
~~. . . .e_,,o'-r'-=d."--tJ-=ef:c....i_,*___________-=.,,....---have inspected the components described.~~
in this Owner's. Report during the period '1 -/ ~- ~~ to '2- ('if- 'f / , and sta-te that to the best of my knowledge and belief, the Owner has performed examinations and ta.kei°ri corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section XI. By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described i_n this Owner's Report. Furthermore, neither.the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this
~~.......~-----~f_.__~~
~~i-n-sp_e_c_t-io_n_._~ Inspector's Signature~~
~~~~---~--Commissions VA 5 43 National Board, State, Province, and Endorsements Date (1-fJ 19 <to~~
~~FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI~~
~~1. Owner Virginia Electric and Power Co. Date_...c.1_z.._,_/_,_/---'7_,_/j_9:;._;;C):...__ _ _ _ _ _ _ _ __~~
~~Name 5000 Dominion Blvd., Glen Allen, VA Sheet _ __,_/ _ _ of .../ ' - - - - - - - - - - - - - Address 23060~~
~~2. Plant Surry Power Station Name Unit ?;'d P.O. Box 315, Surry, VA 23883 tJ CJ # 3 7 t:J(!"J /(JL Y $" /~~
~~Address Repair Organization P.O. No., Job No., etc.~~
~~3. Work Performed by Virginia Power Type Code Symbol Stamp__.N'"'-'-/...,A,___ _ _ _ _ _ __~~
~~Name Authorization No. _ __,,N,..,/'-'A'-'------------ P.O. Box 315, Surry, VA 23883 Expiration Date _ _....,N~A,._,__ _ _ _ _ _ _ _ __ Address~~
4. Identification of System Cc-4b,r6A A.vi) t/(Y.vari: Ca t,Q"Zll'/t'

5. (al Applicable Construction Code B3 l. 1 19M_ Edition,-~N._,_,_/.,_A.___ _ _ Addenda,N-1 N- 7 Code Case (bl Applicable Edition of Section XI Utilized for Repairs or Replacements 19 80W80

6. Identification of Components Repaired or Replaced and Replacement Components
~~Name of Component Name of Manufacturer Manufacturer Serial No.~~
National Board No. Other Identification Year Built Repaired, Replaced, ASME Code Stamped (Yes or Replacement . or No) 4.11. (3,t' (!Pe~ ('\ "'(J)I!. ~~ A,!#.('(" l'l U*~k.,vo.-.,1,v N',& J -C/-/-L--st If'!,.,_- . L),, ...c.t!:J I
~~;i~i')~~
~~h.t.1~~ t!)l"t:. c-,,.,e.t!/~ srt!-c (!) //,~J:,,v1J1..,1v ,(/~ 2-Cl'/,~,,~.,.....C, /';2'~ ILl,.)-~~ h ! 1 . - ..-v1'~~
7. Description of Work __ ~"'""=-re.e....)e:::'&.#~l!""'-'",f~....,6"1..!:v.:c.,:&=,:---'(3""-C."'-"'~'--"-Q-'<Z?O=,:.o,..,c,,f!,-"""""'-------------------------

8. Tests Conducted: Hydrostatic D Pneumatic D Nominal Operating Pressure ~
Other D Pressure _ _ _ _ _ psi Test Temp. °F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is 811:, in. x 11 in., (2) informa-tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form . (12/82) This Form (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017
FORM NIS-2 (Back)
~~9. Remarks --'Cr"=l,(,_,4"""""',t-~(!)=c.. .c.,...C-~~C=o..<<a,;.-..6 __-~C~4-"'1-=~-S~..3~~c-'°=-"3.,.>~12=w~,"-~"-"'~C--~~
~~....';d,,"'""'-------'-/i--=CJ-~_~5~{rv_-~/O~f~/,~&~9~{.,._,_1~,,,.,,.)~~
Applicable Manufacturer's Data Reports to be attached CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this£.??.<:d,:A',.,<,,..?4/ Y conforms to the rules of the ASME Code, Section XI. *
~~rep~ir or replacement Type Code Symbol Stamp _ __._,'-'-"_.__ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __~~
Certificate of Authorization No. ___ N.c./_A____________ Expiration Date __N~/_A_____________ Signed_()"-=~-~/~,=....,,,.,/,-'-2-.--=--G-'c--=__,---~-...-:=S'_~f~~,6e~;e.,:~~=,,.~~~~*~ Date~)~<:-"c--~-~/_2~-----, 19 Owner or O~Designee, Title CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State 9e, or Province of VA and employed by HSBI&I Co. of ______.H~g~"'-T~~~b~r-~cl.,....._.C...:f""'---------------,-,-,~----have 1 inspected the components described in .this Owner's Report during the .period _ _ _ _ _ _&f.,_---'(~'i~-~~~Cf__ to-~t>>~~~f=8_-~q~J_______ , and state that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section XI. By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in* this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this
~~..i.,e:-"~<=-=,=----'--,->/":-:-._-~_...::..-=_.,..e.-=---Commissions __V~A~~5~4~3~----------------~~
i-n-sp_e_c_t-io-"L21-I nspector's Signature National Board, State, Province, and Endorsements Date _ _ _ _ _ /_j._-_/7~_19 r (J I
~~FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI~~
1. Owner Virginia Electric and Power Co.* Date I- ZS-'1 f Name 5000 Dominion Blvd., Glen Allen, VA Address 23060

2. Plant Surry Power Station Unit [WO Name P.O. Box 315, Surry, VA 23883 Address Repair Organization P.O. No., Job No., etc.

3. Work Performed by Virginia Power Type Code Symbol Stamp~N...../ ~ A ~ - - - - - - - -
~~Name Authorization No. - ~ N ~ / ~ A ~ - - - - - - - - - P.O. Box 315, Surry, VA 23883 Expiration Date _ _~N..,_/"""'A,___ _ _ _ _ _ _ __ Address~~
4. Identification of System __c"="*.. ~'-e~~c.~4.~v~e~J~~~d~.t.-<<--:&~.!~~G 6'~~~' .......*~µ=r,~-;eO=_?_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __

5. (al Applicable Construction Code B31. l 19..Q]__Edition,-~N-'J.-.'/A~---Addenda,N-1. N-7 Code Casa (bl Applicable Edition of Section XI Utilized for Repairs or Replacements 19 80W80

6. Identification of Components Repaired or Replaced and Replacement Components
~~Name of Component Name of Manufacturer Manufacturer Serial No.~~
National Board No. Other Identification Year Built Repaired, Replaced, ASME Code Stamped (Yes or Replacement or No) OIL C.OOLE.E BASCO (//Jk'./JO UJtJ NIA 02.--cH- E;-511 UNKt-J4t.1JJJ RtPL.4CE..D >Jo OIL (Ol>Lf.R BA50) ?,111=:olf-D/OI NIA <?2-CJ-l-£;.-5/1 7/30/~ R-&f'LACE,11.:;.; '"v~Kl./6~
7. Description of Work R,E:PLA-CE, LUBE. 0/L COOi-ER.

8. Tests Conducted: Hydrostatic D Pneumatic D Nominal Operating Pressure w' Other D Pressure /(/ () ):, psi Test Temp. It){) r Of NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1 l size is 8% in. x 11 in., (2) informa-tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form .
(12/82) This Form (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017
FORM NIS-2 (Back)
~~9. Remarks _c.tJ,.c.--cO_,L=~::....=__,_R=tJ-~__,C."""S...,'--"'{'----'/-"'3=6~6~'D=5~--0_)_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __~~
Applicable Manufacturer's Data Reports to be attached CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this 'f;E:PLAC£M£JJT conforms to the rules of the ASME Code, Section XI. ,repair or replacement Type Code Symbol Stamp _ _~,_._...__ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
~~- - ~ - - - - - - - - - - - E x p i r a t i o n Date __N_,_/_A____________~~
or Province of VA CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State and employed by HSBI&I Co. of
~~-----1f:141-.. 0 ._.,c~:t......_.:fj_,,,e,~'r__.,.c.\"--J)>--(.,.._T_..~~
___________________ have inspected the components described in this Owner's Report during the period _ _ _ _ _q_-__,/'-----f_-~S~".'t. __ to_...,~-~/-=1/"---w-j'._,,,*__./______ , and state that to the best of my knowledge and belief, the Owner has performed examinations arid taken corrective measures desc'ribed in this Owner's Report in accordance with the requirements of the ASME Code, Section XI. By signing this certificate neither the Inspector *nor his empioyer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspection.
-----<~.......-=~--~~-f . . . . .-~i>F--~-~~-J~-~~*
~~Inspector's Signature~~
~~--Commissions VA 543 National Board, State, Province, and Endorsements Date_ _ _ _ _ ~1---~~,,. __ . 19 q f~~
~~1- j~~
~~FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI~~
~~1. Owner Virginia Electric and Power Co. Date_--=./_-.::2:.:'6::_-__:_°I.;../- - - - - - - - - -~~
~~Name 5000 Dominion Blvd., Glen Allen, VA Address 23060~~
2. Plant Surry Power Station Unit il)}O Name P.O. Box 315, Surry, VA 23883 WO #- 3800 /02353 Address Repair Organization P.O. No., Job No., etc.

3. Work Performed by Virginia Power Type Code Symbol Stamp___.N.,_/'""'A,.,___ _ _ _ _ _ __
Name Authorization No. _.....,_N,.,/c.,A..,__ _ _ _ _ _ _ __ P.O. Box 315, Surry, VA 23883 . Expiration Date _ _..,.N.,_./'"'A....__ _ _ _ _ _ _ _ __ Addrea
4. Identification of System C.H6MICAL. AND \JOLU/VIE. <PNTl<t>L

5. (al Applicable Construction Code B31.1 19...QL_ Edition,_..,N~/A,_,___ _ _ Addenda,N-1, N- 7 Code Case (bl Applicable Edition of Section XI Utilized for Repairs or Replacements 19 80W80

6. Identification of Components Repaired or Replaced and Replacement Components
~~Name of Component Name of Manufacturer Manufacturer Serial No.~~
National Board No. Other Identification Year Built Repaired, Replaced, ASME or Replacement or Nol Code Stamped (Yes l"/'VIJ i:;::'J;? &:>..de:: .... ,.., UN~w.11" NIA oz.-c:.H-E:-SA VN1"-IOI.\IJ Rf:f>LAC£,t> UtJiCJJ:'ll!IJ C.OOLE.g. fV\.Sl"n 'oil 1504-0IOI NIA 02-/u-E-SA /'187 IPi:.t11 v~*A= ... 1,1,1v..i,.,,,J
7. Description of Work RE.PLAce, LV13E: OIL CDtiLER

8. Tests Conducted: Hydrostatic D Pneumatic D Nominal Operating Pressure ~
Other D Pressure tvo> psi Test Temp. .,v'Q7" ° F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (11 size is 8% in. x 11 in., (21 informa-tion in items 1 through 6 on this report is included on each sheet, and (31 each sheet is numbered and the number of sheets is recorded at the top of this form . (12/821 This Form (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017
FORM NIS-2 (Back)
~~9. Remarks --1CO=O=L=E:..:....R..,____._P....,.O;___#._~..,,,a=S::...,.Y_..!:3:....:o:...,~:...s.c....c.....c1_-_5=---R-H---'cs...,,,,.__Y..,__-_,_/"'-3..,.,6"'"6<...><3<...,5=--~'- - - - - -~~
Applicable Manufacturer's Data Reports to be attached CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this 8,f:Pl.ACE.ME!JT conforms to the rules of the ASME Code, Section XI. repair or replacement Type Code Symbol Stamp _ _..u.1--JCJ~--------------------------------- Certificate of Authorization No. _ _N....:.../_A___________ Expiration Date __N....L../_A"'------------- Signed 0-J!!. ,tl ~ Ownero1"2r's Designee, Title J5'.Z: Date ---.c-,h-itl-i=d,=..t..---,,,./'.;~f.___ _ _ , 19 2,t CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State or Province of VA and employed by HSBI&I Co* of H(L W" I &--d J c+/-: have inspected the components described in this Owner's Report during the period (l*l!l..- 8'.1 to ~-1..'.\. ... 'f'l- , and state that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section XI. By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspection.
~~~_p. /i) I ~_ _ commissions_..,V'--'A..._..,Sc...4w3.,___ _ _ _ _ _ _ _ _ _ _ _ _ _ __ -----¥~-=::..><.-=--..!-_._J_c...>,.......c~=-=-=;.........:...~~
Inspector's Signature National Board, State, Province, and Endorsements Date_ _ _ _ ~J~-~'1~_19 '1(
~~FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI~~
~~1. Owner Virginia Electric and Power Co.~~
~~Name Date _ _ ~,:T;._,....b-tJrfe~/_________ 5000 Dominion Blvd., Glen Allen, VA Sheet Address 23060~~
~~2. Plant Surry Power Station Unit /@(!}~~
~~Name P.O. Box 315, Surry, VA 23883 Address Repair Organi:lation P.O. No., Job No., etc.~~
~~3. Work Performed by Virginia Power Type Code Symbol Stamp_..,_..v_4=---------~~
~~Name Authorization No. _ __,,v=-</....,.d"---------- P.O. Box 315, Surry, VA 23883 Expiration Date_~//~14?..,..._ _ _ _ _ _ _ _ _ __ Address~~
4. Identification of System c,,,,t_,;_,.,t!. &-...v.J V(2Lv&.f C/!JµT'4()L

5. (a) Applicable Construction Code B31. l 19~Edition,_N~/_A_ _ _ _ Addenda,N-l, N-7 Code Case (b) Applicable Edition of Section XI Utilized for Repairs or Replacements 1980W80

6. Identification of Components Repaired or Replaced and Replacement Components
~~Name of Component Name of Manufacturer Manufacturer Serial No.~~
~~National Board No. Other Identification Year Built Repaired, Replaced, ASME Code Stamped (Yes or Replacement or Nol~~
8. Tests Conducted: Hydrostatic 12(" Pneumatic O Nominal Operating Pressure 0 Other O Pressure /,S:lC )!~,,µ, psi Test Temp. AN(fl,J,vr °F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is SY. in. x 11 in., (21 informa-tion in items 1 through 6 on this report is included on each sheet, and (31 each sheet is numbered and the number of sheets is recorded at the top of this form .
(12/82) This Form (E00030) may be obtained from the Order*Dept., ASME, 345 E. 47th St., New York, N.Y. 10017
to
~~Le.doe/ )o # Cs,v- .J@,/8"'6 [ )~~
~~~.5' 0 ~do~ )o#of-3,'tJf?~{;./~ ~9 &~~~
~~7 2 x~~
~~csy.3.1~&:J~~
~~)t,#'. . &It!#csy-Yy/)</o/!.,)~~
CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this ~?~~.vr: conforms to the rules of the ASME Code, Section XI. repair or replacement Type Code Symbol Stamp __N_/_A __________________________________ Certificate of Authorization No. _N--'-/_A____________ Expiration Date _ _ N..c/_A____________ Signed 0J r: d~d----: Wner or Own~s(g}lsigr,08;ritle CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State or Province of Virginia and employed by HSBI&I Co* of tllh t- TFor cl , e::t have inspected the components described in this Owner's Report during the period q- l'l -8'J* to ,-1-B~q I , and state that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section XI. By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspection.

~~'Ri~-~~-~-~'~*-~~~-------Commissions __V_A_5_4_3________________~~

~~Inspactor's Signature National Board, State, Province, and Endorsements Date,_ _ _ _ _ _ s~!"..--~'3~0__19 q I~~
~~FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI~~
~~1. Owner Virginia Electric and Power Co. Date _-'hc......L~'-'?c..;)'~'-'¢.;,e.,~.Ll_.9c.........,.9.L/_ _ _ _ _ __~~
~~Name 5000 Dominion Blvd., Glen Allen, VA Sheet I of__,'----------- Address 23060~~
~~2. Plant Surry Power Station Unit --L!!l."'--"o'----------------~~
Name P.O. Box 315, Surry, VA 23883 QC ? ?-2.9 /C Jr, P? Address Repair Org~izetion P.6. No., Job No., etc.
~~3. Work Performed by Virginia Power Type Code Symbol Stamp__,N~(,_,A,..__ _ _ _ _ _ __~~
Name Authorization No. _ _...N~(A,_,__ _ _ _ _ _ _ _ __ P.O. Box 315, Surry, VA 23883 Expiration Date _ _....,N"-L-"-'A,___ _ _ _ _ _ _ _ __ Address
4. Identification of System __.5e::...::c.::.,:;.i=,l'--,'""c"'"£"".,.._-=t{,:::.,,,..fte.LL:.1.t:....-!:'==-'-,t:_-=--------------------------

5. (a) Applicable Construction Code B31.1 19 ..fJ]__ Edition, _...,_N,.,_/...,_A.,___ _ _ Addenda,N -1 N- 7 Code Casa (b) Applicable Edition of Section XI Utilized for Repairs or Replacements 19 80W80

6. Identification of Components Repaired or Replaced and Replacement Components
~~Name of Component Name of Manufacturer Manufacturer Serial No.~~
~~National Board No. Other Identification Year Built Repaired, Replaced, ASME Code Stamped (Yes or Replacement or No)~~
/-CC.-'5-tC l1f .,~u'.'. ,/ l,e,.,.~ **~-A., T,J,, 0 /Vt 1./t /-.suh'21'f-/lJ7C. l<f1'/ h)~Ari!P; t',/(J I
7. Description of Work LsTt9lf..L c3 *co,,,,>;!;.,;,,~ ,Co_.t A?,ii-; No,c,1,;(!).d /-Stt}-,¢,t -/0 2C

8. Tests Conducted:. Hydrostatic [:j°" Pneumatic D Nominal Operating Pre~sure D Other D Pressure__,.J,c....,<rc........._ _ psi Test Temp. ifpl((?,6.,, f' °F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is 8% in. x 11 in., (2) informa-tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form .
(12/82) This Form (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017
FORM NIS-2 (Back)
9. Remarks _ ___...3:........,.-"'_,J"'--"'<.o...>::0. 0::...........L.1.,<ll'-'.._,_C._...o=u;p)?t=,v.=*
~~... ;1".,__;:__:-'->o=--#'_c=-.::...s-ty'---_.J_c¥t_o_.y.:__c_J1...::;."6_C_;._/O___,.,..J.___ _ _ __~~
Applicable Manufacturer's Data Reports to be attached CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this 4.#.::.ct'fCc:&&"',...--conforms to the rules of the ASME Code, Section XI. repair or replacement Type Code Symbol Stamp _ _-4.J.;....,.....__ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ Certificate of Authorization No. ___ Signed Q. ~ /} Owner or ~esignea, Title
~~'.A/_..~~
N...:./_A ff'f _ _ _ _ _ _ _ _ _ _ _ _ Expiration Date _ _ CERTIFICATE OF INSERVICE INSPECTION Date-"'-&~~Y-..Ly ( N..,_/...:A...:...__ _ _ _ _ _ _ _ _ _ __ _ _ _ _ _ _ , 19 9/ I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors* and the State or Province of VA and employed by HSBI &I Co. of Ha,.-n;,,. cl , C -f, have inspected the components described in this Owner's Report durin: the period q- I'?- &9' to-~b_-_(~~~-~Cf_!_______ , and state that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section XI. By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspection.
~~------'~'-=l.L...--"------i--"---->QA=.;""'-=-=:;...J...--Commissions_..,vc..<A.....,_.,.Sc...4...,3.,__ _ _ _ _ _ _ _ _ _ _ _ _ _ __~~
Inspector's Signature National Board, State, Province, and Endorsements Date S--'-f 19 qI
~~FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI~~
~~1. Owner Virginia Electric and Power Co.~~
~~Name Date ~$/ 5000 Dominion Blvd., Glen Allen, VA Sheet /._ of Address 23060~~
~~2. Plant Surry Power Station Unit L<<l(}~~
~~Name P.O. Box 315, Surry, VA 23883 Address~~
~~3. Work Performed by Virginia Power Type Code Symbol Stamp__,N..,_,_/,_,A'----------~~
~~Name Authorization No. ---"N"--'-'A~---------- P.O. Box 315, Surry, VA 23883 Expiration Date _ _~ N ~ A ~ - - - - - - - - - - Address~~
4. Identification of System C'o,1t')dl""JA"'T {J,o4-~;,t:'

5. (al Applicable Construction Code B31. l 19_Ql__Edition,_~N..,_,_/A~_ _ _ Addenda,N-l N- 7 Code Case (bl Applicable Edition of Section XI Utilized for Repairs or Replacements 19 80W80

6. Identification of Components Repaired or Replaced and Replacement Components
~~Name of Component Name of Manufacturer Manufacturer Serial No.~~
~~National Board No. Other Identification Year Built Repaired, Replaced, ASME Code Stamped (Yes or Replacement . or Nol~~
~~8. Tests Conducted:. Hydrostatic D Pn~umatic ~ Nominal Operating Pressure D Other D Pressure '/J - psi ..~~
Test Temp. p4,,h,l't' ° F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1 l size is 8Ya in. x 11 in., (2) informa-tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form . (12/82) This Form (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017
FORM NIS-2 (Back)
~~9. Remarks J *r,,>t10~ ;,ercL Po' Csy-. ?,?6 2ol Go)~~
~pplicable ~~ufacturer's Data Reports to be>3ttached t/3-"' f"rcLe ).e:4££ /() .-, l~1C.s y JOIOS-/ {ll'j CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and thish~<~...,z:: conforms to the rules of the ASME Code, Section XI. repair or replacement Type Code Symbol S t a m P - - ~ + - > - ~ - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
~~Certificate of Authorization No. ___ Signed ~~~ wne;a,; Owr'sDesignee, Title N_/_A_ _ _ _ _ _ _ _ _ _ _ Expiration Date __N~/_A_ _ _ _ _ _ _ _ _ _ _ __~~
.7.£r Date CERTIFICATE OF INSERVICE INSPECTION ~A!.H- 2 'Y , 19 9/
I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State or Province of VA and employed by HSBI&I Co. of H(J.."<' :tFo"' d. , CL have inspected the components described in this Owner's Report duri~g the period 9- fq- ~q to--6-D~*...,f'-"~'---q-'--/-------, and state that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section XI. By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspection.
~~--~-~~-----:-i-\l--.~tE~~~~Commissions_V~A~54~3- - - - - -~~
1nspector's Signature National Board, State, Province, and Endorsements Date
VIRGINIA POWER NORTHCAROUNA POWER Memorandum
To From Mr. John Wyatt Bryan Foster Office/Location Office/Location Mechani ca 1 Mai nt. /Surry Mechanical Design Engineering/S Date March 1, 1991 MISPLACED MATERIALS TAGS WORK ORDER NO. 65684 .- -Cc u fl <Tt-?-(6 SURRY POWER STATION 1 , <j7,,..4-oS Design Engineering has reviewed completed Work Order No. 73755 and completed Maintenance Procedure No. MMP-C-G-017 and conclude that reasonable assurance exists that the replacement components are Safety Related and will perform their intended Safety Related function.
~~The stock numbers specified in the work orders have been traced to Safety Related Purchase orders as follows:~~
~~.. 5-teelrNe. 4~366 -~~
Stock No. 41408650 P.O. SY176354 (valve gasket)

The pipe and two flanges that were used to fabricate the spool piece are not identified on the work order therefore, no traceability exists. However, both Maintenance craft and Quality Control personnel were involved in the installation and would likely have recognized a discrepancy had the replacement components been labelled Non-safety Related. Furthermore. the design rating of the spool piece far exceeds the relatively mild service conditions of the Service Water System therefore. added assurance is provided that the replacement components will perform their intended Safety Related function.
~~If you have any further questions or require additional assistance. please contact me at 84-416. cc: C. J. Kelly QA DEO File~~
dhg-BWF-030lb Form No. 728431 (Oct 89J (Formerly 97024020)

FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI
1. Owner Virginia Electric and Power Co. Date 'f - ID - '11 Name 5000 Dominion Blvd., Glen Allen, VA Address 23060

2. Plant Surry Power Station Unit TIJJO Name P.O. Box 315, Surry, VA 23883 w.o. ~ 380006568't £tJ~?tf'-2/f"
~~.Address Repair Organization P.O .. No., Job t<io., etc .~~
~~3. Work Performed by Virginia Power Type Code Symbol Stamp~N"'-'-/~A~----~---~~
~~Name Authorization No. -~N~* L~A~---------- P.O. Box 315, Surry, VA 23883 Expiration Date _ _~ N ~ A ~ - - - - - - - - - - Address~~
4. Identification of System SERVICE WATER

5. (a) Applicable Construction Code B31.1 19_QL__Edition,-~N....._/~A~---Addenda,N-1 N- 7 Code Case (b) Applicable Edition of Section XI Utilized for Repairs or Replacements 19 80W80

6. Identification of Components Repaired or Replaced and Replacement Components
~~Name of Component Name of Manufacturer Manufacturer Serial No.~~
National Board No. Other Identification Year Built Repaired, Replaced, or Replacement . or No) ASME Code Stamped (Yes VALVE. UNKNOWN UNK,,JowN N/A 0;2.-sw 4-5 UNKI\JCIAIN REPLAC~D N/A VALVE., 2"1 CHECK VELAN, INC. Fos~oo.3'1B-13a!Y N/A 02.-sw- 4't5 /Cf'l,l.f RfPLAC.EMENT N/A 5POoL p lt.c.',E.. ,I.a. ~ .uA AJ/,,, A/j ,,v~ JtJJT'j JJ./,. """"',_L.,.,,':"' ...,~
~~7. Description of Work~~
~~- - - - -VALVE. -REPLACED --'---------------------------------~~
8. Tests Conducted: Hydrostatic [B'" Pneumatic D Nominal Operating Pressure D Other D Pressure/. rx:Nfiif,...., psi Test Temp. '1ruJ,f,-,'f' °F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is 8% in. x 11 in., (2) informa-tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form .
(12/82) This Form (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017
FORM NIS-2 (Back)
~~9. Remarks -~P._o_._#:_....c..S....c.'<_-_0-'--'ll----=5-Lf'-Cf.,____ _ _ _--'-A-'-'5CC..MC........:.E=-----"C-=L'--'-A-S-'--S~='I = T = - - - - - - - - - - - -~~
Applicable Manufacturer's Data Reports to be attached I J>~s-,~N' c!,vt;.-,v;tfA;vG CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this RE.f'LACl;MENT conforms to the rules of the ASME Code, Section XI. repair or replacement Type Code Symbol Stamp _ _- ' - ' - J . . ' ' - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Certificate of Authorization No. _ _N_...:.../_A_ _ _ _ _ _ _ _ _ _ _ Expiration Date __N-'-/_A_ _ _ _ _ _ _ _ _ _ __ Signed~-~ Ownw or Owner's Designee.'Title
~~,T5J; CERTIFICATE OF INSERVICE INSPECTION Date _ _ _ _ .z_;'-+/---"/---=0---, 19---'9__,_/__~~
I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State l orProvinceof VA andemployedby HSBI&I Co. of ______tf_a_t-T~fu~rd~~J...... c~f__.__________________ have inspected the components described in this Owner's Report during the period _ _ _ _ _ _ _q..L__ -__,_1-'<l'-----"~-9-'--_to fu-n/-Cf! , and state that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code,' Section XI. By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations an.d corrective measures described in this Owne_r's Report. _Furthermore, neither*--the lnspector*nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspection. _ _ _ _(J_._.~~---___.,,J,__.,_~~~~------Commissions_~V~A~5~4~3_ _ _ _ _ _ _ _ _ _ _ _ _ __ Inspector's Signature National Board, State, Province, and Endorsements Date_ _ _ _ _ _ _ 4._-_/~/_19 qI e
~~-~ **-,;:....;.~~
1. Owl'llf FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI Virginia Electric and Power Co. Date___;3~--UJ:.-_-~~~/----------------~
~~N1me 5000 Dominion Blvd., Glen Allen, VA Sheet __--:.___ of~--------------------- Addr- 23060~~
~~2. Plant Surry Power Station Unit ___ T..;.W.;,.;'O;;,.________________~~
~~Neme P.O. Box 315, Surry, VA 23883 Addr* Rapalr Organization P.O. No., Job No., ate.~~
~~3. Work Perfonnedbv Virginia Power Type Code Symbol Stamp__..N,../_.A....__________~~
~~Nam* Authorization No. _-L!N./.(,lA.___________ P.O. Box 315, Surry, VA 23883 Expimion D11t1 _ _...,N""/.,_A,___________ Addrea~~
4. Identification of System SERVICE WATE{?

5. (al Applicable Construction Code 831. 1 A.._____ Addenda,N-1, 19~Edition,_j,;N,.._{.... N-7 Code Case (bl Applicable Edition of Section XI Utilized for Repairs or Replac:emenu 19 80W80
. &. Identification of Componenu Repaired or ReplllClld and Replacement Component, .* ASME Code National Repaired, Stamped Nam, of Name of Manufacturer Board Other Year Replaced, (Yts Component Manufacturer Serial No. No. Identification Built or Replactment or Nol VALVE. JAME5BEMY 5150-/2./'IOOTT N/A 02..-sw-131 11,JiwowAJ RcPU\c:e.O c>>nc,,,~w.i VALVE BALL 1! FRI:Joll(CRN ~<j N/A 02-SW-13/ /cr:10 RS~ iJfJK/WIJ S-f\J~ ~ NIJTS IINKNOW,J IIN~oOJtJ N/A 02,-sW-/'31 (Jllt'./,IOUJ,J l<Efl.Ac.f:l) ~
STUt>S I i -13 CARDINAL DID. 45/Jb N/A 02--svJ-/3J l'llfO REPLACE:N,EIST UIJ~H I NOVA </1./-IZ J9flf NUTS, y-13 IJ/A 02-5W-131 1qqo RcPLlt1=NrEIJ1 uAIKAbWN CARl>D>AL UJD. l/678'5
7. Description of Work REPLACE. VAJE

8. Tests Conducted: Hydrostatic O Pneumatic 0 Nominal Operating Pressure [a-'
Other rid" Pressure ,tJoP psi Test Temp. tJoT *F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided 111 size is 8% in. x 11 in., 121 informa-tion in items 1 through 6 on this report ii included on each sheet, and (31 each sheet is numbered and the number of sheets is
~~.recorded at the top of this form. * . - (12/821. This Form (E000301 may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017 *.. ~~~
~~FORM NIS-2 (Back)~~
9. Remark* yA.LVE.. P.O.#. CSY- 322308- I A~M£. c IA:!,S 3 Applicable Manufecturer'1 Data Raporu to be attached STUDS P.o. # CSY- 291.f6C/7 - 2
~~~UT5 P.O.#" SSY- 33024-'f -/~~
N\JT5 P. o. #" CS'{- 322 C/77 -:z. CERTIFICATE OF COMPLIANCE We certify that the statements mede in the report are correct and this RE:f>I...PCE.MEJJT conforms to the rules of the ASME Code, Section XI. rapeir or raplacament Type Code Symbol S t a m P - - . . u . . ~ - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Certificate of Authorization No. _ _N-'/'--A___________ Expiratlon Date _..;N_./._A'-------------- Signed ~~llnN,~~ or Province of VA Date _ __,,...3~/<-.:;.;2::..><4::"------, 19 9/ CERTIFICATE OF INSERVICE INSPECTION 7 I, the under1igned, holding a valid commission issued* by the National Board of Boiler and Pressure Vessel Inspectors and the State
d employed by HS BI &I Co , of t/..o..x:Iro r J 7. Ct have inspected the components described in this Owner's R;;rt during the period q....1 ff q _ 1 to /:,-I~* q f , and state that to the best of my knowledge and belief, the Owner has performed examinations and taken ~orrective __measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section XI.
By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this i_n_sp_ec-ti-on-~+-~---.--f_. _8__ ln1Pector'1 Signature
~~~~~~----Commission1 YA 543 National Board, State, Province, and EndorHment, Date_ _ _ _ ____./d_-~//__19 9/~~
~~FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI Virginia Electric and Power Co. .Data 3-UJ-'I/~~
1. Owner Name 5000 Dominion Blvd., Glen Allen, VA Addr- 23060

2. Plant Surry Power Station Unit TWO Neme P.O. Box 315, Surry, VA 23883 WO* 3SOO /06i27 ~ 1 l'il Repair Organization P.O. No., Job No., etc.

3. Work Performed by Virginia Power Type Code Symbol Stamp.....&N...,/__.A...__ _ _ _ _ __
Name Authorization No._~N...L~A_,__________ P.O. Box 315, Surry, VA 23883 Expiration Date _ _.:.:N,./..,A.,___ _ _ _ _ _ _ __ Addrea
4. Identification of System CHl=NIICA4. f\Nb VOLUf./lE:. C.OIJTR.OL

5. (al Applicable Construction Code B31, l 19..Q.Z_Edition,-~N,../...A...__ _ _ Addanda,N-1, N-7 Code Case (bl Applicable Edition of Section XI Utilized for Repairs or Replacements 19 80W80

6. Identification of Components Repaired or Replaced and Replacement Components
~~Name of Component Name of Manufacturer Manufacturer Serial No, National Board No.~~
Other Identification Year Built Repaired, Replaced, ASME Code Stamped (Yes or Replacement or Nol LUBE OIL UJOLER. &lSCO ONKNOWtJ IJ/A o;;z.-CH-E-SB UAJ!aJOIIIN Ref'LAC e.L:> IN-ll'NOW"1 SPEC.IAt..TIES LJJ&: OIL. COOi.Ek 6/IIC:iR CORP SSl~/02 N/A 02-u1--S6' 1'136 ReftACEMENT t.V,ll:IJOU)l,l
7. Description of Work J<':E:PLAcE: LV6E 01'-' COOLER WITH crJATED Cr:;ol-6P,

8. Tests Conducted: Hydr0static D Pneumatic 0 Nominal Operating Pressure [B--
Other D Pressure tJo P psi Test Temp. }/()T °F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (11 size is SY.. in. x 11 in., (21 informa-tion in items 1 through 6 on this report is included on each sheet, and (31 each sheet is numbered and the number of sheets is recorded at the top of this form .
* (12/821 This Form (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017
~~FORM NIS-2 (Back)~~
9. Remarks C.00 LE.R P.o.# csY- Joq/69-1 A.SM.e Applicabla Manufacturar'1 Data Reporu to be attached CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this REPL.AC£ME.NT conforms to the rules of the ASME Code, Section XI. repair or replacement Type Code Symbol Stamp _ _........,..,_.___ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
~~Certificate of Authorization No. _ _N_,_/_A___________ Expiration Date __N-L/..:.A-'------------ Signed ( / ~ ~~~
~~./-i~or 0/(nt'Ai¥,e..~~
~~Owner's Oe1ignee, Title CERTIFICATE OF INSERVICE INSPECTION 3p_r, _ _ _ _ _ _ _ _ , 19 Date __:=.,a_e..::....;:;... Q/~~
~~£,t.~~
I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State orProvinceof VA andemployedby HSBI&I Co. of Ha:-,.,1::&\'"J , ct have inspected the components described in* th is Owner's Report* du.ring the *period 't - I q- ~' to
fa - I £s' ... q 1. , and *state that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section XI.
By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspection.
~~-----~-'-.-=--'----'-----1¥-'---M-=--=-=-'=""'---~~
I nspector'1 Signature Commissions __V~A...__.5._4~3.._________________ National Board, State, Province, end Endorsementl Date 2 - a-7 . 19 '1 /
FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI
~~1. Owner nRGINIA ELEC!B.IC AND EOWRR CD Date Name~~
~~-....L.-- o f - - ' ' - - - - - - - - - - - - -~~
~~5000 DOMINION BLVD,, GLEN ALLEN, YI:! 23060 Sheet Address~~
~~2. Plant SURRY POWEB. S!AUON Unit-~=--------,--------~~
Name P.O. BOX 315. SQRB.Y, VA 23883 q}(}t/f,rOt)86,Cko?f 1/#,g ?'2-,t()a"' Address Repair Organization P.b.No., Job No., etc.
~~3. Work Performed by VIB.GINI8 PQWER Type Code Symbol Stamp_......eN,._./c...,A....__ _ _ _ _ __~~
~~Name Authorization No. _N'-'-'-/-'-'A'------------ P.O. BOX 315, SURRY. YA 23883 Expiration Date _ _.,N!..L..<A"------------- Address~~
4. Identification of System_...,,.._S:...~..:c~.c...::il.;.c'l...:Ctf"'.'"-_._@A."-"'~'<-__,<<~:.:JZ'"""---------------------------

5. (a) Applicable Construction Code B3l, l 19....6.2._Edition, N/8 Addenda, N-1, N-7 Code Case (b) Applicable Edition of Section XI Utilized for Repairs or Replacements 19@ ul/{7J
6. Identification of Components Repaired or Replaced and Replacement Components Name of Name of Manufacturer National Board Other Year Repaired, Replaced, ASME Code Stamped (Yes Component Manufacturer Serial No. No. Identification Built or Replacement or No)
~~{!ijt!t:/e ',.,,, ,,.L, Jh__,,_, - - ..l.. ,1,:,} ~ I/ l;IJ - /J-A-&.J,e,,h .. dll~~
7. Description of Work tR,.'f)e.,tC-,;.t.- t/&d?

8. Tests Conducted: Hydrostatic ff Pneumatic D Nominal Operating Pressure 0 Other O Pressure JJ psi Test Temp, #"L °F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is 8Ya in. x 11 in., (2) informa-tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form .
(12/821 This Form (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017
FORM NIS-2 (Back)
~~9. Remarks _ _,5=-+(--..i/.-'-Y:...:.~c...¥~t/-------------------~~
~~----4t~~~&=t/_,.,{,'---'--).-='()c...4/~~
APPlicable Manufacturer's Data Reports to be attached CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this k?,!,?"4"}e.!et,,boll"."conforms to the rules of the ASME Code, Section XI. repair or replacement Type Code Symbol Stamp _ _ _N:ll...._A.___ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ Certificate of Authorization No. _ _.....,......_ _ _ _ _ _ _ _ _ _ _ _ Expiration Date __N=/-=A-=-------------- Signed '4]tf: / ___ *~ O w n ~ g n e e , Title f5.T b~ru&f~ Date_/t~* ~'H~',e~c~#~=?" _ _ _ _ , 19 Yd!J CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State or Province of and employed by HSBI & I CO* of
°'-* ..JHwaAu;R,..T.._F....,.O,..R.,,.Di.u,__;C...,,T~--------------,--,,.-,.--=-r----have inspected the components described in this Owner's Report during the period / 1-:J. - 2' b to 9-(9- S'9 , and state that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section XI.
By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspection() ,1 -Ir-! /Z) ~
~~- - - - - ' ~~-=--.:.,--'-~~ - ,r;L'"-::".:--'~-~~~-~~~---Commissions _ _ _ _lJ'._CL_* __ S=._t/_:__>___________~~
Inspector's Signature National Board, State, Province, and Endorsements Date,_ _ _ ~j~--1__ 19 C/ 0
FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI
~~1. Owner __V.Ll,I"'R.,G..,I.._N~~
~~......I.A.._.E...r.,.,..~~
E..,,C._T.,R..,T.._C,..__..1;;A..,.NP....,__p.lCJ..p..,WEu:...iR>--... C.a..D1.-...- Date ___ .2.-1,,/:...-'...:J:...-..1.b......:.9'..;0:___ _ _ _ _ _ _ _ __ Name 5000 DOMINION BLVD,, GLEN ALLEN, VA 23060 Sheet
~~2. Plant SURRY POWER STATTON Address Name Unit _ __,_/....,¥=><-:;;.o_ _ _ _ _ _ _ _ _ _ _ _ __~~
P.O. BOX 315, SURRY. YA 23883 Address Repair Organization P.O. No., Job No., etc.
~~3. Work Performed by VIRGINIA POWER Type Code Symbol Stamp_.....,.N,.,/c..,A"--------~~
Name Authorization No._,N,.,.,_/...,A,___ _ _ _ _ _ _ _ __ P.O. BOX 315. SURRY. YA 23883 Expiration Date_..e:N,.,/~A:!...__ _ _ _ _ _ _ _ _ __ Address 0
4. Identification of System __c=.:...,...:....;.~;.;'4§c.......::<.!'c::ll/::....:tf<---------------------------;__----

5. (a) Applicable Construction Code B3l, l 19....62_Edition, N/A Addenda, N-1, N-7 Code Casa (b) Applicable Edition of Section XI Utilized for Repairs or Replacements 19 i"'P w/f'tl
~~6. Identification of Components Repaired or Replaced and Replacement Components Name of Name of Manufacturer~~
'* * 'National Board Other Year Repaired, Replaced, ASME Code Stamped (Yes Component Manufacturer Serial No. No. Identification Built or Replacement or No) /1{.;4,1,_e - -- - i~CH .,c;,,t/-
l. 2"? .r.,p - 11'2c)"'9tllJ -

8. Tests Conducted: Hydrostatic D Pneumatic D Nominal Operating P r ~
Other ~ressure /l/0 () psi Test Temp. #t!J r °F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is 8% in. x 11 in., (2) Informa-tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form . (12/82) This Form (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017
FORM NIS-2 (Back)
~~9. R e m a r k s - ~ - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -~~
Applicable Manufacturer's Data Reports to be attached CERTIFICATE OF COMPLIANCE , We certify that the statements made in the report are correct and this ~ej>4,,e conforms to the rules of the ASME Code, Section XI. repair or replacement Type Code Symbol Stamp _ _~N.,.,_.._A.__________________________________ Certificate oQf Signed Autho: owe(orown=-
*10,.
~~No*--==------.---- at~ion 7 ______ Expiration Date _~N~/~A~------------~~
.-£ 5'.:t:- .C:-gr#c-,,£,e, Date __,_ka'..~. . . . ./._..,.y' . .___ _ _ _ _ _ , 19-2~cJ__
CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State or Province of ' and employed by HSBI & I CO* of __.H,..A.....,R.,.T....*F_O""'"'R..P....., _,C"'T,,_-___________--,-~--,--,,-------have inspected the components described in this Owner's Report during the period _ _ _.,_/_,'.l."--...,1=--......._S,-=(.'-----tO 9-/9- ?'f , and state that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section XI. By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspection. ') A -fl- ,(} /) _ __.._V ~-=---:...-..:........L..t_.('"""".~ Inspector's Signature
"----Commissions_*t/i~a.~§i~q-=-3_ _ _ __ . National Board,_S~ate, Province, and Endorsements Date_ _ ~'3_--+q__ C/ 0 19
~~FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI~~
~~1. Owner YIR\UNIA ELECTRIC lll':i!D EOWER co Date Name~~
~~_ _......_ of_.,.__ _ _ _ _ _ _ _ _ __ 5000 DOMINION BLVD,, GLEN ALLEN, Address~~
srn 23060 Sheet

2. Plant SURRY POWER STATION Unit _ _J.N'--"'~tl'---------------
~~Name P.O. BOX 315, SURRY, VA 23883 Address Repair Organization P.O. No., Job No., etc.~~
~~3. Work Performed by VIRGINill EOWER Type Code Symbol Stamp _ ___.N,../c.,A...__ _ _ _ _ __~~
Name Authorization No. --'N,,..._/...,A.___ _ _ _ _ _ _ _ __ P.O. BOX 315, SURRY, Yll 23663 Expiration Oate_""'N.....,A...__ _ _ _ _ _ _ _ _ __ Address
4. Identification of System .Rd.,,,O?ZI,? ~.,~....,,..-

5. (a) Applicable Construction Code B3 l, 1 19..fi.2_ Edition, N/11 Addenda, N-] , N-7 Code Case (b) Applicable Edition of Section XI Utilized for Repairs or Replacements 19,?V a/£1')
6. Identification of Components Repaired or Replaced and Replacement Components Name of Name of Manufacturer National Board Other Year Repaired, Replaced, ASME Code Stamped (Yes Component Manufacturer Serial No. No. Identification Built or Replacement or No)
~~.....~ u 5r,,,, I/ k ~*.ufu~-- ;J - - .2 -dc..-,!'-/C.. - ~d!/>~~ec!?l /Vo I ).). 1v~*
I
*~ /L ... 2 ,/2(.c,/I' jl/i)
8. Tests Conducted: Hydrostatic 0"' Pneumatic 0 Nominal Operating Pressure 0 Other O Pressure -<.V< psi Test Temp, .S-¢? °F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is 8Y. in. x 11 in., (2) informa-tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form .
(12/82) This Form (E00030) may be obtained from the Order Dept,, ASME, 345 E, 47th St., New York, N.Y. 10017
FORM NIS-2 (Back)
~~9. Remarks _ _~~
~~S_r,,__,,u=,;,~,A_'tl_u_E-_7_-_,~_,1,~/~?'.~2=-<-2.~~
~~________________~~
~~,du,..- /& # ,,;_t-Applic:',llJ.l'Manufacturer's Data Reports to be attached -z--~ r2..2,.,~~
CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this ,a,.>~,.......-- conforms to the rules of the ASME Code, Section XI. repair or replacement Type Code Symbol Stamp _ _ _N..,_.,_.._A.__________________________________ Certificate of Authorization No. _ _.,.uc.._ _ _ _ _ _ _ _ _ _ _ Expiration Date -~N~/~A~------------ f;}.,£ //._ - s*igned --o"'w_,n_.e__r_o_.r,_0-<.,w~""n"'a-'FD'-'e~s~lg"' Lr _75_:z; .:f'4. D te z..ktfo n-e"'e-,-T-it_l_a--~=~-='--'z...a-___ a ---=--=-'"..:;..;::__ _ _ _ _ _ , 19 CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State or Province of and employed by HSBI & I CO* of __.H...,A,....RMTMF~Q~RMD"--1-<<~C~T~.- - - - - - - - - - - - - - , - - - - - - - r - - - - - - h a v e inspected the components described in this Owner's Report during the period _ _ __,_f_..:h"-,_,,,a."'-'--....._8 .........fu"----to fl-/.9-*}fCf :. * *, and state that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section XI. By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspection.
~~--f-Q.C...,:,...,:~=--<w----"-'----'-,~i.-----'~~'-'-=-commissions_V:_o....~~
~~I~ s Signature~~
~~~s-4.,__J_ _ __~~
~~National Board, State, Province, and Endorsements Date_ _ _ _ _ i~--_/_6__19 90~~
~~.-. ' ...'.;. .. .:~_.~:,. ... " . .-.,..~~
~~FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI~~
1. Owner YIRGINI8 EI,ECTBIC ANil EOWEH Name cc Date z.&s' ~,ti 5000 DOMINION BLYI2,, GLEN 8.LI,EN, VA 23060 ....\., Sheet I.. of I Address

2. Plant SURRY POWER STATION
~~--r-,,,.,~~
Unit _.......,~'--"'.e,c,::..:'"'--------------- Name P.O. BOX 315, SURRY, Y8 23BB3 Address Repair Organization P.O. No., Job No., etc.
~~3. Work Performed by YIBGINIA EOWEH Type Code Symbol Stamp _ ____.N,../C.!A.,,__ _ _ _ _ __~~
Name Authorization No. --'N>J.L./..,A,.__ _ _ _ _ _ _ _ __ P.O. BOX 315, SUBBY, VA 23683 Expiration Date _ _.,N"'/_.A...__ _ _ _ _ _ _ _ _ __ Address
4. Identification of SYst!lrn.,..,....:.,l,..::.s.6~~"'.!r"°'t"-""i<-'~"""--d'-'d)=Oc.::~:.::~.:.=:,,/-'r'---------------------------

5. (a) Applicable Construction Code B3l,] 19..fiL_Edition, N/A Addenda, N-1 , N-7 Code Casa (bl Applicable Edition of Section XI Utilized for Repairs or Replacements 19 f12 <</,YII
6. Identification of Components Repaired or Replaced and Replacement Components Name of Name of Manufacturer National Board Other Year Repaired, Replaced, ASME Code Stamped (Yes Component Manufacturer Serial No. No. Identification Built or Replacement or No)
~,,..~*., H.....,.,... " $ ..A 1,/k ...l'Q~~,,.,J -- - ~ -/h-~-IC. - 4._...).,4ift) t""./0 11~--*~~., ~........ , ti...:, ,-4 Vd
8. Tests Conducted: Hydrostatic []}" Pneumatic D Nominal Operating Pressure 0 Other O Pressure .l.13.f' psi Test Temp. ,J-f'. 7 °F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is 8~ in. x 11 in., (2) informa-tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of th is form .
(12/82) This Form (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017
FORM NIS-2 (Backl
~~9. Remarks ~..=J;'---"7<--"e,~:>"--... )_j(;?~d--ttf----'-7'_,..._~-'---=V'-~"---"~-C..,~-------------------~~
~~Appllc~e Manufacturer's Data Reports to ba attached~~
~~//ur ;)o# '"~ee/J~ r 2- l-CERTIFICATE OF COMPLIANCE ,~~
We certify that the statements made in the report are ~o;;ect a~d this . ~ .;f-)"'~&!,;,~orms to the rules of the repair or replacement ASME Code, Section XI. Type Code Symbol Stamp _ _ _N..,,.,__.A.._________________________________
~~--='-"'"------------Expiration Date _~N~/~A~------------~~
CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State or Province of and employed by HSBI & I CO. of __,H,..A._,R...T.,F._O..._R..P<-&.r_,C._T.._____.,...-----------,,--,,---------have inspected the components* described in "this *ow'rier'~ Report during th~ perrod _ __.f..,4-=--....,;)_~~.....;:$/=-c(:=------to C(:--f 7':..-S7 7 ., . *;.*'* *-*~ .and* ~t~:; that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective '!!e,asu_~~s.d~~ritJ,a~}i:i_this Owner's Report in accordance with the requirements of the ASME Code, Section XI. By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this
*m--sp-ec_t..:~-n-.~--"---'----,-1.--:.___,~=.a:c...t.--=a.....:.....;..._ _ _ commissions _ _ _j~)-a..__. -~S~L{....._""J~----------
~~lnspector's Signature National Board, State, Province, and Endorsements Date,_ _ _ _ __.J_...__-..../_,,(.__19 ? ()~~
~~,\, *""~~
~~FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI~~
~~1. Owner __V.i'. .,1,I.ER~Gz.....I N.....,I.c.A......_.E_.r..,,..E"'C""T...,R,._I....c,.._.c.A,..ND ......a,___~~
~~......_p~a"""Wtr."""R"--C Date _ _.2...__,,,b:....:/.c..,,G1.....£..~--'j'-')~---------~~
Name 5000 DOMINION BLVD,~ GLEN ALLEN, 'VA 2306() Sheet - . . / of _ __ , _ - - - ' - - - - - - - - - - Address
~~2. Plant SURRY POWER STATION Name Unit -----~~
~~,/,,J(J P.O. BOX 315. SURRY, VA Address 23883 tda .vJI Jo'e()~~~
~~Repair Organization P.O. No., Job No.,~~
~~?~.,s't) r etc.~~
~~3. Work Performed by VIRGINIA PQWEB Type Code Symbol Stamp _ _.N,../c.,A"'--------~~
Name Authorization No. ---'N,.,_.._/.,,,A,....__ _ _ _ _ _ _ _ __ P.O. BOX 315. SURRY. VA 23883 Expiration Date_.e,N'-'/.!A:!....._ _ _ _ _ _ _ _ _ __ Address
~~4. Identification of System_.....:..A_'$._~_cr.-'-"(J::::~=---'c-"8"'~=-=..,,.e<..:W=..,/'---------------------------~~
5, (a) Applicable Construction Code B3l,J 19....6.2_Edition, N(A Addenda, N-1. N 7 Code Case (b) Applicable Edition of Section XI Utilized for Repairs or Replacements 1~8'.P 41!l'1J
6. Identification of Components Repaired or Replaced and Replacement Components Name of Name of Manufacturer National Board Other Year Repaired, Replaced, ASME Code Stamped (Yes Component Manufacturer Serial No. No. Identification Built or Replacement or Nol
~ ...A.e" H ... .., C Uk-. , -- - :; _,ee- .?-1/.J - ~,!_:i .... e,1,J ,,vi:, ~ ,A N .,, ~1_. ,.. -- - µ?)
~~7. Description of Work _ _,.,,t.=~=-;rR""#i="-C.="-&----;rp'"",t!~,..,,.,...:.;;..,.,.~o/-r--,,..,_--'~==:;.;~;..::~~Y:'--~Eo<...:c.C"::::...:::.J:..:.2:;___:~:...:.:M:....:=""~~-~~
~~...:.5e:__C.!.:..l.f/..r.:c,~i::..1*....z:.L~.G=cJ:i--:)::___ __~~
1
8. Tests Conducted: Hydrostatic ~ Pneumatic O Nominal Operating Pressure 0 Other O Pressure Z-../3 f psi Test Temp, S-1" '? °F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is 8% in. x 11 in., (2) Informa-tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form .
~~(12/82) This Form (E00030) may be obtained from the Order Dept., ASME, 345 E, 47th St., New York, N.Y. 10017~~
~~"-', FORM NIS-2 (Back)~~
~~9. Remarks ~-~A. . .o'. . --il"'_~_~. ./'-._/---~..,C-,.'/'-=r._2_L____________~~
~~-->'-'~--"er""':b"-'S..__-"'~::........<,;(/....:::....;;,;.,...:..,,,,.~~
Applicable Manufacturer's Data Reports to be attached CERTIFICATE OF COMPLIANCE *
We certify that the statements made in the report are correct and this d.t;w.,.,6"~,.....,conforms to the rules of the ASME Code, Section XI. repair or replacement Type Code Symbol Stamp _ _ _N ~ ~ A ~ - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
~~Certificate of Authorization No. Signed_~Q=-=-c...~'f=-""-=,, o\:vnerorOw~itle~~
/--'F_= -,L./"""-----"'..Z:S..==J:.::c. ____
Expiration Date ----"'N,../_,A"'-------------- 6.-c_-=-,. ._._ Date _ _~A~e,e,~'4.~,-'/'""',.S""../'----, 19 ~cJ CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State or Province of and employed by HSBI & I CO* of liAETFORD I CT . have*. inspected the components* described in this Owner's Report during the period ./ ~- i., fl 7,; to f- /'i - s> 'J . , and state that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures*described*in this Owner's Report in accordance with the requirements of the ASME Code, Section XI. By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspection. _ _,.,_:Q'"""'"~~~'*'--~...._~~~Commissions---:-,--:-i-=---,,ca_-=-=-5"lj...,__.,,3,_____ __ Inspector'.s Signature .. Netlonel Board, _s.~ate, Province, and Endorsements Date_ _ _ _ _ 1. . .~/{,....__19
~~. 'f D~~
~~FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI~~
1. owner VIRGINIA EI,ECTRIC IH:l:D POWER Name co Date 5000 DOMINION BI,V;Q. , G;i:.EN ALI,EN, :SZ:A *23060 Sheet _ __,.___ o f _ - L : - - - - - - - - - - - -
~~Address~~
2. Plant SURRY POWER STATION Name Unit k.10 P.O. BOX 315, SURRY, VA 23883 Address Repair Organization P.O. No., Job No., etc.

3. Work Performed by VIRGINIA POWER Type Code Symbol Stamp _ _.,,_N,.,/..,A"'---------
Name Authorization No. __,N,.._/..,A,.___ _ _ _ _ _ _ _ __ P.O. BOX 315, SURRY, VA 23683 Expiration Date_..;;N,../~A"'------------- Address
4. Identification of System_~.....;;.-~_;;.:....::a.::~""--..::G=c,:..:~::..:~c,:;.,P""-'/'-----------------------------

5. (a) Applicable Construction*ca"d~* B3i, J 19....6.1_Edition, NIA Addenda, N-l , N-7 Code Case (b) Applicable Edition of Section XI Utilized for Repairs or Replacements 19 ,i'(J 1/Uf"t}
~~6. Identification of Components Repaired or Replaced and Replacement Components Name of Name of Manufacturer~~
*;- National Board Other Year Repaired, Replaced, ASME Code Stamped (Yes Component Manufacturer Serial No. No, Identification Built or Replacement or No)
~~I}). u !_ ~,~,,.,_,:.,.J.-,.£ - - *J-~,,,._e-14 - ,R~)u41c$-J /VO ll~~
/ '.. >>Jl , Al i-..- ale.,wJ;,,,,..§ ~ ~-~t.--~- ,,&:; - v .A/11
~~7. Description of Work .h c'c q;,c ~ I~~
~~~ - , -..t!.fI~~
~~8. Tests Conducted: Hydrostatic ~eumatic 0 Nominal Operating Pressure 0 Other O Pressure .2,, 1 :r.f"' psi Test Temp.~~
f'e/) °F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is 8¥.. in. x 11 in., (2) informa-tion in items 1 through 6 on this repon is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form .
(12/82) This Form (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017
FORM NIS-2 (Back)
~~9. Remarks---4s;~::,!:C..o/~e,;~:,:__~#,e__'.,L)U_=vL.Z:S:~..!../2...,,o~#-~C"--"'-/-- _0L__/_~_2_2-._________~~
Applicable Manufacturer's Data Reports to be attached CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this#&::i:"""c&f..d'..vr conforms to the rules of the ASME Code, Section XI. repair or replacement Type Code Symbol Stamp, _ _ _..,NLL.<A..__ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ Certificate of Authorization No. Signed Q. V ~ e,~ _zsz;- 4v,e,~ Owner or Ow s Designee, Title Expiration Date ---"'N,../..,A...._____________ Date~h~k/~~/.~:.f"~----, 19 ~8 CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State _ _,...,._ _ _ _ _ _ _,and employed by HSBI & I CO*
of
~~__.=..,......._"""'"""'.._..,.,......__________________-~-----,have inspected the components described CJ- ..l'f-~~
' , .........8 '1 ., * : , . . *;,and ,. state . that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section XI.
By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspection
~~---11-~-~-~~i.'"""-~~------,-C~mmissions _ ~Signature~~
__,.(h:..,Q""'__,_S._t.f..L....,,'3£.:.'-'-------- National Board, State, Province, and Endorsements Date,~~~~~-~<F--~/=/,.~_*19,__.*C/__:6::..__
MEMORANDUM _ _ _ _ _ _ _ _ _ _ _ _ _ OFFICE TO ~:S:..,,.o.><...b__.~u.<=.<.,_,...,.,,4/2'"'-.--'A'~"""*......._~3'-"g_.._0...._.00'-=0_,_4"""'-3-"-g=-t,,---~ FROM____;l,J~*.....:::L.:.....---"'-~-'-'/*._*£....,~c.t..r:_ _,,,4<,,,__,_(-=J:..r.:~...,,....""'~......__--~
*sueJECT ~ J \)ct<:~
~~2.-C.H- P-IA /n ewts ~'i-a%b ftM 4-w-J x4d aA (l~+-~~
~~~.v40r ~ ry' ~~~
~~ISIGNEOI _ _ _ _ _ _ _ _ _ _ _ _ _ __ REDUCE rou. CALLS BY USING fHIS ,ORM. WRITB MaSSAGa IN LONGHAND, USING PYIClL.~~
*~ .- .
~~FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI~~
~~......-"P...D,..WE"""R...__..c.,_n.__~~
1. Ovvner __V::J.. .J,I.oR>>Gi!....I N.i.I..A...__E....,Lu.E..,,C-T._R.,,._..J.,.C......o:A:1.1ND Date_...::.._J-.L.-/5___,_A_....:._1-=-.0_ _
Name 5000 DOMINION BLVD ** GLEN ALLEN, VA 23060 Sheet _ ____./_ of / Address Unit ___+,.._\;>J...;:;.._O ______________
2. Plant SURRY POWER STATTON N11m11 P.O. BOX 315. SURRY, VA Addrm 23883 3q-oo vo L/ .1> ~ l Rapalr Organization P.O. No., Job No., ate.

3. Work Performed bv VIRGINIA PDWEB Type Code Symbol Stamp _ _;;N,../'-'Ai&--------
N11ma Authorization No. ___,N"'"'-/...,A,___ _ _ _ _ _ _ _ __ P.O. BOX 315. SURRY, VA 23883 Expiration Date_""N"'/_.A..__ _ _ _ _ _ _ _ _ __ Addrea
~~4. Identification of System ___ c~* ~b~e..,m--'-"-"""'C""t\'-'-1'-*.......&"'-"'_,,J.___..;():' l_~-'. -. .~a,....._C_c;..,"-...:....'1_~-'()"-'J'--------------~~
_..o.... 5, (al Applicable Construction Code B31, l 19...6.1..._Edition,__.N,,.,._I.. A____ Addenda, N-l , N-7 Code Casa (bl Applicable Edition of Section XI Utilized for Repairs or Replacements 19 _ _ __
6. Identification of Components Repaired or Replaced and Replacement Components Name of Manufacturer National Other Year Repaired, Replaced, ASME Code StllmJ)ed (Yes Name of Board Component Manufacturer Serial No. No. Identification Built or Replacement or Nol Jrr p": (J .p *s,l{. l1-.:; h.hir" J?3'.0'oo 0 ;J/rf d- *-cJ{ -f2o~ CP J JJ;/r, R4JlvJ ;Uo Rf/,1A.*~r)x3 rJ , l-l&fJ~q8'/ 0 ~All.A : !~ .:; .*
~~.... ;v/t. : ,.~~
I
) ,_::? *; -l 11~A tf°'-J ~tlt'. ~bt)~7£/oo /II/A 1/J Jvt!/A J ii
7. Description of Work R-ep /0 e -e. Or,£ Le.

8. Tests Conducted: _H_~c!r~~!..~ic ~neuma1n. CJ I\Jnn,inaJ_.Or.:-<ttinQ.iz!!!.~f.e ~
*. *- --a. - . Other [7f Pressur~ ,< ~SJ *P:ti re!~r. r~;,~*,1:i .. ~._0.~F ....;... - *-=-- --~- . - .-_
N\JTE: Supplememal sheets in form ;:f lists, sketches, or drawings may be used, provided (11 size is SY.a in. x 11 in., (21 Informa-tion in items 1 through 6 on this repo" is included on each sheet, and (31 each sheet is numbered and the number of shetrlll is recorded at the top of this form. (12/821 This Form (E000301 may be obtained from the Order Dept., ASME, 346 E. 47th St., New York, N.Y. 10017
FORM NIS-2 (Back)
~~9. Remarks_~~o--:U--_5_Y-_l_o1_b_95_{'---'.,,,'---_3_'r~e~+-P""_ _ _ _ _ _ _ _ _ __~~
Applicable Manufacturer's Data Reports to be attached CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this llMc.<f?ttGwt". conforms to the rules of the ASME Code, Section XI. repair or replacement Type Code Symbol Stamp _ _ _" " N ~ ~ - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Certificate of Authorization No. Signed __ Expiration Date _ _._N"'/....:A=-------------
~~/-,'F"""'*tf"~./_ _=r-'-s=~=--,e;:;"-'-~<$"-'-.______ Date _ _-'-h-=.,.,~4=....,_/..,J.______ , 19 U.:;:c.....~"---'-'-'e....o::~~
Owneror~ Oesignee, Title 70 CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State or Province of and employed by HSBI & I CO* of _.H...A.....,R...,T..F...,,.Oc-R..D,LJ..,_.....,C._T..___ _ _ _ _ _ _ _ _-,-.,...-:-----::=.----------have inspected the components described in this Owner's Report during the period _ _,..;;ic...~......::l;;..-__,f::....:G"'------to 'f-11-:? 1 , and state that to the best of my knowledge end belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section XI. By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this i-nspect-ion-1--1--.~q,a=.~"f--w--:--::::"--t.. . - ~ ~ ~ - C o m m i s s i o n s ~ ' . LI.~({ -=---6 t.f.___J_ _ __ I Inspector's Signature N11tlon11I Board, State, Province, and Endorsements
~~l .*0,-11,*______: ___________ _&..;+-"/tf __ ,?!ltL__~~
~~L--- --- ~----~- *---- .. --i--* - ~~~
** .... ~---- ------------- .I
~~FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI~~
1. Owner nEQINIA ELECTRIC llND Name POWER co Date 5000 DOMINION BI,,:\[D,, ~LEN llLLEN, Yll 23'060 Sh.eet __.....;l_~f-'...cl__________
~~Address~~
~~2. Plant SURRY POWER STATION Unit_-"/---="'=()_ _ _ _ _ _ _ _ _ _ _ _ _ __~~
~~Name P-0. BOX 315. SURRY, VA 23663 Address Repair Organization P.O. No., Job No., etc.~~
~~3. Work Performed by VIRGINill PQWEB Type Code Symbol Stamp _ ___,,N,../""A"'--------~~
Name Authorization No. __,N.,_/LA2.__ _ _ _ _ _ _ _ _ __ P.O. BOX 315. SURRY, Yll 23663 Expiration Date_..,.N!.£-OA..__ _ _ _ _ _ _ _ _ __ Address
4. Identification of System __ c...J.<d'-"4.=~"-""6~1cc,#c...L6L------------------------------

5. (a) Applicable Construction Code B3 l. l 19....61._ Edition, N (ll Addenda, N-l , N-7 Code Case (b) Applicable Edition of Section XI Utilized for Repairs or Replacements 1~ ~ ulg"t)
6. Identification of Components Repaired or Replaced and Replacement Components Name of Name of Manufacturer National Board Other Year Repaired, Replaced, ASME Code Stamped (Yes Component Manufacturer Serial No. No. Identification Built or Replacement or No) s;.(,f)JJ 00.t41 - - - 2*C/l.,w,11./.J.U,1A
--. ,2,,(/)~<:61 /VO ii-~ i6~4) / - - - IZ*CK* ~-.--,~~')A -- ~,,!µw9et!,\ Nn
7. Description of Work _ _.&c....:;G=er?-e.'-~;_;_;cc...c::e-...,;J'-----',(J=-'():<..#_.:./sl_e;;.,e..LL--',d.=_,,oc.:..._=-r;-"~..<.:.,;;,',::....e,~'--------------------

8. Tests Conducted: Hydrostatic D Pneumatic D Nominal Operating Pressure 0 Other ~Pressure Aloi) psi Test Temp. A::' O C: ° F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is SY. in. x 11 in., (2) informa-tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form .
(12/82) This Form (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017
FORM NIS-2 (Back)
~~9. Remarks ~S';-'--rv=0~-,,..,.,/~~(?~d:-_....,.S.._,1.,_z".~2~6=~~/-'--?~9~0-'1"""'____________~~
) _ \ Applicable Manufactur~r's Data Reports to be attached AJ..,y- ,c._O # C...; f 2?,,6 /? '1 {z.,!_
CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this be4(<e."&,,!,,,Jrconforms to the rules of the ASME Code, Section XI. repair.or replacement Type Code Symbol Stamp _ _ _N..u._.A..___ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ Certificate of Authorization No. _ _..._.~~----------Expiration Date_~N~/-'A~------------ Signed W- ~ ,/J_
~~Owner o ~ w ~ e e , Title f.5 f ' E..v6,. Date _ _,J;;;'-"""<-",</,-'-,___./._.if""------, 19 CERTIFICATE OF INSERVICE INSPECTION~~
?' t:J I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State or Province of and employed by HSBI & I CO* of
__.H..,A..._R..T..,F...,.O""R,...D,......_,C,T"------------------=,-.,.,------have inspected the components described in this Owner's Report during the period _ _ __,_/-'.).=----'-";J."----'S:7-'-_-'b"'"*---to c/-(c/ .. ~9 , and state that to Jhe, best of my knowledge an_d *belief, the Owner has performed examinations and take~ corrective measures described in this Owner's R~port in accordance with the requirements of the ASME Code, Section XI.
BY sign_ing this certificate neither the Inspector nor his employer makes any warranty, expressed or' implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspec'\;!-/J !. /1) /)
---+~-"'-'-'l:::u--->.1'~--~~--'£l"'-'--~=~~~-~---Commissions _ _ _ _ ~CL u=* __... 5'--l-'-/_3__________ ' Inspector's Signature National Board, State, Province, and Endorsements Date_ _ ___,_/_-+/7-+*,_ _ _19 9D ~-'-'-~~~~.::~-~-*:**._..~--~~~
~~FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI~~
~~1. Owner _.....::1.V..1I..i;Ri.iG;i..I.,,.Na.iI...A:i.. . . E., I.1.1,..~~
~~E.,,C~T...,R.._I....,.,C'-"A""NP~~
~~....... . . c:P...auWEu:.JR"-"'"C..D1.-._ Date_.,_1.,._b......,..f'---"/i---'-9..;;..fJ__- - - - - - - - - -~~
~~Name 5000 DOMINION BLVD, , GLEN ALLEN, YA 2 3 060 Sheet I of_.L-_ _ _ _ _ _ _ _ __ Address~~
~~2. Plant SURRY POWER STATION Unit_.L.Je,c..oc'-----------------~~
~~Name P.O. BOX 315, SURRY, VA Address 23883 .3root2 zo 99 9 Repair Organization P.O. No., Job No., ate.~~
~~3. Work Performed by VIRGINIA PQWER Type Code Symbol Stamp _ __.N,.,/:...,A"--------~~
Nama Authorization No. __,N,,.,/.._A,..___ _ _ _ _ _ _ _ _ __ p_o. BOX 315, SURRY, YA 23683 Expiration Date_-"N,../_.A...__ _ _ _ _ _ _ _ _ __ Address
4. Identification of Syste';' s~v't~.f 4r-t<.e

5. (a) Applicable Construction Code B3 l , l 19....6..2._Edition,__.N.,.,,r--1..,A_ _ _ _ Addenda, N-l , N-7 Code Case (bl Applicable Edition of Section XI Utilized for Repairs or Replacements 19 _ _ __
6. Identification of Components Repaired or Replaced and Replacement Components Name of Name of Manufacturer National Board Other Year Repaired, Replaced, ASME Code Stamped (Yes Component Manufacturer Serial No. No. Identification Built or Replacement or No)
.r/'15. /4... ,i,r(,. ,A 6.e"'1/,/;f),'t (1_., .d;Vd , I e, 9t'J7-I ,l/1... .l.-.541*.!-/4 - R.!-.""-~ , I /Vt}
7. Description of Work _ _.c.b=e:.<)~,t;.=ef£..!=~:sc...:;.,,\,..___,_,0:L.::.e.:.:e#=-cC'--......:4-cc..:.~..;:cc.:c,S':~~='-'"'"'~""~"';.f,,...__ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __

8. Tests Conducted: Hydrostatic ~Pneum89c D Nominal Operating Pressure D Other D Pressure I ID lf),,. psi Test Temp. IV a7 °F 1 .
NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is 8% in. x 11 in., (2) informa-tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form . (12/82) This Form (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017
FORM NIS-2 (Back)
~~9. Remarks _____.2'------o_#~c=5-,j_-~2.~oJ~?_o_ri_C~1-)_________________~~
Applicable Manufacturer's Data Reports to be attached CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this !f4j'4?<<-i'Lvr conforms to the rules of the ASME Code, Section XI. repair or replacement Type Code Symbol Stamp _ _ _N=-<-_..A.,__________________________________ Certificate of Authorization No. _ _...,_,_.,._ _ _ _ _ _ _ _ _ _ _ Expiration Date _~N-/~A~------------ Signed ~~ ~ Owner o ~ ~ l t l e
~~.TS'...Z::- L . . . e;;... Date ;;kho ,19 _ _ __~~
CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State or Province of and employed by HSBI & I CO* of HARTFORD, CT
have inspected the components. described ln ttiis Owner's Report during the period----+-/_..i"---/"'2'-------'-?f.,_,G,aa.*_ _ to 9- ( 9 .: f<? ** * * , an/~t~te that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section XI.
By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspection. J _ _ __
--+-Vi-i.:;,...-(~__,,,_;l_g,J----<..c;...J_*--=f-=--'.,__(9~~~-Commissions----,---:--Ut-=c..;:.A----""Y.:....._,L/_::;_' ** Inspector's Signature National Board, State, Province, and Endorsements Date_ _ _~/_* -~/~7___ C/Q 19 .. ' . -* ~- *- ---.,..~ ~-::* --- . . ', - ..-. -*~*
..... :* - ATTACHMENT 2 \
FORM NIS*2 OWNER'S REPORT OF REPAIR OR REPLACEME.NT 2. Ownet Plant Vi rgi ni a Power P.0. Box 26666 Surry Power Station IN~ As Required by the Provisions of ASME Code Section XI i,.oo,..., P.O. Box 315,!A00..111 Surry, VA 23883
~~3. Work Performed by_Y....A e.r. ________~~
........_._l;'O~w... 38000 '?Q O '} I 4'11-i -..same 4, Identification of Synem , cl.!-& iJ,~WArt!-,t..
~~5. (1): Applicable Const,vctlon Codi! 831-1 19 67 Editlon, .....H .....A.._____ Addenda, Code Cases _...,,NA____~~
~~(bl' Applicable Edition of Section XI Utilized for Repain or Replactmtntl - 11..BD, WBD Addenda, Code C.IH _...[:J.,...A.____~~
1. Identification of Comp0nenu Aepai~d or Replaced, and Replacement Components Namtof Name of Mfn.Str. -Nat'L CRN Othtr Vear Repaired. ASME Codi Component Mfr. No. Bd. No. ldentJ. Buth Replac9d. rtamped No. rac,tion 0, ;*;"nor Nol R1pl1caman1
~ -p.., ,AS:, 041 . .?.ii *,,J 'Y r*'."lC\tL.. ..,< ~ oso oi:Hv ;\J/A IN/A 1,. sw~"foil* ~h.r"A /J/k R. f nJ G'c 7"" c.,. +- No I
~~.7.~~
~~a. Description of Work__.f<.,.,_~...?-M-... Tests Condvc,ed: e.~4-J_._~_.t... ......""-~~-~-'.;-v A Hydrostatic O Pneumatic O Nominal Operating _Pressure Pr11i&l,e_ _ _ *pat *.* *T11t Temp._ *F~~
~~. __ v'""i:~~
~~___11__/P___ r___________________ 0 Other 0~~
~~CERTIFICATE OF COMPLIANCE Wt certify th*t the natunenu *made lifthis report.,. ,orr11c, *nd this Code"//* ~ . ' .~~
~~C:"'f.Ac~:ea..t conforms to Section XI of the ASME Signflf W-'co,.,,.,t 111~~
.a.d a Du,v,,..I ISI ' TIiie '"G.,
~~t~or1epiacemenQ~~
. C0.1eJ..P.ec. ? y . ,, r':'r CERTIFICATE OF INSPECTION I, lhe undersigned, holding I valid commission issued by the National Board of Boiler and Pressure Vessel lnspecton and the St1t1 or Province of VA, - ** . , empfoyflf by HS8" I &I CO. . of Hartford, CT I have inspected the '.. e /tt_c..{/\-.e.r__* dmribtd in this Rel)Ol1 on . ,- :I . ,s.19. . IR*P** 11 or '!*:>l*ctrne"l(II *.
and Stale that to the btn of my kno1Nltdgt and belief, this repair or replacement his been connrucaed-in 1cc:o,d1nce with Section XI of the ASME"Code. By signing this certifica1t, nei1her the Inspector nor his lmploye/~akes ~ny warranty, uprened or.implied, concern-ing the repair or replacement described in this Report. F~nhe~ort, neither the Inspector nor his employer shill be liable in any manner for any personal injury or property dfYJi~'°: of any k*ind arising from'or connected with tMs lnrpection.. *:-- *_* . .* Datt / - t.{,, ?o * ** * ~f. ~
~~. Cl"~Ptcllllf)~~
Commi11ion1 t/A 5:42 * * **
'151*11 or ~;r,ci. lllllioNI. 8oudl Piion: S11pplemer,tal ,t. .. iw In form of llni."iki1ch*, or drii,;,lniie mey be u1*CI *p,ovld*CI (IJ 1lze h JX In. X 11 In .. *.
~~CZ) lnfoune~lon. In ITern1 ,-,h;ough 4 *o" thi1 Cle*,. *,epo*n.'1_1. lftclud*d Oft. ee~h *ahNI, and (3) Heh 1hHt la numbered~~
end w,.e.nurnber of 1hNt1 l1 recorded *t 1h* 1op*of mi* form.*
\
~~FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI~~
~~1. Owner __VY..,1.I"'R.,,G,.I"'N'1.I..,A......,E,..r,..,...~~
E..,.C..T":"R._r...... Name c--"A,..N,..,n..,_""'p.,.,o"'WE""""R"-... c.._n,___ Date _ _ L./_..L.'l-t-'-,,.L-¥...Jh~r"'--49'----------- 5000 DOMINION BLVD,. GLEN ALLEN, VA 23060 Sheet _ ___:/ _ _ of _ __,__ _ _ _ _ _ _ _ __ Address
~~2. Plant SURRY POWER STATION Unit_...L..&IL.--------------~~
Name P.O. BOX 315. SURRY, VA 23883 Address Repair Organization P.O. No., Job No., etc.
~~3. Work Performed by VIRGINIA PCWER Type Code Symbol Stamp _ __,.N,_./....,A"'---------~~
Name Authorization No. __,N"-'-/-"'A'------------ P.O. BOX 315, SURRY. VA 23883 Expiration Date_.eN,.,/~A...__ _ _ _ _ _ _ _ _ __ Address 0
4. Identification of System~,""5:c..e.,,!-.o.a4-.. ~:o:,/_./u,:!-.e.=C'~...,td,"--"'"'!4:z...<..r;_.,;:;-=e,../.-~~------------------------

5. (al Applicable Construction Code B,31, J 19....61..._ Edition, N/A Addenda, N-1 , N-7 Code Case (bl Applicable Edition of Section' XI Utilized for Repairs or Replacements 19 g'() (.<}8'0
6. Identification of Components Repaired or Replaced and Replacement Components Name of Name of Manufacturer National Board Other Year Repaired, Replaced, ASME Code Stamped (Yes Component Manufacturer Serial No. No. Identification Built or Replacement or No) c21-1~ ,-- 1,AH,.I - - - .z-sw-e-16 "1.!.>,A,.<)~,{ //,If)
7. Description of Work_-L@-"4"':r),,-,e~,....~,..._--=t:::.:tE-;;;.:;'f;.,;.,;&=.-----------------------------

8. Tests Conducted: Hydrostatic ~ Pneumatic 0 Nominal Operating Pressure 0 Other D Pressure fr psi Test Temp. /i/o 1"' °F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is BY. in. x 11 in., (2) informa-tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form .
(12/82) This Form (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017
FORM NIS-2 (Back)
~~9. Remarks _ _.!.~.::...!0=#::..::b'c....._ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __~~
Applicable Manufacturer's Data Reports to be attached CERTIFICATE OF COMPLIANCE /,/ We certify that the statements made in the report are correct and this /CJ!!>;,1-,a conforms to the rules of the ASME Code, Section XI. repair or replacement Type Code Symbol Stamp, _ _ _..,_..__.A..__ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ Certificate of Authorization No. _ _....,_.~~----------Expiration Date _ ___e;N,.,/_,A,..___ _ _ _ _ _ _ _ _ _ __ Signed '2-~ ,/ -~ Owner or Own~gnee, Title Date _ _ _ )_.,._e_c~,~/_f" _____ , 19...::.?':~9__ CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State or Province of
~~a~d employed by HSBI & I CO. * ** ** of~~
....Ac.R,._T....F...,,O...,R..,D..__..--'C,.._,.T~------------~-~--~-----have inspected the components described .....1R in this Owner's Report during the period _ _ _ _(._.1.==--_,!},..,__-_._RL.....:lo:c'_ _ to ,q*-1 1 - 8q , and state that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section XI.
By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this i-n-sp-ec_t_.,.Ql-'n.'41~=->'---'----"'i-',--'~~=-->"""----'----Commissions _ _*--,-,u"""""{i..._..,.s,::;;-lf..,__,J...,__ _ _ _ _ _ _ __ Inspector's Signature National Boera, State, Province, and Endorsements Date_ _ _ _/......,4:,__-...,_j<..{_,____19 <§ J
FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI
~~1. Owner __V:.. . .i.I.-R.,Ga..I~N.. _. I....l\..__E..,r..,..,E..,,c..,T.,.,B.,I~c......A,. ND.. .,_. . . _P.,_n""WE'"""'.......~~
R C...a.,____ Date-~1~~.:.z.:..:z.~h.L.>o,:,...._ _ _ _ _ _ _ _ _ _ __ Name 5000 DOMINION BLVD,<< GLEN ALLEN, VA 23060 Sheet _ _2-- _ _ of _ _L_ _ _ _ _ _ _ _ __ Address
2. Plam SURRY POWER STATTON Unit l;a Name P.O. BOX 315. SURRY. VA 23663 ~Y()l~IF/9/f)
~~Addrea Repair Organization P.O. No., Job No., etc.~~
~~3. Work Performed by YIRGINil\ POWER Type Code Symbol Stamp _ __.N,..lwACL.-------~~
Name Authorization No.---'N"'"/,_A2-_ _ _ _ _ _ _ _ _ __ P.O. BOX 315. SURRY, VA 23883 Expiration Date _..,N""/"°'A"------------- Address
4. Identification of System *')j,,z.J,d Ul,4,&e--

5. (a) Applicable Construction Code B3 l, l 19....61__Edition, NIA Addenda, N-1 , N-7 Code Casa (bl Applicable Edition of Section xi Utfozed for Repairs or Replacements 19@ ~,fO
~~6. Identification of Components Repaired or Replaced and Replacement Components~~
.. Name of . Narrif!of Manufacturer National Board Other*
Year Repaired, Replaced, ASME Code Stamped (Yes Component Manufacturer Serial No. No. Identification Built or Replacement or No)
~~., ...r.h. r.:...t. --~~
~~2. /.A-_"..,. /'f,/r.J,(' (;, - -- -- Re~ /v/.~~
/ J, ~ ;;.~-"-.v4' {!,M-fh..,!~ / . -~ /.: *- ~-- - - - /1 - .,, ( '
~~I I %.. ., I( .l. 'A:r),.,,.LA. .T.#.~~
~~/AiSCH'--,L,J - - - - Ad'>... A I~~
~~I ,~~~
7. Description of Work_...Lg=..!:&)c....::: ......d,:i,:.<.G..c;if:~-:?~-':Jri)."e....__,-,~/~-/_m~:.s::¢~'4~S'::..___________________
7
8. Tests Conducted: Hydrostatic ~neumatic 0 Nominal Operating Pressure 0 Other D Pressure :1-c psi TestTemp. dh(J,4PT°F NOTE: Supplememal sheets in form of lists, sketches, or drawings may be used, provided (1) size is 8% in. x 11 in., (21 Informa-tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form.
(12/82) This Form (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017
FORM NIS-2 (Back)
~~9. R e m a r k s - - - - - - - - - - - - - - - - - ' - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -~~
Applicable Manufacturer's Data Reports to be attached CERTIFICATE OF COMPLIANCE We cenity that the statements made in the repon are correct and this ,£-l?c&tt&r' conforms to the rules of the ASME Code, Section XI. ::**. *.
~~repa(r or replacement Type Code Symbol Stamp _ _ _..,_,_....__ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __~~
~~~:~cate o Q o ; o ; . - -....... b:a...-----,,~~
~~......____________ Expi::~:-n_D_a_t_eV._-._,4"""":'-~'-A-z.=-..~~
_../ ?a 19 Owner or O w n e ~ l e CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State or P~ovince of VA and employed by HSBI & I CO* of HARTFORD , CT have inspected the components described in this Owner's Repon during the period { ~ - j- }f b to 9- { 'l - 8'.J , and state that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described In this Owner's Repon in accordance with the requirements of the ASME Code, Section XI. By signing this cenificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Repon. Funhermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspection.~~f
~~-----'--"-====----..,,_-;.... &~ I f: 'SL.f :3~~
______,..*commissions-...,.,--,-"-l/_z~=---""--------------- 1nspector's Signature National Board, State, Province, and Endorsement* Date_ _ _L../-___.&"-'--i-{'---_19 ro
FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Coda Section XI
~~1. Owner __ v.....r...R.,,G..,I...,N.....,I..,A,...._..E...r..,,E...,.,c..T..,.RName~~
...I..,c_.cA..,ND CO.___ ....._P...,..o..,WE.....,R........... Date _ _ 1._h.__,=z.=+h.....,ae<------------
~~5000 DOMINION BLVD,. GLEN ALLEN, VA 23060 Sheet _ _-'-_of _ _"".'L---'---,,,.....------- Addren~~
~~2. Plant SURRY POWER STATION N11m11 Unit~~
~~. \.~~
~~M" P.O. BOX 315. SURRY. YA 23883 "tdo #~~
'3t!"c;; ~ *2 2/ e/7 : ,, _Repair' Org11nlzinl_on P.. o, No,. Job;No.,.etc.
~~A.ddren~~
~~3. Wor~ Perto'mi~ by vtRGTNIJ\ POWER Nam11 Type 9ode Symbol Stanip _ __.,N,../c.,A....__ _ _ _ _ __~~
Authori~aticin fl!o. __,'-N"""'"/...,A._'- - - - - ' - - - - - - - P.O. BOX 315. SURRY, YA 21883 Expiration Date _.e;Nulc..A'"------------- Addreu
~~4. Identification of System_.....,S:....f=,e:.t,/.'-',""~""e!"--'{M=_,,~ ...a~~
~~...~=~:;_,_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __~~
5. (a) Applicable Construction Code B3l ,l 19....61.._Edition, NLA Addenda, N-l. N-7 Code Case (bl Applicable Edition of Se~~i~n- x"i Utilized for Repairs or Replacements 19 Yf) w!{fJ
6. Identification of Components Repaired or Replaced and Replacement Components Name of .. Name-c;,f., Manufacturer Natio_nal Boilrd
** Other .. * ~ *Ye~r Repaired, ' . Replaced, ASME Code Stamped (Yes Component Manufacturer Serial No. No. Identification Built or Replacement or Nol 2
~~a~ l'fc.C*.e,.,,°cN "~~
*. t,,,)f)&,~ .I,ve. -- - - -- /(_~~4e.c) /VO
~~2. 7;£~~
'?tdi()u)"'#MIJ >.J. - - -- - I 7' ., rfe.Co~,.,.~~ ~ -- -- , lz. , 0 '5' (l t!.,_, u).,e, ,i L1... - - \
~~I h~~~
~~L,.,?,ll ~c1t1-~~
~~.,"u:~, ; J;.~u t. - - - - '~~
~~z. , £~~~
~~"je; 1h. .. 1() 0 ~.t./~~
~~I JI,. 7' ;,, !;,,,.,\ -- ---= - !JV ijl~~
7. Description of Work._.:.~-=.:'":..e-j>."-~"-.ci""'-'"'""',f.._.,,'e=;'J1=-i'~J'~~,'J.:,;IY:.:..:O::.....~o::.:;'~r.c.r.~~.e.M::.:4,s.:S~.*---------------------

8. Tests Conducted: Hydrostatic ~ Pneumatic 0 Nominal Operating Pressure 0 Other O Pressure d"" .s"" psi Test Temp. d@dfvt"' ° F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is 8% in. x 11 in., (2) informs*
tion in items 1 through 6 on this report is included on each sheet, and (31 each sheet is numbered and the number of sheets is recorded at the top of th is form . (12/B21 This Form (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017
FORM NIS-2 (Back)
~~?o u .J I fl.. '/.. '/2. . s:y-n.11 ~ 6)~~
CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this ,#c>a@e.t!.,,,,,,_,.,,,... conforms to the rules of the ASME Code, Section XI. * ** repair or replacement Type Code Symbol S t a m P - - - ~ ~ - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - a Certificate of Authorization No. _ _..._.._....._ _ _ _ _ _ _ _ _ _ _ Expiration Date __N..,_,.I....A.::...._ _ _ _ _ _ _ _ _ __ Signed }f ,.,ii :/µV' 5s.z- CV<( Date_......,,.._U""-"-'~:.....,.*_.z....az_a..-_ _ _ _ , 19 'JD Owner or O~sDesignea, Title
. CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State or Province of and employed by HSBI & I CO* of ......B..A.i.R.,..T..,F...,,O..,R.,..Di,t.J.,__,C,..T------------~.---;;---.;;;C'T"-----~have in5B,_ected the components described in this Owner's Report during the period _ _ ___,/...,i'"'--*...,i<a.....-......,,$>......,C_____ to 1, ID * , and state that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section XI.
By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspection.~ f ~ .J
~~---~~-=--7"---:--:--=-:~:...........>:~=-:oa...=-...;...._ _ cominissions _ _v_t:tL'-.__;s:::::*_.lf_.:__3___________~~
~~Inspector's Signature National Board, State, Province, and Endorsement* Date_ _ _ ~/-_:}___.4__19 r ()~~
~~FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI~~
~~1. Owner VIRGINIA ELECTRIC AND POWER CO. Date __,_/...,,,_2-'-~"'---+-ft'.,,,_~9- - - - - - -~~
~~Name 5000 DOMINION BLVD., GREEN ALLEN, VA 23060 Sheet_~/_ _ of Address --~----------~~
~~2. Plant SURRY POWER STATION Unit_.......,""------------------~~
Name P.O. BOX 315, SURRY, VA 23883 hJO- '.J ?fooo 7111 f.o Address Repair Organization P.O. No., Job No., ate.
~~3. Work Performed by VIRGINIA POWER Type Code Symbol Stamp ___N~/~A_ _ _ _ _ __~~
Name Authorization No. _ _ _ _ _..::.N:.<./...;:Ac:.__ _ _ _ __ P.O. BOX 315, SURRY, VA 23883 Expiration Date _ _ _ _ _ _ _ N~/_A_ _ _ _ _ __ Address
4. Identification of System c<!l>dlr6','"r4d'e::r::: <;;:A,!&/1'

5. (al Applicable Construction Code B3], 1 19....6.2._Edition, N/A Addenda, N-1, N-7 Code Case (b) Applicable Edition of Section XI Utilized for Repairs or Replacements 19 80 WBO

6. Identification of Components Repaired or Replaced and Replacement Components
~~Name of Component Name of Manufacturer Manufacturer Serial No.~~
~~National Board No. Other Identification Year Built Repaired, Replaced, ASME Code Stamped (Yes or Replacement or No)~~
),e,;><; (t)cA ) ..--- - Al4 ,l- CS, rNJrl-2/17/., - .flB A e. ) No N,,rr {.;o~j - / - - ~/~ 12- C.5,-"ftJl-;102. J'i - j)_,e:,..
~~A~£), dn~~
8. Tests Conducted: Hydrostatic D Pneumatic D Nominal Operating Pressure Other D Pressure J/Of' psi Test Temp. /l(c:J/ °F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is 8Y:z in. x 11 in., (2) informa-tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form .
~~(12/82) This Form (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017~~
*1 FORM NIS-2 (Back)
~~9. Remarks ____,.S:.~,u~:i>S~dJ~_P_(:__~S~!r-V~-2~/~9,t.,_,8"J~1~0.,,...,)_ _ _ _ _ _ _ _ _ _ _ _ __~~
~~)0 4 5.s -~~
CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this ,e>.f,><J?egt.,ci,.,Tconforms to the rules of the repair or replacement ASME Code, Section XI. Type Code Symbol Stamp _ _:.IV_:_.:...h Certificate of Authorization No._-,,.P::;...L#.::,~'-------------Expiration Date -,.,/V'--=£?""'-------------- Signed Q /. ~µ/' wneTOrOefs Designee, Title Date .i>.tc, 5 ,19 Y9 CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State or Province of VA and employed by HSBI & I CO* of _H_a_r_t_f_o_r_d......c.,_C_T_ _ _ _ _ _ _ _ _ _ _ _,------,,-,,-------have inspected the components described in this Owner's Report during the period _ _ _~fl~-~:),.,_,-"'JJ,__,C,OC<....___ to "I - I ~ ff' 1 I , , and state that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section XI. By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this
~~-~-'=s"--'L{----"3____________~~
i_n_sp_e_c~"'"ti.!:o:....:n.=---_;__-,----'i......,..--,-,~=-=--='--......C...----Commissions ___U=--A.=-* Inspector's Signature National Board, State, Province, and Endorsements Date_ _ _ ~/~-~d-_G~_19 ro
FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI
~~1. Owner __V:LjI""'R,.,G;,.I..N.....,.I.,;;.A....._.E..,I..,,,,..E.,.C,.,.T~R,.I,..c..._.A...NP Name~~
......_P~a"'WE"""B~c a.___,_ ...... Date_*..L..,12.o::;)'-'/;....i.~'--'~'-"JJ-z.c..._ _ _ _ _ _ __
~~5000 DOMINION BLVD,, GLEN ALLEN, VA 2"3060 Sheet _ _.!./__ of / Address~~
2. Plant SURRY POWER STATION Name Unit kJa P.O. BOX 315. SURRY, VA 23883 Address Repair Organization P.O. No., Job No., etc.

3. Work Performed by VIRGINIA PQWER Type Code Symbol Stamp _ __._N,../_,A...___ _ _ _ _ __
Name Authorization No. --'N ....../.,,.,A.___ _ _ _ _ _ _ _ __ P.O. BOX 315. SURRY. VA 23883 Expiration Date_...,N'-'/-'A"------------- Address
~~4. Identification of System~~
~~A4e-r4A (7Qt).eA?..vZ:::::::~~
5. (al Applicable Construction Code 831.1 19...6.2_Edition,__,N~l..,A~_ _ _ Addenda, N-] , N-7 Code Case (bl Applicable Edition of Section XI Utilized for Repairs or Replacements 1970 4.l87'
6. Identification of Components Repaired or Replaced and Replacement Components Name of Name of Manufacturer National Board Other Year Repaired, Replaced, ASME Code Stamped (Yes Component Manufacturer Serial No. No. Identification Built or Replacement or Nol S'r-~.) r ~
~
~~v/4~~
~,,1 ) 1.Z-12£.,#cJ/,J.JV/ .J'.J-~,_Ae.J,) / , / l'l #e.r.r r/Z /~) ,. - ///~ 12.&.u, .,,2,$'$')C - ..d,!!--~e.4-u,.,\ AIO
7. Description of Work. _ _._~=--,F-;i-=i,:."'-d;<--'d"""'-___.~i<..~"'c.,?=,/_,,~::;;.....~Z'!:'-'-'~"-'-'/.A('-'---------------------

8. Tests Conducted: Hydrostatic ~Pneumatic D Nominal Operating Pressure D Other O Pressure 2Ja.r psi Test Temp. l j 7 °F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is 8~ in. x 11 in., (2) informa-tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form .
(12/82) This Form (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017
FORM NIS-2 (Backl
~~9. Remarks ~-~~q=y_*___c?,__;;_o_*d_-=E-=5-+f-2_._,:'=f ......3"'--'-'?6....__,,G_...,6_,'_~~
~~-} _ _ _ _ _ _ _ _ __~~
Reports to be attached CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are.correct and this 4)~#C:Conforms to the rules of the ASME Code, Section XI. repair or replacement Type Code Symbol Stamp _ _ _N ~ ~ A ~ - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Certificate of Authorization No*--='-"-'-----------Expiration Date __N=/-=A"'-------------- Signed ~-Jf Owner ~~Daslgnee, Title _/ --,~/ n.:z- c:!',..,,t>>/u~t!d Date )~c. / ,(
--~~=~~-~----, 19 ----- Y,f CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State or Province of and employed by HSBI & I CO* of -.1li.i.A=R..,.T..F.._O"""'R..P<.z..<<......,.C..T.________________-:::---------,_have inspected the components described in. this. 0V)lner's Report during the* period--+-1-'e::L=--'--";:l._-...;-'_..;8~4'-----to C, -( 1- 8' 'j , and stata that to the best. of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this . ,l Owner'~ Report in accordance ,with.. the _requirements bf the ASME Code, Section XI.
By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this i_n_sp_ec-4-~->io<C.n.;:____-,- l_. _ _ ....,G~~-=--__._..==&::::~----COmmissions _ _ _ Inspector's Signature v_~_...:,5"--4-'-_________
~~-3 National Board, State, Province, and Endorsements Date,_ _ _/1-oJ:<=---.....,_It.{......___19 ~q~~
~~FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI~~
~~1. Owner __V.....,I..,R.,,G,.,I,...N .......a..___~~
~~...I.....,A.__.E..,r....,E...,.C""T~R,_I._c..._.A....NP.....__p"""'n"'WF."""R"--C Name Date_.,_/ Jr:;_z_.,_l-1'--'-;--"J>_,9'---------~~
~~Sheet_~_ _ of _ _I_ _ _ _ _ _ _ _ __ 5000 DOMINION BLVD., GLEN ALLEN, VA 2'3Q60~~
~~2. Plant SURRY POWER STATTON Address Name Unit -~~
_~/<~w~O-------------- J rooo ?62.s'o P.O. BOX 315, SURRY, VA 23883 Address Repair Organization P.O. No., Job No., etc.
~~3. Work Performed by VIRGINIA POWER Type Code Symbol Stamp_~N,../....,A..__ _ _ _ _ __~~
Name Authorization No. _N~/=A,___ _ _ _ _ _ _ _ __ P.O. BOX 315, SURRY, VA 23883 Expiration Date_-"'N!.L/_.A_.___ _ _ _ _ _ _ _ _ __ Address
~~4. Identification of System , W~~~
~~-*- \ -\' .~~
T(
~~/ £..rec.7'2~~~
~~5, (al Applicable Construction Code B,'.31. l 19...6.Z_Edition,_N __ L~A_ _ _ _ Addenda, N-1~~
N-7 Code Case (bl Applicable Edition of Section XI Utilized for Repairs or Replacements 192tl ull(t}

6. Identification of Components Repaired or Replaced and Replacement Components Name of Name of Manufacturer National Board Other Year Repaired, Replaced, ASME Code Stamped (Yes Component Manufacturer Serial No. No. Identification Built or Replacement or Nol s;&JJ>C C2~~J - - /VJ; 2 - ~.,::..2.J. 9 - b>~e..J,I ,.u,.,
~~7. Description of Work_~_.e.__..L=r,~~?=d~c-tf.__-"'-£~~
....TY--=~~'-f.._r,._~6 .....d......S"'Ar:=--'~'-'-/r-+- ........e__.4,=-=e.=--;,fl'--",v-"--",el.::...::u::..:;._r:..::":f'------------
8. Tests Conducted: Hydrostatic D Pneumatic D Nominal Operating Pressure W Other D Pressure _ _ _ _ _ psi Test Temp. _ _ _ _ _ _* F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1 I size is BYa in. x 11 in., (2) informa-tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form .
(12/82) This Form (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017
FORM NIS-2 (Back)
~~9. Remarks _7?_0.:;,.__#°_C._J_~y'-',l-~_0~~-'//_(_1"'-)----------------~~
1 Appllcable Manufacturer's Data Reports to be attached CERTIFIC~TE .oF~CC>MPLIANCE , ., _ We certify that the statements made in the report are correct and this t2&f)e.4e,f,t,J(!lr conforms to the rules of the ASME Code, Section XI. repair or replacement Type Code Symbol Stamp _ _--'N,..,_.._A._________________________________ Certificate of Authorization No. _ _..,._..._ _ _ _ _ _ _ _ _ _ _ Expiration Date _~N~/~A=-------------- Signed ~~~Tip_z- Date_~>~e~C=*~~/~.y'~---, 19 ,Yj' CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State or Province of and employed by HSBI & I CO* of HA,RTFORp , CT have* insp~ted the. *_components described iri this Owner's Report during the period / 'l. R~ to q- 'er- 8'"{ , a*nd state that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section XI. By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspection.
-~. . . .hr~--:-* ~f,"".'"'"'":@,"""::':'~~--Commissions_~lja_~*
~~1nspector's Signature~~
~~-=-54---'J"--------~~
~~National, Board, State, Province, and Endorsements Date_ _~ / .,._Q-~(__,t,/_____19_f~1-~~
~~FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI~~
~~1. Owner VIRGINIA ELECTRIC AND POWER CO. Date _ _ _ ~l?-___./~b~/_t~~-7________~~
~~Na~.<d.V 5000 DOMINION BLVD. , Cffi.fEN ALLEN, VA 23060 Sheet _ _,_/__ of _ _- + - - - - - - - - - - Address~~
~~2. Plant SURRY POWER STATION Unit _ _ _~W __Q_ _ _ _ _ _ _ _ _ _ _ __~~
~~Name P.O. BOX 315, SURRY, VA 23883 Address Repair Organization P.O. No., Job No., etc.~~
~~3. Work Performed by VIRGINIA POWER Type Code Symbol Stamp ___N~/~A_ _ _ _ _ __~~
Name Authorization No. _ _ _ _ _.;:.N:.c/...cA.c:.__ _ _ _ __ P.O. BOX 315, SURRY, VA 23883 Expiration Date _ _ _ _ _ _ _ N~/_A_ _ _ _ _ __ Address r_+~Q~"--...(,....o.,,...,..0~/-~~'f~-----------------------
4. Identification of System _ _ _ _ _~.....,._,f~0...

5. (a) Applicable Construction Code __B~3-J~-~J~_ _ 19--6.l_Edition, __N~/=A~_ _ _ Addenda, N-1, N-7 Code Case (b) Applicable Edition of Section XI Utilized for Repairs or Replacements 19 80 W80

6. Identification of Components Repaired or Replaced and Replacement Components
~~Name of Component Name of Manufacturer Manufacturer Serial No.~~
~~National Board No. Other Identification Year Built Repaired, Replaced, ASME Code Stamped (Yes or Replacement or No) (o"-"~~
~~)f S iltll) 5 SSY-J-'146~1 37fy :iJ, I (u'll- ))IA- J.-Rc.- Ffaf.-JJA }J)Jt gePkul )):v~~
~~§ 11~~
~~;VuT J cs Y- JJCJ ~'ti 0).. o iq110 ;J/A J ;J)A f fp)qcl') ;Jo I~~
7. Description of Work _ _~R---'-:ffr--/Ci~Jc~e..~~t~J~~--:;}t-~e-~~G~l\j~,k~e,,_+_s___________________

8. Tests Conducted: Hydrostatic [B/Pneumat~ Nominal Operating Pr!~sure D Other D Pressure lJ?o psi Test Temp. J 112 °F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is 8Y:z in. x 11 in., (2) informa-tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form .
(12/82) This Form (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017
FORM NIS-2 (Back)
~~9. Remarks --~M~~c~,1r~t!,~,- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -~~
Applicable Manufacturer's Data Reports to be attached CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this ,i2;:t).,cl(P&.hvTconforms to the rules of the ASME Code, Section XI. repair or replacement Type Code Symbol Stamp _ _ ~>>~~/p_-~--.------------------------------- Certificate of Authorization No. _ _.;,.,Uc..J;~~=-----------Expiration Date -~A/'-"-_.:h~"-*----------- Signed()_ K /J ~ Owner o r ~ Designee, Title CERTIFICATE OF INSERVICE INSPECTION _A,.. t,. ! Date-""""'-""""'""-"'-'--~-------, 6 19~-~~- I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State or Province of VA and employed by HSBI & I CO. of Hartford, CT have ir.;eected the components described in this Owner's Report during the period /a~i'.J.~ f~ to Cf-rf- lr_"t , and state that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section XI. By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspection. _ __,U+fi..,,:::c=.~---/_,,......,._,,,eJL=w.......:=""------Commissions _ _ _ _ ,/A~C{=""""--'.)=--=4~J.____________ Inspector's Signature National Board, State, Province, and Endorsements Date_ _ _ /~')__-_6_ _ _19 t7
~~FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI~~
~~1. Owner VIRGINIA ELECTRIC AND POWER CO. Date _ __,l~z..,,,&~'.f"'~h~r'---'S------------~~
~~NameG~$v 5000 DOMINION BLVD. ' C.Jl.JtlN ALLEN' VA 23060 Sheet_~_ _ of / Address~~
~~2. Plant SURRY POWER STATION Unit_~~----------------~~
~~Name P.O. BOX 315, SURRY, VA 23883 Address Rep'iflr Organization P.O. No., Job No., etc.~~
~~3. Work Performed by VIRGINIA POWER Type Code Symbol Stamp ___N~/_A _ _ _ _ _ _ __~~
Name Authorization No. _ _ _ _ _Nc.c*,_/.;;;.A_ _ _ _ _ __ P.O. BOX 315, SURRY, VA 23883 Expiration Date _ _ _ _ _ _N~/~A _ _ _ _ _ _ __ Address
4. Identification of System he.:'> uJ tP ,cl,2.;

5. (a) Applicable Construction Code_~B~3~J~-~J_ _ _ 19_6l_Edition, __N~/=A~-_,..-Addenda, N-1, N-7 Code Case (b) Applicable Edition of Section XI Utilized for Repairs or Replacements 19 80 W80

6. Identification of Components Repaired or Replaced and Replacement Components
~~Name of Component Name of Manufacturer Manufacturer Serial No.~~
National Board No. Other Identification Year Built Repaired, Replaced, ASME Code Stamped (Yes or Replacement or No) s T/.JJ s - --- -- 2./~.7~/?/ - ~~;i<<n,=&,) .PCJ
~~/IItor1' - - - L-/aJ-n/ - ~-E)<Wad /V~~~
7. Description of Work_~c{J~~tl._c;~;,.~~~:..9.~V.~~~d:~j'---"~~,fl~~~t/~e!~------------------------

8. Tests Conducted: Hydrostatic G3'0neumatic O Nominal Operating Pressure 0 Other O Pressure ;OiP'&> .~~,epsi Test Temp. !ti"£ °F 13~0 NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is 8% in. x 11 in., (2) informa-tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form .
~~(12/82) This Form (E00030) may be obtained from the Order Dept,, ASME, 345 E. 47th St., New York, N.Y. 10017~~
~~FORM NIS-2 (Back)~~
~~9. Remarks _.,......s=c..,(:...,.Uu,_0"----...!........IL...---'=C'-'s~v..::-c..,Z""-"3"-'0"'--£9_3<-J-S::::::---1.C_e1.!.,,L)_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __~~
rApplicable Manufactur r's- ata Reports to be attached CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this conforms to the rules of the ASME Code, Section XI. repair or replacement Type Code Symbol Stamp _ _,_#:......c~_'r)-'--------------------------------- Certificate of Authorization No. _./V::..;;.....,h....:..,;_ _ _ _ _ _ _ _ _ _ _ _ Expiration Date _ _ _ /V_,_j;-'-'------------
~~/_~_4_..s_~/i~3'_1_____ ,19 __.K"'---'9'--~~
Signed__.tfl!fa..,L.~£=--"'L=-.i_-'20:..!l""R'""-.....-==,r:........:...-.s_=..z_.::...,....... __ .:.!._tv---'/$-'-'r'--v---"-,!.-=~"-'~"---- Date _ _ Vw"ner or~er's De1ifonee, Title CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State or Province of VA and employed by HSBI & I CO* of _H_a_r_t_f_o_r_d....c,__C_T_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ have inspected the components described in this Owner's Report during the period, _ _ _ _,_/_'l.~--~~~--8'----'q___ to '1-('f - g 1 , and state that to the best of my knowledge and belief, the Owne_r has performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section XI.
.By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this *m--sp-e-c-ti-o--'n~L*'-"-',c..._ _ ____;;i_.-~=-:=:...:::.c='---'~----Commissions_--,-__ -=-°'-=--..,5":'--::-'{--'--"3"----:--------- t}=--
1nspector's Signature National Board, State, Province, and Endorsements Date_ _ _ _ ~/~'l._-__._S:::__19 g 1 ___ . _. ___ *----~--- _.*: - . .
~~~---- _:... -**~- .~~
~~FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI~~
~~1. Owner VIRGINIA ELECTRIC AND POWER CO. Date_~1~z..~t=s_"~;;~,Y~C)_ _ _ _ _ _ _ _ _ _ __~~
~~Name~~
~~~.!-/II 5000 DOMINION BLVD., AddressGjt~N ALLEN, VA 23060 Sheet_-----<_ _ of _ _/;___ _ _ _ _ _ _ _ __~~
2. Plant SURRY POWER STATION Unit L Name P.O. BOX 315, SURRY, VA 23883 Address Repair Organization P.O. No., Job No., etc.

3. Work Performed by VIRGINIA POWER Type Code Symbol Stamp ___N_/~A_ _ _ _ _ __
Name Authorization No. _ _ _ _ _..:cN:.c/..:Ac.::....__ _ _ _ __ P.O. BOX 315, SURRY, VA 23883 Expiration Date _ _ _ _ _ _ _ N~/_A_ _ _ _ _ __ A.d.dress .
4. Identification of System-'-h-"c_';/....,.'J>td~,..A...,.,c~.,~,_.e,--------------------------------

5. (a) Applicable Construction Code B31 , 1 19-6.l...._Edition, N/A Addenda, N-1, N-7 Code Case (b) Applicable Edition of Section XI Utilized for Repairs or Replacements 19 80 W80

6. Identification of Components Repaired or Replaced and Replacement Components
~~Name of Component Name of Manufacturer Manufacturer Serial No.~~
~~National Board No. Other Identification Year Built Repaired, Replaced, or Replacement or No) ASME Code Stamped (Yes Sr~i>S 0.i!~A) - --,~~
;vh .l-/b}-/.<~ - P,\ ,.I do /lur5 lv,M) / -- -- /Vt 2-/&J-/..5'6 - h:---. - ,.I ,A/"'
7. Description of Work __()~,/,~',!~'4-~h::~~~'=o/.~,:;;-d~d~-~-'4_.t..~r/,~',,£~-------------------------

8. Tests Conducted: Hydrostatic ~ Pneumatic D Nominal Operating Pressure D Other D Pressure ;:vrez psi Test Temp. /lf"f; °F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is 8Y. in. x 11 in., (2) informa-tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form .
~~(12/82) This Form (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017~~
~~FORM NIS-2 (Back)~~
~~9. Remarks _"'"'5..e....!...n=-e,=~'--J../i_..~'--#--""C==.5e.._,YL-.,.-2""""".J-"O<:.....L,9.:1..,_,_.,~~
~
~~7 <'----"ft--'~?")'----------------- Applicable Manufacturer. Da a Reports to be attached~~
~~/- 6) #, 5_ LO I~ . .~~
CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this ~?c#f'&,,s..,~onforms to the rules of the ASME Code, Section XI. repair or replacement Type Code Symbol S t a m p _ . . , _ / f / _ _ . ' - - ' ' H - = - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Certificate of Authorization No .....t! .....kc..~_;_____________ Expiration Date _c(.<--<-~-/;)~------------
~~~A~.=""c~,~~
~~Signed,_...,Q_ or Province of~~
~~......_,/:f-d--'...,....._,/J~AU,l/""-"'~~
~~Owner or Ow~ Designee, Title VA~~
""--~-=.o:--r,::.....,,:S_;C=---"~"";.v""'--"~~/.=:v'.c..,;;._.~c""'"'""f&- Date CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State and employed by
_H_a_r_t_f_o_r_d_,__C_T_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ have inspected the components described HSBI & I CO*
. _.s_-_ _____ , 19 ?"J of in this Owner's Report during the period, _ _~l~~~~....~,IC----g~c:rt-----to 9-/'f- 8'? , and state that to the best of my ,knowledge and belief, the Owner has performed examinations and taken corrective measures described*in*this Owner's Report in accordance with the requirements of the ASME Code, Section XI.
By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concernirig the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this i_n_sp_e..,.W=_t-io,,_n_.-=. i_. _ _ _....... --"~"'---=-e=-------Commissions _ _ _""'~ Inspector's Signature
~~...--(,(..'----=~=--'{+--_'3____________~~
~~National Board, State, Province, end Endorsements Date,_ ___,__,,{1=---')'-------_ _19 g' 1~~
-- *----*--*----------*- -- -- ~ * . * . ' :.~.~ :_,.- *:-. -:**** . :; *--~: ~ *. **:__! ~-~ _*(. :.: ** _.*.*: *..,..! ' .-_. _*. - -*~ *.**** ~-~.: '::... :~<- ' -. ~-: .: *.. !* **... :* *,_: .* < ..
~~FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI~~
~~1. Owner VIRGINIA ELECTRIC AND POWER CO. Date _ _ /._~~k~.,. /r~~9'_*___________~~
NameG~,v 5000 DOMINION BLVD., Sfi?H ALLEN, VA 2.3060 Sheet _ _+-_of Address --------------
~~2. Plant SURRY POWER STATION Unit --+--""C.I.l.---------------~~
~~Name P.O. BOX 315, SURRY, VA 23883 Address Repair Organization P.O. No., Job No., etc.~~
~~3. Work Performed by VIRGINIA POWER Type Code Symbol Stamp _ _-'N""/'--A'---------~~
Name Authorization No. _ _ _ _ _ _ N~/_A_ _ _ _ _ __ P.O. BOX 315, SURRY, VA 23883 Expiration Date _ _ _ _ _ _N::.:.L../.::.A::...._ _ _ _ __ Address wnCL.c,,~u.-""'~~_,.,:z,,..1;z,../<..e..C_~S3~..,,_~"="-#yV'---------------------------
~~4. Identification of System__,C."'-"'...~~
~~~ /~~
5. (a) Applicable Construction Code B3], l 19....6.l__Edition, N/A Addenda, N-1, N-7 Code Case (bl Applicable Edition of Section XI Utilized for Repairs or Replacements 19 80 W80

6. Identification of Components Repaired or Replaced and Replacement Components ASME Code National Repaired, Stamped Name of Name of Manufacturer Board Other Year Replaced, (Yes Component Manufacturer Serial No. No. Identification Built or Replacement or No)
.s;.,,1 (" (;"bJ ) - --- ut ~-C.5-.A.~.!-LOdA ,!),,L',. ,A_ L.,j NG' #u;-, 0 2. .tA) / - - ##2, :7-"'<'~ AIA.f~,l_()(),./ ~c:,_..,y,_..<:J 1\/(7'
7. Description of Work _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __

8. Tests Conducted: Hydrostatic D Pneumatic D Nominal Operating Pressure ~
Other D Pressure ,Ve, c' psi Test Temp. t</o r °F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is 8% in. x 11 in., (2) informa-tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form . (12/82) This Form (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017
FORM NIS-2 (Back) s Data Reports.to b.e attached CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this conforms to the rules of the ASME Code, Section XI. repai~ or repl~cement Type Code Symbol Stamp _ _---'--,,t/ __h..;....-,------------------------------ Certificate of Authorization No. _ _/v__.;h_C,,?,-'-___________ Expiration Date _..,_/V'._,..J;'-~'--------------
~~h. . .~~
Signed_~---.c../:_._,_:(~-:L..,_'.M:/""""=-~.:zj=---"'5'-=:?~~L=,,1CL-"15=1d...c.-...0¢_,,,t1.,'-""--_ Date____./c.:L.,,_,_k=.-.ri.... n_,__ _ _ _, 19 d Owner or O ~ s Designee, Title or Province of VA CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State and employed by HSBI & I CO* of _H_a_r_t_f_o_r_d_,_C_T _________________--,-..,,...______ have ing:ected the components described in this Owner's Report during the period _ _ _ _~L~~=-'~:).~-~fr......,Jc---tO 9-f<f- 1 * , and state that to the best of my knowledge and belief, .the Owner has performed examinations and taken corrective measures described iri this Owner's Report in accordance with the requirements of the ASME Code, Section XI.
*By signing this certificate neither.the *Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this 0
i_"s-pe-ct_i~fM=-- ....U=~'---'f_._c9:A=-=-"""""--'~--commissions--,--*"""~~a__.-=--=s~'f'"="""3:::..__ _ _ _ __ Inspector's Signature National Board, State, Province, and Endorsements Date_ _ -'-'/')"--_,,j:..__ _19---"'-'J_,_J_
~~FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI~~
~~1. Owner VIRGINIA ELECTRIC AND POWER CO. Date _ __.c/_2.-"-k-""--<~'-"'--(j"-----------~~
~~Name(S.,.~p 5000 DOMINION BLVD., S,f-~EN ALLEN, VA 23060 Sheet_~_ _ of _ _.,___ _ _ _ _ _ __ Address~~
~~2. Plant SURRY POWER STATION Unit _ _....1.6:._-.-_.,,~"'--"o'--------------~~
~~Name P.O. BOX 315, SURRY, VA 23883 Address Repair Organization P.O. No., Job No., etc.~~
~~3. Work Performed by VIRGINIA POWER Type Code Symbol Stamp _ __:N::.,/c...A=--------~~
~~Name Authorization No. _ _ _ _ _;;:.;N:<./-=A-=--------- P.O. BOX 315, SURRY, VA 23883 Expiration Date _ _ _ _ _ _N::.L/..::A:..__ _ _ _ __ Address~~
4. Identification of System Ee!:e~wd/ "15-£__

5. (a) Applicable Construction Code_~B~3~J~-~J...__ _ 19---6.L_Edition, __N"'-L-/-"'A.___ _ _ Addenda, N-1, N-7 Code Case (b) Applicable Edition of Section XI Utilized for Repairs or Replacements 19 80 W80

6. Identification of Components Repaired or Replaced and Replacement Components
~~Name of Component Name of Manufacturer Manufacturer Serial No.~~
National Board No. Other Identification Year Built Repaired, Replaced, ASME Code Stamped (Yes or Replacement or No) s,.,~ <, ( " " J' ----- - ,t/ /,4 2-/w-/~? - ,?),~
~~.A -,1. /t/¢ ).4,-) ( Z.O .!A /~~
~~J -- - A/.£. .7- L ,_;_ ,,:-)~~
~~- L-r-::._,.,.u?A 7 .Nt1~~
~~7. Description of Work_~a~:V-:~e!-=;?=,-,fl.~'4:.,_.,,d~b=--"t/_'---'--"4-'-'4=-=-t/.~'&~-------------------------~~
8, Tests Conducted: Hydrostatic ~neumatic D Nominal Operating Pressure D Other D Pressure / I!to psi Test Temp. /%(2 °F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is BY:. in. x 11 in., (2) informa-tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form . (12/82) This Form (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017
FORM NIS-2 (Back)
~~9. Remarks-S: r_u~--L-A. .o'. .--#_c_s_y:'-----"-.i"-'e/~1-2_t--+-'1~4-.z......) _ _*_*_ _ _ _ _ _ __~~
~~~ -H I ..~~
Applicable Manufacture~)'s Data Reports to be attached I aJyr 5 v-;.:19 ?/2 ( 1 _ CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and thi~ @ ..."?G~&b/Cconforms to the rules of the ASME Code, Section XI. repair or replacement Type Code Symbol Stamp _ _ ,,v'--h'---------------------------------- Certificate of Authorization No._.:..V_.,_~_'#---=-------------Expiration Date _ __./V.....;....._fa...;.~-=------------
~-"""'~-"""":A"'d""'""__..,.,.::....______________ Date * ..,,*>=lli; Signed_-.:Q_c...=c.....-_...c;/,__ /.Z.. / o,r: ,19 ri Owner or Ow~esignee, Title 7 CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State or Province of VA and employed by HSBI & I CO. of
_H_a_r_t_f_o_r_d....;.,_C_T__________,______~ - - ~ ~ - - - - h a v e inspected the components described in this Owner's Report during the period _ _ ___,/c.....,,c'-(+-..,'J.,~(--=2--"1'---to VI i/ ftC, * *** and ~ta~e that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures.described in.th'is Owner's Report in accordance with the requirements of the ASME Code, Section XI. By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspection. ___._(LJ-W.C....v-kJ~~i_. Inspector's Signature
~~--~~~--Commissions_--"c~-=-=a.,'--""5}"--'-4--=-'3_ _ __~~
~~National Board, State, Province, and Endorsements Date_ _ _ _ ~/~l....,./_f: ( __19 2f j~~
~~FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI~~
~~1. Owner VIRGINIA ELECTRIC AND POWER CO. Date_~/~2.=+-4 <~~k~_,..q___________~~
~~Name Ge.<!cv 5000 DOMINION B L V D . , ~ ALLEN, VA 23060~~
~~~ Sheet _ ___,'-- of _ _~ - - - - - - - - - -~~
~~Address~~
~~2. Plant SURRY POWER STATION Unit _ _...,.J;2i'--"""-'n""--------------~~
~~Name P.O. BOX 315, SURRY, VA 23883 Address Repair Organization P.O. No., Job No., etc.~~
~~3. Work Performed by VIRGINIA POWER Type Code Symbol Stamp _ __:N:.:.,/c.;A=--------~~
Name Authorization No. _ _ _ _ _N"'*,_/.::..A:___ _ _ _ __ P.O. BOX 315, SURRY, VA 23883 Expiration Date _ _ _ _ _ _N~/_A_ _ _ _ _ __ Address
4. Identification of System~C~M~~=&~"-C=~~?~p"',.~14~-.,;~v~,..~c-e.._~a-o~,v~,,.~--;e,a~~t::...~-------------------

5. (a) Applicable Construction Code __R...._3....J~J.......__ _ 19 _fil__ Edition, -~N=/~A~___ Addenda, N-1 , N-7 Code Case (b) Applicable Edition of Section XI Utilized for Repairs or Replacements 19 80 W80

6. Identification of Components Repaired or Replaced and Replacement Components
~~Name of Component Name of Manufacturer Manufacturer Serial No.~~
National Board No. Other Identification Year Built Repaired, Replaced, ASME or Replacement or No) Code Stamped (Yes sruJ<: G.~d} - - /,I /,11 .2.-C!//-~,/-,,Z,U)} - .h,>~,J ;va
~u<< (.zc/ LA ) ./ - - tvh, :l-c#-,4£.,/-;>_J Or - Ax *A-..e.,J - A/0
7. Description of Work _:t,v~)ccz:::: ~,<.1,)

8. Tests Conducted: Hydrostatic D Pneumatic D Nominal Operating Pressure Q-/"
Other D Pressure /VO,) psi Test Temp. ,,t(o r °F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is 8% in. x 11 in., (2) informa-tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form . (12/82) This Form (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017
FORM NIS-2 (Back) CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this .,'1'&',)'dc.!'~conforms to the rules of the ASME Code, Section XI. repair or replacement Type Code Symbol S t a m p _ - ' - ' , . ( / c . . . . . . , ' - " - ' < - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Certificate of Authorization No. -~)/,c_,,_k~----------- Expiration Date --"-'A.~V<---,,,..k?~~----------- Signed~~~ Date /.t.- /r , 19-=Y,__.J;..__ wner or ownes0esignee,Ti1e CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State or Province of VA and employed by HSB I & I CO* of Hartford, CT have inspected the components described in this Owner's Report during the period 'l.. to =!/ / ~( ~ j . , and state that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section XI. By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this _ _ _i-"-.*--~---------Commissions _ _ _ _ _ i-n-sp_,~_.ct""io..:.n_.-=-LI J_a_._~5'"--l(--'-_________
~~-J _~~
Inspector's Signature National Board, State, Province, and Endorsements Date_ _ __,_/_.,_,:y,__....,_5_ _19 'iJ J
FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI
~~1. Owner __Vx.. Ia1R.i.G1.o1I...N;a.I.,l\..._..,E..,r...E;uC,..T...B..,I C.....,A...NP ........R_..c...a..__~~
~~.........Pi;.iQ_.~~~
~~Name 5000 DOMINION BLVD,, GI.EN ALLEN, VA 23060 Sheet / of__,..___ _ _ _ _ _ _ _ __ Addr-~~
~~2. Plant SURRY POWER STATION Unit ----,...,.-_"'6,_1- - - - - - - - - - - - - -~~
Nam* /H-G, P.O. BOX 315, SURRY, Yl\ 23BB3 Addrea Repair Organization P.O. Na., Jab Na., ate.
~~3. Work Performed by VIRGINIA POWER Type Coda Symbol Stamp _ _.,N""/...,A...._______~~
Name Authorization No.__,N,../,._A...__ _ _ _ _ _ _ _ __ P.O. BOX 315. SJIBBY, YA 23BB3 Expimion Data_~N~/s.AL...---------- Addrwa
4. Identification of System_,..ha...ci~::.1 .....J..,4_,;111e:Ea'::..'8-=adc~'----------------------------

5. (a) Applicable Construction Code 631- l 19....fi2_Edition, N Ill, Addenda, N-1 , H-7 Codec-(bl Applicable Edition ~f Section XI Utilized for Repairs or Replacemenu 19 YO ~.fD
6. Identification of Componanu Repaired or Replaced end Replacement Componanu Nemeof Nemeof Manufacturer National Board Other Year Repaired, Replaced, ASME Code Stamped (Yes Component Manufacturer Serial No. No. Identification Built or Replacement or Nol 5ruJ '> (,o >J - - Al/.-, Jl.-~t,J- /? z. - h!>,,,.,J,,) P'tJ
~r< ~",!A) / - - p~ 2.-/:-/,,)-/72 - IJ.A~ .-.2,J ,,;I/!')
7. Description of Work_--1,a.,1£/.c.trf:ra,l()..liO~:zas'o:li~or.,"::....-£/.~,-t~L-(/:..!~=-.-------------------------

8. Tests Conducted: Hydrostatic ff Pneumatic D Nominal Operating Pressure D Other D Pressure /..3 ro psi Test Temp. 13'b °F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided 111 size is 8% in. x 11 in., 121 informa-tion in items 1 through 6 on this repon is included on each sheet, and (3) each sheet is numbered and the number of sheetl is recorded at the top of this form.
112/82) This Form (E000301 may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017
58466"'1 9- 4-91 2: 19FM SENT EY:A FORM NIS*2 (Bick)
~~e. Remark, ,Sr.,.>t ea~~
~ .pt. ,11t C..s Jl-.2,,1'9 2-tf!U) ~lh:able Manuflr:fjj,_,.,D,n ReDOrtl to bl nr,,onea ~ .f,t. ... ~ti 2t.? ~
~~vlo** ~#4 d Jl'~(J()/'( ;> Z'. J~~
~~~'*Mi'!'t:C,....,..~~
JIIJ= ,?- / w~/72. CEFITIFICAT! OF COMPLIANC! w, c11rr11v that the netam1nts mllOI In tn1 N1Dart 11'1 correet and thl1 ~ c o n f o r m s to the rul11 of the ASME Cod11, Section XI. ** r 0
~~reu1ac1mint TvDI Cod* &vmbal St1mp, _ _ _l,Q,_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __~~
~~s,,.,. 'fl.. L - z::., tt'-,. ... ~<---~.> z~~
. - = - - &~-<-e Clate ~ ef ...,.,..., Dale N/A .)---:.;.c;.,I,;~------- , 19.Q.
C!IIITIFICATli OF INlll!ftVICI INll'ECTION I, tha underaigned, holding I valid commlulon luuld tw th& N1tlon1I Boll'd of Baller and Preuura Veuel lt19"Ctore anci the ltna or Provlnc11 of VA 1n01T1PIOVIG by HSBI&! Co ft of 1 f e - r e ,- to r, to th* best of mv know.._ and ti.lief, the Ownar hit performed **1mln1tion1 and tlictn r:ormtlva mH1&.1N1 deac,ibed In tlll1 I\IMt lnret!Clta thll COM+)OMnta d11Cribtd
~~q. . ' '~~
~~and 1t11* thllt Owner, Reporr in aor:ordanca with th, 1"9qul,..,,.nT1 of th* AIM! Cada, section XI.~~
~~av 1l;nlnt thl* cartlflcata n*lrh11r th* l ~ r nor hi* emaloyer malrM *ny uva"*ntv, ll(pr-..d or lmDIIICi, con111rn1n9 the~~
**em1neuon1 end corrective meuur11 d1terlbld In thi1 Owner's Report. Furrhermort, n1ltnar ,he lnll>>CIOr nor ni1 emplover shall bl ll11bl1 in env menner for ,riv p1P10nt1 lnJurv or 1:iro1>1nv damage or 1 101& of ,ny kind arising fran, or connl!Qtta with thl1 inspection, /? {) ~ J. ~ 1M;a1C110r'a &l11nat11,..
~~S.._~~-------=------~~
~~c::ommlt1ion1-"!'Y~A"":-"5._4.. Nnlona1 11011111, &iata, ~rovlnoe. ana ilinao.........ma o,,. I> . 1'1, ,a4~~
~~FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI~~
~~1. Owner VIRGINIA ELECTRIC AND POWER CO. Date _ __./:...;Z.=+k;...£.._L.k.,___~i------,-------~~
~~Name,-~~
~~'-'"-,!Al~~
~~_5_0_0_0_D_O_M_I_N_I_O_N_B_L_V_D_._,_Gl<.-'it,,,,,BJl=._N_AL_L_E_N_,_V_A_2_3060 Sheet _ __,__ _ o f _ - + - - - - - - - - - - -~~
2. Plant P.O. BOX 315, Address SURRY POWER STATION Name SURRY, VA 23883 Unit___.~"-----------------
~~Address Repair Organizatici; P.O. No., Job No., etc.~~
~~3. Work Performed by VIRGINIA POWER Type Code Symbol Stamp _ _....:N:::.L../.:.:A:....__ _ _ _ __~~
~~Name Authorization No. _ _ _ _ _.:::N"-/-=A.:..__ _ _ _ __ P.O. BOX 315, SURRY, VA 23883 Expiration Date _ _ _ _ _ _.::.;N"-/-=A"-------- Address~~
4. Identification of System Ge~)>a'."",'l.u C ~~ q'

5. (a) Applicable Construction Code_~B~3~J~-~J......__ _ 19_6l_Edition, __N=<-/-=-A.___ _ _ Addenda, N-1, N-7 Code Case (bl Applicable Edition of Section XI Utilized for Repairs or Replacements 19 80 W80

6. Identification of Components Repaired or Replaced and Replacement Components
~~Name of Component Name of Manufacturer Manufacturer Serial No.~~
~~National Board No. Other Identification Year Built Repaired, Replaced, or Replacement or Nol ASME Code Stamped (Yes~~
<;"';-;.,,) ... 0o e4) - - ,,//4 7 ,;, C, .f"C! - ..e'~J. - .1,/ .A//7 drc (ri -~~j '- / - -- ,.v /4 .2 -/?. I", - <<? - ,,tJ,r. >. * . , ,,\ A/0
7. Description of Work._.L,4_-'-A~'CJ??~=,(~,S~;r=g~D=-<;~~,&~-~~r:.~:r~/6_G.='#.~£.~'Af=C'---------------------

8. Tests Conducted: Hydrostatic O Pneumatic 0 Nominal Operating Pressure ~
Other D Pressure ,1/o k psi Test Temp. /VO r °F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is 8% in. x 11 in., (2) informa-tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form . (12/82) This Form (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017
FORM NIS-2 (Back)
9. Remarks _S_,_n-=u=lJ-""s'----'A<-=-i:'_.zr._--=c_s--ti~---"i'--4...;...1.\......;......cb'----l'--'if_~_~_~___________
~~\. Applicable Manufacturer's Data Reports to be attached Aleta ?o# ssv 1'1~3t'l-l I~~
CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this ~ A : ~ conforms to the rules of the ASME Code, Section XI. repair or replacement Type Code Symbol Stamp _ __ac........,kc..:'4L.._ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ Certificate of Authorization No._P~~h:~------------Expiration Date __AY~k~------------- Signed W ~~ Ownero1"0ner's Designee, Title ll.:Z- .E.vtf,-v~c-L Date-~/~L~~-~~-------, 19 Y,2 CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State or Province of VA and employed by HSBI & I CO* of _H_a_r_t_f_o_r_d_:..,_C_T _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _-:-:=--=-------have inspected the components d.;iscribed in this Owner's Report during the period----~'~~~..-~~-~'8~*~"~--to q - I q - <f 'j ** , and state *that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in tf:iis Owner's Report in a~cordance with the requirements of the ASME Code, Section XI. By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspection.
~~- - - ' - - ' ~ ~ ~ - - ' - *-~-~=~---Commissions _ _~~
~~Inspector's Signature~~
~~~IJ_a..._S_'-f_3_ _ _ _ __~~
~~National Board, State, Province, and Endorsements Date_ _ _ ....,/-'J......------=b'--__19 g /~~
~~. .:-,.~~
j .... :*

ATTACHMENT 2
~~,,~ 1 \~~
~~FORM NIS*2 OWNER'S REPORT OF REPAIR OR REPLACEMENT~~
/4J Required by tht Provi1ion1 of ASME Code S1c1io11 XI ..,. own1r Vi rgi ni a Power Datt-l.-*6_!:Y._7k._*f_ _ _ __
P.O. Box 26666 ShNl....----............. of______.._________ IAOCl*esll 2. J. Plant Surry Power Station Work ,erformtd
~~.... -=. .-~~
~~e.o. Box 315 Surry, YA 23883 t,y. aV...A pi.,...~~
~~...same 111 r________~~
~~ftil/TIII~~
4. lde~tlfic1tion of Srnem ;tf,,,v~.rMJ~.e,

5. la) Ai1Plic1blt Consttuctlon Code 831-1 11 67 Editlon,...H ...A..______ Addendl, Code Casa _ __.N._A_ __
(bl Applicable Edition of Section XI Utilized for Repain or Replacemenu-11..80, wan Addtpda, Codt Caset ..... N...A._____ I. Identification of ComPOnents Aepai~d or Replaced, and Replactmtnt Componentl Name of N1mt of Mfrs. Ser.
Nat1. CRN Other Year Res,eirtd. ASME Coda Component Mfr. No. Id. No. ldentl- Bullt RepllCld, rumped No. fic1tion Replacament
~~;*,11 o, Not ftw~~~
~~Ai><<- Joi-AH, Ve,,~., 5~~
./,:.G{w'll';1 f'rt< r H,.... ~ -- v£i ;ti '4 ~~.M.f-..Yt!t', ;lh:,A p 6,P~ )?r;;r-JL.h"'
~~12.!J:,,e~ee#e"-,;..,~~
~~~o iV I)~~
7.
I. Dtscription of Work __.._..........._.....___...._...,..........____________________________________________ Tem Conducttd: a CERTIFICATE OF COMPLIANCE We cenify that th* n1t11nenu made In this repon ,,. correct and this-s.&=-,,-.1><<.'*""'"".f....6...,,t:......,.4...r'------COnform1 to Section XI of Ult ASME Code. r ) - /l_ / ~ I t'tp&lfGrlt~ Si1MCS V~.'t">> jOw,w rtt 0-.,-1 De~ I
~~-e&C... IsT*IIr J)4c.~~
CDIIII t,l . ,, TS' CERTIFICATE OF INSPECTION I. the undersigned, holding a valid commission luued by the National Board of Boiler and Prn1u19 Vessel lnapecton and the S11t1 0 01 Provine, of VA,
employed 1,y~lu.iSo1.1B1.1._l,1..1&,1,,IL-JoC.&1.0'-*. . . . _ - - - - - - - - - - - - - - 0 f Hartford , CT, have inspe<:ltd the Re f} \ u. c.e M e,..,T demibed in this Report Oft IR*p1o1111 o, ,.:1,*ce,...111111 .
/ ,!l - /Lf , 11.Rl end natl th1r10 tht btn of my knowl,c:t;e and belief. this repair or rtplacement h,s b!tn connrvc1ed in acc:c,danct with Section XI of the ASME Code. By signing this cenifiutt, neither the Inspector nor his fmploytr maltrs any warranty. uprentd or implied, concer~
int the rep1i_r or replactmtnt dPScribtd in this Repon. F unhrrmore, neither tht Inspector nor his employer 1h1II be liable in any manner for any Ptr1on1I Injury or propeny dam391 or a lou J;f e"!~i1in11 from or conne<:ttd with this ln111>1ction. D11e /',k-(4 - $'C/ ~1 . ~ Commiuion1 _ _..;;.V_ct_,*,""£,,_:i-'-*-=3"',,-_~--:c:c---c=----- ll"*PK*Of> 15,... or ~IICt. Nal,onal l!lo&i,II It.,, .. llloft: Swpplemeni.l , .... ,. 1.. form of 11111, 1h1ch*, or drawlnsa may 'be v .. d provided 111 tlH 1ft. X 11 lft.. 12J lnform11lon In 1nm, t throui,ti , on thl1 dlla upor, 11 Included on ..ch 1hNt, and 131 ..,h ,h.. t 11 numbered end "'* ne,mber 'of 1hHII 11 **corded II th* 1op of 1h11 form.
* * =-,. . --* :* - ATTACHMENT 2 \
~~FORM NIS-2 OWNER'S REPORT OF REPAIR OR REPLACEMENT~~
/u Rrquirtd by tht Prowi1ion1 of ASME Cod, S1e1ion XI ...,. o-,,, Virg i oi a Power P.O. Box 26666 ~,..., Shift of_ _ _ _ _ _ __
2. ,,ant Surry Power Station P,O, Box 315 ""~ Surry, YA 23883

i. Wo,k P,rformtd by_Y...A .......- ..........
~~111~~
~~~...r.....,._.,..______~~
~~(Hamel 38000 2(.17 c~~
~~"'-PAif~iu1-,.0NQ.,Jo<<I ..... "'- . --same **I. lde~tlficttion of Syn1m b,tcn,~~Z::~~
fa) Applicabl, Construction Codt B31-ln67 Ecfltloft,..l~~A.,___ _ _ .&ddcnda, Codt CaHt _ ..... N...,A.____ fb) Applicable Edition of S1c1i011 XI Utilized for Repair, or A1plac1m1nt1- 11..BO, WBQ Addtndt, Codt C.Nt_..N... A___ I. Identification of ComPOntnts R~1i11d or Rtpl1c.d, end Replac:tmtnt ComPonenu Namtof Name of Mfn.Ser.
Ntt1. CAN Other Ytar Rrpairtd, ASME Codi Compo111nt Mfr. No. Id. No. ldtntJ. lulh ..eplectd, ~i.mc,ed No. f"ication or ;-,ft or Nol lltplacamtnt
<:"'.,....uj,C' ~I-~ -- ~~ ,,.,,4 .vL.. 2.ec-sv-n/A ,r<f"I.A ...,..._l .. ~.1,1 ,AL* .A L.1 V'o ~,,,
7.
I. CERTIFICATE OF COMPLIANCE CERTIFICATE OF INSPECTION I, the undtraivntd. holding 1 .,,lid commission issued by the National Board of Boiler and Prnsu,. Vtsstl ln~ton and the Sratt or Proviftcuf VA, *employed bv USB' I &I CO, of Hartford, CT. h1vein1Pt'C1tdtht i e'.)lo.. e/Vletvl tR, **'111 o, 11!*:>*ac,,...,.,,,1 dmr~inthisR1pot10ft //-17,,911. and na11 that 10 tht but of my !tnowlf'dpt and belief, this r,p1ir or replacement h11 ~tn eonnrvc11d in 1cc:crd1ncw with ~ction XI of the ASME Codf. By si11ning this certifiu11, neither the Inspector nor his lmploytr maltu any warranty, upr1ued or impli1d, concer~ i"II the repair or rtPIKtment df'scribtd in this Report. Furthermore, neither tht Inspector nor hi1 employer shall be li1bl1 in any ffllMlf for any e><<r1onal injury_ or pros:>tny d~~'9' /"*I~ (!1 a??~n11 from or connected with this '"-~IIP*ction. 0111 l 1-, 7- RC/ ,~~ J.. ~~ Comminions -~Vi.i..as..a<-6"--tf.1...>--------:---- (II\IPf'CI011
~~""oN: Svppl*rnantal 1h"t1 1.. form of Ilia, 1Utch*, or dr*wlnpa may be u**d p1ovlded 1111lu II IX 1ft. X 11 lft.,~~
~~jSltll 0, PTi,nt,ct. ~alc,t\AI ao.,u,~~
12) Information In '"" t thro 11 gh 4 on thh dn* upor, It lncl11d*d on ..ch 1hNt, and Ill Hell 1hNt 11 n11mbered end lhl ,n,mbolr of 1hNII 11 r*cord*d a11ha 1011 of ihl* form.
1. Owner FORM NIS.2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI Virginia Electric and Power Co, ____....2....2,...~,1-v.....::>T Date ____A~U__.(;""'"".... ....I :f...._9........_!_ _ _ __
Name 5000 Dominion Blvd., Glen Allen, VA Sheet _ _ _ l ___ of ____l __________ Addr- 23060
~~2. Plant Surry Power Station Unit _ _ . . ~ - - - - - - - - - - - - - -~~
~~Name CfH9<~~
P.O. Box 315, Surry, VA 23883 :'.l9 b ~ 12 38"@0 0 Ssf~S- ~ Repair Organization P.O. No., Job No., etc.
3. Wortc Performed by Virginia Power Type Coda Symbol Stamp tJ / A Nam*
Authorization No. _ _ __.N.,..1.,_t... ~---------- P.O. Box 315, Surry, VA 23883 Expiration 01te _ _ _ _._.N,..,/...8 ......_______ Add1'9G
~~4. Identification of System _.,..4::......,..""'a""/..,,_~-'--...~~
~~' y'-'?/:i"".-eo""'""'"'<<(""'- - - - - - - - - - - - - - - - - - - - - - - - - -~~
5. (al Applicable Construction Code B3 l. 1 19§.l_ Edition,_N_/_A_ _ _ _ Addenda, N-1, N- 7 Codi Casa (bl Applicable Edition of Section XI Utilized for Aepairs or Replacements 1980W80

6. Identification of Component!* Repaired or Replaced and Replacement Components
~~Name of Component Name of Manufacturer Manufacturer' Serial No.~~
~~National Board No. Other ldentifieation Year Built Repaired, Replaced, or Replacement or Nol ASME Code Stamped IY" BoNNE-T f.OC#i)EI.L -~~ Vl\lKl\:loiol\l 1~~
~~N/A i --1"\S-N PU -20 Ic. i> l\'ljal.)Ol.lll RcPlilcE~ ~o BorutoET R,O(,}(t,.)\::\..\...~~
~~1'.ru-rf~N- c.oRf H,-~2~1obiso I N/A p() _Ai{ ss>'~~
~~-=2,13,lbJ-\ 1~g9 R..E\"l.fla:M'E NT ~o 1).. MS-IJR\/.. ~otc i~~
~~I I~~
~~7. Description of Work _ _ _,..R~ep'F-~/e:.""-"o""'~=J_..__ __..b....t221~~
~~.....""'tz""""'e-"';f'-----------------------~~
~~8. Tests Conducted: Hydrostatic O- Pneumatic O Nominal Operating Pressure B-"~~
Other O Pressure _ _ _ _ _ psi Test Temp. _ _ _ _ _°F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (11 size is BY.a in. x 11 in., (2) Informa-tion in items 1 through 6 on this repo" is included on each sheet, and (31 each sheet is numbered and the number of sheets is recorded at the top of this form .
* (12/821 This Form (E00030) may be obtained from the Order OePt., ASME, 345 E. 47th St., New York, N.Y. 10017
~~FORM NIS-2 (Back)~~
~~9. Remarks ---i/\ . . . . .$-=-M--~~~
~~. ___Co=-=~=;..-a~..J\.......2....5 - -....&=------------------~~
Applicable Manufacturer's Data Raporu to be attached CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this gEMceM/e./\lT conforms to the rules of the ASME Code, Section XI. repair or replacement ..., Type Code Symbol Stamp __N_/_A_____________- - - - - - - - - - - - - - - - - - - - - - - - Certificate of Authorization No __N_/_A____________ Expiration Oate _....;;.N....;/..;A~------------ Signed ( / ~ Al<rr't=-: *
~ ? e r or Owner's O~signN, Title orProvinceof Virginia -X6 I CERTIFICATE OF INSERVICE INSPECTION Date _ _ _...q,=~--*. . .d.. ....
I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State andemployedby HSBI&I Co. es......__ _ _ , 19 9'/ of tk-t'('T fo .. d J ct have inspected the components described in this Owner's Report during the period f-/-'IQ to £-Jo,'ft.J , and state thet to the best of my knowledge and belief, tt,e Owner has performed examinations and taken corrective measures described in this Owner's _Report_in accordance with the requirements of the ASME Code, Section XI. By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures* described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal_ i~jury or property damage or a loss of any kind arising from or connected with this in~ec~io_n .. _D.!J~!. ____--.Jli1H;..="-
~~~ ........~"'-""-:--'""=:~(b'-:"_.,.~""'-'"---;.....-COmmissions __v_A_..;;.5_4..;3;....._________________~~
~~I nspactor's Signature National Boara, Stata, Province, and Endorsement,~~
~~1. Owner FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS~~
' As Required by the Provisions of the ASME Code Section XI Virginia Electric and Power Co, Date-1-,A:J..V~l;!u.cJ.:..5<!.iU:_...,2=.i.(~l~/-q'-qJ...L../_ _ _ __
Name 5000 Dominion Blvd., Glen Allen, VA Sheet _ _....:11.___ of _ _..:l,___ _ _ _ _ _ __ Addr- 23060
~~2. Plant Surry Power Station Unit _ __ . . " " - " - - - - - - - - - - - - - -~~
Name P.O. Box 315, Surry, VA 23883 bib Na, 3!f@a, 112 C9I 1Udlot1-1!>1-Repa1r Organization P.O. No., Job No., etc.
3. Work Performed by Virginia Power Type Code Symbol Stamp N/ A Nam*
Authorization No. _ _ __.NJL,f-t"'A-------- P.O. Box 315, Surry, VA 23883 Expiration Date _ _ _ _o,b)Ll-/~81......_ _ _ _ _ __ Add~
~~4. Identification of System _ _ _ 6:c...<..'u.oz~---------------------~~
~~)n,..f......,,;,_.~'-"'--h.<..,C;,.t..;,-/.._e,. .c....~~
~~5. (al Applicable Construction Code B3 l. l 19§.I.._ Edition,........;N~/;;.;A;__ _ _ Addenda, N-1, N- 7 Codi Case~~
~~....., (bl Applicable Edition of Section XI Utilized for Repain or Replaee~mts 1980W80~~
~~6. Identification of Components Repaired or Replaced and Replacement Components~~
ASME Codi National Repaired, Stamped Name of Name of Manufacturer Board Other Year Replaced, (VII Component Manufacturer Serial No. No. Identification Built or Replacement or Nol t "c!,ec/c I/a.Ive VELl9N 6/'1*3/1 '10-/J~ N/A 2-s:r. - ?--9 V,VJ(/ll'bj if FlcPlJ\CI: ~ ~o poJ:t .ss;Y t " ~ lttl~ VElltt\J VR/1/E ltRP. Hf':# ':(!)()(If f/,;d /fr N/A 2.-°13 C:Jo I 1781- RE\"l.M"MtNT NO
~~(.a -s:r - 7'1 ) I I~~
7. Description of Work. _ _ _ ,L;£~~"'""'"4=""-"C-.a1:e~e/""--'£~;:-"...J.c:...k=;;;;t:r.~L~-..6:0:;.,j'4"<4::Z,.,~g;;;.________________

8. Tests Conducted: Hydrostatic ~Pneumatic O Nominal Operating Pressure 0 Other O Pressure _ _ _ _ _ psi Test Temp. _ _ _ _ _°F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided 111 size is 8% in. x 11 in., 121 lnforma-tion in items 1 through 6 on this report is included on each sheet, and (31 each sheet is numbered and the number of sheets is recorded at the top of this form .
* (12/821 This Form (E000301 may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017
~~FORM N1S*2 (Backl~~
~~9. Remarks _A:,...:..-5...,*.._l"}"-"E:,=-___{:..,.....c,u..D~.E.-=a....-iC""""iJ;IA:S.-,,...';;>~.-.--------------------~~
Applicable Manufacturer's Data Aeporu to be attached CERTIFICATE OF COMPLIANCE We cenify that the statements made in the repon are correct and thisgsp~MEN't'"' conforms to the rules of the ASME Code, Section XI. repair or rep1acament Type Code Symbol Stamp __N_/_A_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ Cenificate of Authorization No._N __/_A_ _ _ _ _ _ _ _ _ _ _ _ Expiration Date _ _N-'/_A _ _ _ _ _ _ _ _ _ _ __
~
~~Signed ~lv-,~~
~~/;6w~'or Owner'I Oe1lgnn, Title orProvinceof Virginia ,--z;;:5:L E;v~J;J? Date _~~
CERTIFICATE OF INSERVICE INSPECTION _,,_('?,..._.:ja,--'__o?_/__, 19 CJ! I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State andemployedby HSBI&I Co. of H tl .. I Ft> rd l ct: have inspected the components described in this Owner's Repon during the period f*L-90 to '£--lo - 9':{ , and state that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described In this Owner's .Repon in accordance with the requirements of the ASME Code, Section XI. By signing this cenificate neither t.he Inspector nor* his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Repon. Funhermore, neither the Inspector nor his employer shall be li~ble 'in any manner for any personal injury or propeny damage or a loss of any kind arising from or connected with this inspec~~ /. /1) (\
~~---~.i..=;.::;..---a---,----"-'-:--=-:-(_~~ .....~~-------Commissions __V_A_5_4_3 ________________~~
Inspector's Signature Nattonal Boera. State, Province, ana Enaorsementa Date_ _ _ ___..g>.._-~l'"":.---19 q/
1. Owner FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI Virginia Electric a.nd Power Co, Date _ .....A""""""u""6""",1""J~.._:T..__..:2...=0:.....L.,...;)1...'.:t~'\.~\.:......._____
Name 5000 Dominion Blvd., Glen Allen, VA Sheet _ _ .,.1.___ of _ _...a:l=----------- Addr- 23060
~~2. Plant Surry Power Station Unit _ _ -=......- - - - - - - - - - - - - -~~
Name P.O. Box 315, Surry, VA 23883 ::S:ob No 0i000:)i]fu}), fe$5t-f:2.1 Repair Organization P.O. No., Job No., etc.
~~3. Work Performed by __V;. .;1; .*r;;..;ag.;;;i""n;.;;i;.;;a=--P;..o;;.w=e..;:r_______ Type Code Symbol Stamp __.tJ..._/..,A'--~~
Nam* Authorization No. _ _ _ _N1::1..1,/:..i:A1.-_ _ _ _ _ __ P.O. Box 315, Surry, VA 23883 Expiration Oate _ _ _ _..&;h,l,~,../Ai;i..._ _ _ _ _ __ 1 Addrna {' ' ' 1:1
4. Identification of System _ _. , ). ,e::..iC.. .11"-2ulC....1e"--.-.,u.J=fl..,.-:-\-;..u:;e...1f--------------------------

5. (a) Applicable Construction Code B31. l 1s§l_Edition,_N_.;./_A_ _ _ _ Add1nde, N-1 2 N-7 Code Case
~~...., (bl Applicable Edition of Section XI Utilized for Repairs or Replaeemmts 1980W80~~
~~6. Identification of Components Repaired or Replaced and Replacement Components~~
~~Name of Component Name of Manufacturer Manufacturer Serial No.~~
National Board No. Other Identification Year Built Repaired, Replaced, or Replacement or Nol ASME Code Stamped (Yes 1.\.1 I\U-f\CE. &, s:2.1oe.1,r2.tt I ~o HOl.0 ..l'.Nl>\l~TOA. N/A 1-Sw-FI-2t>ll ()l'llkRtUlit: R.fPlFICI: [':-:. i°\'c SN 'FIN XXIt~l{.,5)r ' C.fl t\OTH'i .Th:lc. j11M Po.\\. n,y FlOlO .:(l\lJ>ICfflClf-\ S~f-0\~'2 I N/A 3~0S°IJ.j.-1 I~ Cf I RE\" lfla:Mctq ~o i ( :)-.!k1-fL.-1cJIC I l
7. Description of Work _ _ __,l\e'-""-tr.u\.,.c,..,..r_.,c;:.,.d,..,__-\.....,,\""\:tl..,,_,_,),..__'.ulp....._..j_""\u.C.;.i.C""ct""-"i:iu.C-------------------

8. Tests Conducted: Hydrostatic O Pneumatic O Nominal Operating Pressure g---
Other O Pressure _ _ _ _ _ psi Test Temp. _ _ _ _ _° F NOTE: Supplemental sheets in form of lists, sketches, or drawings mav be used, proviclecl (1) size is 8% in. x 11 in., (21 lnforma-tion in items 1 through 6 on this report is included on each sheet, and (31 each sheet is numbered and the number of 1heets i1 recorded at the top of this form .
* (12/821 This Form (E00030l may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017
~~FORM NIS-2 (Back)~~
~~9. Remarks -..J~=.::S\-"-::::.:...cc::E:-=-__,,U""""'il::>::~=-~~-=..:-:::..:::S<..-;.3=----------------------~~
~~Applicabla Manufacturer's Data Reports to be attached~~
~~..,,.-*r:,. '~~
CERTIFICATE OF COMPLIANCE We cenify that the statemenu made in the repon are correct and this ~t:'erJ't conforms to the rules of tha ASME Code, Section XI. repair or replacement Type Code Symbol Stamp __N_/_A_________________________________ 1 Cenificate of Authorization No._..;.. N/A _ _ _ _ _ _ _ _ _ _ _ _ _ Expiration D a t e N/A LI Signed VMor Owner's l5J;ner or Province of Virginia
~~;:r:::sr OasignH, Title EiJ6r(rJE&-:~~
CERTIFICATE OF INSERVICE INSPECTION Date-----°'zj,...._=i-.....' ~(;},-=--D......._ , 19 I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State and employed by HSBI&I Co*
9/
of
~~..1._*___________--::=--~------have inspect,:t the compon_ents described~~
_ _ _,_H.;.._<t...,r;._T.,_,_Fi_.r,.,_1-_.d~J-"C in this Owner's Repon during the period------..::~,,_-__,/_-....... 9..,.0:;....__ to S-/0 - C/1./ , and stat11 that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's _Repon in accordance with the requirements of the ASME Code, Section XI. By signing this cenificate neithe_r the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations ~nd corrective measures described in this Owner's Report. Funhermore, neither the Inspector nor his employer shall be liable in any manner for any personal_ injury or propeny damage or a loss of any kind arising from or connected with this in~ec~io_n., ~ - . ~ A~!. /t) ~
~~-----t-""'""~~'='---::-:--::.d...f-"'"-:>"~'"""'-==-=----Commissions __V_A_..cS_4_3________________~~
lnspactor'1 Signature National Board, State, Province, and Endc;,rsemanu Date,_ _ _ -=g_-..1_L . ___19 'ff
FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Ph>visions of the ASME Code Section XI
1. Owner Virginia Electric and Power Co, Date Au bn)"t,T 2 11 19 9 I Nam*
~~5000 Dominion Blvd., Glen Allen, VA Addraa 23060 Sheet _ _ ..,,l.___ of _ _..,l=-----------~~
2. Plant Surry Power Station N_ama P.O. Box 315, Surry, VA 23883 Rapalr Organization P.O. No., Job No., ate.

3. Work Perfonned by_....;V;..;1.=-*r:.cg.=i:.::n:.ai:.aa:.....;P:...o=-w=e-=r------- Type Code Symbol Stamp__.NLIL+./""'A'--
Nam* Authorization No. _ _ __,_,N.,/uA"--------- P.O. Box 315, Surry, VA 23883 Expiration Dete _ _ _ _..LN>>-1-/.1:181.--_ _ _ _ _ __ Address
4. Identification of System _ _ J/,:.....L.,a~_...14...____.f.h'-'.'-'P.-61=421-~---------------------------

5. (al Applicable Construction Code B31.1 19§.Z__Edition,_N;;.;..:.../.;;;.A::...-_ _ _ Addenda, N-1, N-7 Coda Case (bl Applicable Edition of Section XI Utilized for Repairs or Replaceme-rtts 1980W80

6. Identification of Components Repaired or Replaced and Replscement Components ASME Code National Repaired, Stamped Name of Name of Manufacturer Board Other Veer Replaced, (Yes Component Manufacturer Serial No. No. Identification Built or Replacement or Nol ROtkWElL (30!U[l/,E-"T ft>WARD.S 5/0'601q ! N/A )-/VIS -/IJ Rll-'2J:i II PAJkNOHJ ' Rk:PlJKI: ~ ~o i{NJ::WGU Hi:ti /ltl .# 5>Y' 130/U(/)ET ..:rru TtHN coRP I~ 'f-oll 1 I N/A /3/j' J8s--1 1tB'"*r R!:t'Lfla:McNT ~o i
~~II I~~
"'e~""' 1---"h"-"'<n1.LL,a~e_l-,_________________________
7. Description of Work _ _ _.,_IG"""7'"i"f<(2.""t""'q"'e....

8. Tests Conducted: Hydrostatic O Pneumatic O Nominal Operating Pressure G3"'"
Other O Pressure _ _ _ _ _ psi Test Temp. _ _ _ _ _° F NOTE: Supplen;i.ental sheets in form of lists, sketches, or drawings may be used, provided (1 I size is B~ in. x 11 in., (2) lnforma* tion in items 1 through 6 on this repon is included on each sheet, and (3) each sheet is numbered and the number of 1heet1 is recorded at the top of this form .
~~(12/821 This Form (E000301 may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017~~
~~FORM NIS-2 (Backl~~
~~9. Remarks - - ~.....S-....M_E.-......_~W?~-T"E--=--(..a_1,""'Jt5.._5..,__Z-, _______________________~~
Applicable Manufacturer', Data Repom to be attached CERTIFICATE OF COMPLIANCE We cenify that the statements made in the repon are correct and this f:E"P< OC~ conforms to the rules of the ASME Code, Section XI. repeir or replacement* Type Code Symbol Stamp __N_/_A_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ Cenificate of Authorization No._N-'-/_A________.. _.----Expiration Date _ _N_/_A ____________ Signed ~e:(;f.£'£e Oate _ ___,_~-=.:'"*"--'d CERTIFICATE OF INSERVICE INSPECTION
~~...../....____ , 19 1!~~
I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State orProvinceof Virginia andemployedby HSBI&I Co.
of
________H...,_g--.ar_T ~~r-'J_..,.,,-*
.........F..... _caa..it.________________ have inspected the components described in this Owner's Repon during the period S 9o to--S:-- 1 ......e=---q_iz_______, and state that to the best of my knowledge and belief, t'1e Owner has performed examinations and taken corrective measures described in this Owner's Repon in accordance with the requirements of the ASME Code, Section XI.
By signing this cenificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be li~ble 'in any manner for any personal injury or propeny damage or a loss of any kind arising from or connected with this
* ,...-~'-:-'"-::-:-:-::-='f'"'=.-=©tr-..--..~~-.;......-Commissions __V_A_5_4_3 *in--~-ect-_io-*n-~-i-.
~~lnlpKtctt'ISlgnature National Board, State, Province, and Endorsement* Date_ _ _ __....g_ ........~~
~"'""---19 Cf/
1. Owner FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI Vir&inia Electric and Power co, Data __..t\-_,_u,_61=l)~S1...:.........;Z;_..;.l_.,__._\j...__'1.:;..i.l_ _ _ _ __
~~Name 5000 Dominion Blvd., Glen Allen, Addr-VA 23060 ShNt _ _.,l_ ot_ _ .:l~--------~~
~~2. Plant Surry Power Station _ Unit _ _ _.21,._ _ _ _ _ _ _ _ _ _ __~~
Name P.O. Box 315, Surry, VA 23883 JobRepair No, 3<a0\2J \\, ':f. .\:, g'2-~I-PS3 orvanlzatlon P.O. No., Job No., etc.
3. Work Performed by Virginia Power Type Code Symbol Stamp t,I / A Name Authorization No. _ _ _..,Na.:,,-i(Aci__ _ _....;.._ __
P.O. Box 315, Surry, VA Addrea 23883 Expiration Date _ _ ____.Nl&l-/.... a~------ x~....f ... 4, Identification of Svstem _ _....S"'i... ....'...o:n.l.Llo-----------------------
~~!..:;/'---=r...P>f-j.L.(...c:G~~
5. (al APPiicabie Construction Code B3 l. 1 1 9 ~ Edition,_...;N;.;./:....;A~---Addenda, N-1, N- 7 (bl Applicable Edition of Section XI Utilized forRepairs or Replicements 1980W80

6. Identification of Components Repaired or Repl!!Ced end Replacement Components ASME Code National Repaired, Stampad Name of Name of Manufacturer Board Other Year Replaced, IY*
~~Component Manufacturer Serial No. No. ldantlflcation Built or Replacement or Nol~~
~~. ~*'~~
I ,, s ,v c, .5 lJN1'NOwN \l N l<tMtl'.l l\l I N/A 2~sr- ~ - 2..ci.tt-s ll~~'ICICII l\t.PLJ\Gb ~o C/ll?PJJlJf#. IA/I> ' H1-.P PO~ !.S!/ I " S 1tJ t>; /JROl>"Ct.5 Cl)/(f' 9r;9'1-:i.C/t I i N/A 3 3 9131-'i-'I 17V ~~IJ\<EJfl!l,,.\"T ~o
/
11 NO,> ()~KN-OU,~ L?N t::l\lO-WM I N/A 1.~<J.-r-~-~'-tS- IIN\t~ P,1:1) l.l\c:Q NO WIIRDallJRE. H'f =II Po"' .5 .s,y I" NU{5 Sf'J!C/trt,Y cP It.Jc, '30 33 2.. I N/A. 1/ ':f'f§-) l'IJ'! PalhC.1:1'\iN'T NO 0""'cs=:~J1--__,,(....1LL.b)..._....
~~7. Description of Work _ ___,_R...,f-tf""\.... s+~~
... el::...s~..1.&,l),.........l,.(..:i3u2~J....L......IP,IOClia..!,,4.:J+/-.:..::s,,.___ _ _ _ _ _ _ _ __ ...,IA...
~~8. Tests Conducted: Hydrostatic O Pneumatic O Nominal Operating Pressure [a-"~~
Other O Pressure _ _ _ _ _ psi Test Temp. °F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided 111 size is 8% In. x 11 in., (21 lnforma-tion in items 1 through 6 on this repon is included on each sheet, and (31 each sheet ii numbered and the number of sheets is recorded at the top of this form .
~~112/821 This Form (E000301 may be obtained from the Order Dept., ASME, 345 E. 47th St., New Yortt, N.Y. 10017~~
~~FORM NIS-2 (Back)~~
~~9. Remarks _ _A~?_M...-;E.. ______c='..O=--=D'-'£.=--C ........1....~~
~~.A.,_2 :S.___..b:"----------------------~~
Applicabl* M*nufactur*r'* Oat* R*poru to b* *ttachlld CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this )$Pl.A~ conforms to the rules of the ASME Code, Section XI. repair or rep1*cam*nt ...., Type Code Symbol Stamp __N_/_A_________________________________ Certificate of Authorization No. _N_/_A____________ Expiration Date _....;;.N..:/....;A~*----------- Signed Y11"1"J. x.ltf'M= 7&';;.i. or Own*r's oJsignH, Titl* orProvinceof Virginia
~~;;t;-SI 6v6'tlll,?~~
~~CERTIFICATE OF INSERVICE INSPECTION andemployectby HSBI&I Co.~~
Date --~~"""""-"F---'-~-~---~.
~~~ - ,;),/,~~
I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel lnsPectors and the State 19 9/ of Ho..V'T ford J ct. have inspected the components described in this Owner's Report during the period S- f- 'lo to 5'-1 O
Cf r..J , and state thet to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in .this Owner's Report in accordance with the requirements of the ASME Code, Section XI.
By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this
~~. inspection. . -4 1~~
_*__*_*_*.~-. ..*--:-..~------:~*f~. lnspactor'1 Slgnatur*
~~~~-----*~-Commissions __V_A=....;;5_4....;3:;...._______________~~
~~National Boera, State, Province, and Endorsemenu Date*_ _ _ _ _ _ }J_-....,:J:.....7....__19 q f~~
~~FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI Au<;,vsr .LI I j'j I~~
,. Owner Virginia Electric and Power Co, Date I Name 5000 Dominion Blvd., Glen Allen, VA Addr- 23060 Sheet _ _ _.lt.-_ of _ _...:1=-----------
~~Unit _ _...r:,,___ _ _ _ _ _ _ _ _ _ _ _ __~~
2. Plant Surry Power Station Nam*
P.O. Box 315, Surry, VA 23883 Repair Organization P.O. No., Job No., ate, J. Work Performed by_.....;V:..;i:.;*r:..cig.:i~n:..:i:..:a::-:P:...;o:::.w=e.:.r_______ Type Code Symbol Stamp __.N'A-1-/.aAc..._ Name Authorization No. _ _ _....NU/lo.f,/*Fl~------- P.O. Box 315, Surry, VA 23883 Expiration Date _ _ _ _....i;N,~/.1:181..-_ _ _ _ _ __ Addraa
4. Identification of System _ _~/Jiu:ie~n'"c'"'"h.,_,_.,;z::::....__ _,_C_.a:22:;""<.<.,c.&?.=.-n"""--I:.,__ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __

5. (al Applicable Construction Code B31. l 19§.L__Edition,_N;.;..:./.=:A=-----Addenda, N-1, N-7 Codi Case (bl Applicable Edition of Section XI Utilized for Aepain or Replacements 1980W80

6. Identification of Components Repaired or Replaced and Replacement Components
~~Name of Component Name of Manufacturer Manufacturer Serial No.~~
National Board No. Other Identification Year Built Repaired, Replaced, or Replacement or Nol ASME Code Stamt>ed (Vas 1'RlfYI fl5s&M8J/ C~PH--VUMN V/II I(1//tJWN . ! N/A '2,-/?,c..o)(cv-mc VNIWfllvN Rt:l'lJICt ~ ,~O p(J ,ti C. AJ7 1RWJ RSSE/J18£j' c"f'ES- fl() l(JW L-l<t,JJt,fo I N/A :n.l '3 b~-I 11-:;-s- R.E)" lf>,cH'\'t NT ~o I I
7. Description of Work _ _ _L.8":~ria..,,"'""'c"'e--"L~-~.t..J.CL'lu.~~....a""* ,a.M~e4:.,;.r,c;;u:.£i!.,!~~....:*-'-------------------

8. Tests Conducted: Hydrostatic O Pneumatic O Nominal Operating Pressure 0 Other O Pressure _ _ _ _ _ psi Test Temp. _ _ _ _ _°F NOTE: Supplemental sheets in form of lisu, sketches, or drawings may be used, provided (1 I size is 8% in. x 11 in., (21 Informa-tion in items 1 through 6 on this repo" is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form *
* (12/821 This Form (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017
~~FORM NIS-2 (Backl~~
~~9. Remarks _ __,,A6""'~fY1........£::;....._,C~a....D'&-a.=__,.C ...-:wCRl:L..t....?....* "'::).....__......._ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __~~
~~APPiicabie M11nut11cturer'1 Data Repom to be attached~~
~~.. ,;, .**. ' . ~ .~~
CERTIFICATE OF COMPLIANCE We certify that the statemenu made in the report are correct and this Pi;Pif!:WE:1'r1 conforms to the rules of the ASME Code, Section XI. repair or rei:11acement Type Code Symbol Stamp __ N_/_A________________________________ Certificate of Authorization No __N_/_A _____________ Expiration Date _ _N...;./_A _____________
~
cl
~~Signed *0-7 ~~~
* ~ r or Owner's OesignH, Title To.I £iv frltJ/,1;:? Date. t%,
d I , 19 '91 CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel lnsPectors and the State or Province of Virginia and employed by HSBI&I Co* of
__________,.ft......,a......."" ...I-E ..... J--t,. . .c"--' a'"'r...... . t-.____________ have inspected the components described inthi~Qwner'.sReportduringthe.period 5"-f,'-(D to !£'/O-'fc..J ,andstatethet to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's _Report in accordance with the requirements of the ASME Code, Section XI. By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer 0 shall be liable in any manner for any personal. i11jury or property damage or a loss of any kind arising from or connected with this inspec~io_n*n~~
~~----*-~,._*__,~-----""'.f~:-*-_,~_...-~~
~~I napec:tor's Slgnnure _____ commissions __V_A__5_4_3________________ National Board, State, Province, and Endorsamenta Oate_ _ _ ~[.,___-d:~7_19 C//~~
~~FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI~~
1. Owner Virginia Electric and Power Name Co, Date AU/n , >sr 2 t , 19 9 1 5000 Dominion Blvd., Glen Allen, VA Sheet _ ___;;.:l....:....._ of_ ___:dv:.;;..._ _ _ _ _ _ _ __
~~Address 23060~~
~~2. Plant Surry Power Station Unit _ __i;z,.___ _ _ _ _ _ _ _ _ _ _ _ _ __~~
~~Name P.O. Box 315, Surry, VA 23883 Address Repair Organization P.O. No., Job No., ate.~~
~~3. Work Performed by Virginia Power Type Code Symbol Stamp _ _ _ _i.:N;./L.£81...____~~
Name Authorization No. -------*!..N:;-"/_A!::.!.. ____ 7 P.O. Box 315, Surry, VA 23883 Expiration Date _ _ _ _ _ _ _ _.,_N,c__,../'--LA:i...._ _ __ Address 7
4. Identification of System _ _ _ _ _- ' - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -

5. (al Applicable Construction Code B31.1 1s§l__Edition,_N:.:..c./;;.;A:....._ _ _ Addenda, N-1, N-7 Code Case (bl Applicable Edition of Section XI Utilized for Repairs or Replacements 1980W80

6. Identification of Components Repaired or Replaced and Replacement Components
~~Name of Component Name of Manufacturer Manufacturer Serial No.~~
~~National Board No. Other Identification Year Built Repaired, Replaced, ASME Code Stamped (Yes or Replacement or Nol~~
\\l:\\IRY VOf_rT.. 'H*~ f'O.::\l SNS Vb.,ive Cr) (l/l\'\(.\-1\~t'- co :me.. '112.kS-9\\ N/A 31~~\-~ lq %'i REflf\C9V\ El'J'f NO
~~7. Description of Work \?p \ f?*t;:£-, el ho!AJ C\t":rl 2 1~~
~~' \/q (If(,, .~~
~~8. Tests Conducted: Hydrostatic ~Pneumatic D Nominal Operating Pressure g}-~~
Other O Pressure _ _ _ _ _ psi Test Temp. °F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (11 size is 8% in. x 11 in., (2) informa-tion in items 1 through 6 on this report is included on each sheet, and (31 each sheet is numbered and the number of sheets is recorded at the top of this form . (12/82) This Form (EOOOJOI may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017
FORM NIS-2 (Back)
~~9. Remarks _ __,_{¥:.,~j'Ae......._.."'--~C-b~c£.-~c.........->C_.1,.....-A5~_,_S"""-~Z..,=-------------------~~
Applicable Manufacturer's Data Reports to be attached CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this )?la?LA{E./\A¢tJL conforms to the rules of the ASME Code, Section XI. repair or replacement Type Code Symbol Stamp __N_/_A __________________________________ Certificate of Authorization No. _N_/_A_____________ Expiration Date _ _N_/_A _____________ Signed lj'Y]_ Li :rsr
~~*0/s*wnrir or Owner's Designee, Title or Province of Virginia b./(i.o/ffb-CERTIFICATE OF INSERVICE INSPECTION and employed by HSBI&I Co*~~
~~Date----~"""""c..c,, "'+-_ _c;;/_/~- 19 I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State 91 of~~
--------~H'-'-t:{,-=r_T,_,_fo-=_rJ=-.,iJ....,.C"-'-f,.,_;_______________ have inspected the components described in this Owner's Report during the period _ _ _ _ _ _ _~£ ...*c..--,./_-__.</""""O'---to s-10-'f"L and state that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section XI.
By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspectio~ f ~ Commissions __V_A_5_4_3________________ Inspector's Signature National Board, State, Province, end Endorsements Date _ _ _ _-=.~----:~..o.-:b'--19 Cf f
~~FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI~~
~~1. Owner Virginia Electric and Power Co, Date _....JfA.c:i..,.1),,_f-n..,l""'l'S,:c.;r:...._....cl'-'l-+l-'-1:J..1.'1......,I_ _ _ _ __~~
~~Name 5000 Dominion Blvd., Glen Allen, VA Sheet _ _....,,!...__ of _ _..::l..=---------- Addrea 23060~~
~~2. Plant Surry Power Station Unit--~!.,_--------------~~
Name P.O. Box 315, Surry, VA 23883 Jl')b No 380ex2l:):559l f?g_fl"9/-BS Addreu Repair Organization P.O. No., Job No., etc.
3. Work Performed by Virginia Power Type Code Symbol Stamp N / A Name Authorization No. _ _ __...N._,/c..1Ai...._ _ _ _ _ __
~~P.O. Box 315, Surry, VA 23883 Expiration Date _ _ _ __.N,""'+/""'f\...__ _ _ _ _ __ Address~~
4. Identification of System _ _ _ _..,,.,B'-'L=::O::..W=... 1).,_,,.Q""'l"",Q"'""-N""--------------------------

5. {a) Applicable Construction Code BJ 1. 1 19§.l__ Edition,_N:..:.:../.;:;A:..__ _ _ Addenda, N-1, N-7 Code Case (b) Applicable Edition of Section XI Utilized for Repairs or Replacements 1980W80

6. Identification of Components Repaired or Replaced and Replacement Components
~~Name of Component Name of Manufacturer Manufacturer Serial No.~~
National Board No. Other Identification Year Built Repaired, Replaced, or Replacement or No) ASME Code Stamped (Yes r:"~ (3' (")~ ~") ii l\JKi') OWN i) l,..ll'(l..)OU}l\l / N/A 2-13b-S-;, lJN~NclC\* ~)..f)C.~ l'\O FR IS CH\l'.ORJ" H-r~ Po~ 11 c.<::,y p; p-e :!NC. lD~S°/3 I N/A '5 .j,\"3 'f l- % 1qc\l R.cPlAQ:ME-11.lT NO 11 I E.\ btiw (_'l. 90°) VN Kl\l oW1-.) l) i\J \",f\)Dl.\) N I I N/A 2..-°{:,b-S~ t.11\J\Clotw; R't-Y I.Fl Cf~ NO
~~;l'OH~ 1-\ ~SQ\~ po~ ssy l=lbcw )-;ff\.' J:N C. '~~
VN K~ tn., l\l I N/Ft ~t~~9%-1. I~ gq Rl:'Plfi~~N1 NO 2-Bt>-Ss v~1~ e O . "') UIVktvew tu lJl\l~cTl):)N N/A ~ l)iJ~~b REflA(E-D NO
7. Description of Work ~ r/oced l~'ae / e.lL cr?<r- c1i? ;) "{lg,&/~

8. Tests Conducted: Hydrostatic ~eumatic D Nominal Operating Pressure ~
Other D Pressure psi Test Temp. °F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is 8% in. x 11 in., (2) informa-tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form . (12/82) This Form (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017
FORM NIS-2 (Back)
~~9. Remarks _ __.../l,.,_-S=-'-f\-\....,,t-=-~CooE.-~-=--"Ct""'"'"'"ef\"-'-$'""$"'--"'"'Z,_,""'---------------------~~
APPlicaole Manufacturer's Data Reports to be attached CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this fEgAfM{c:N conforms to the rules of the ASME Code, Section XI. repair or replacement Type Code Symbol Stamp __N_/_A __________________________________ Certificate of Authorization No __N.. . ;. /_A_____________ Expiration Date _ _N..;/_A _____________ Signed (/t/r)L) -;r;,,.,-_,y fuottJE,tp
~~~ner or Owner's Designee, Title or Province of Date _ _ _~~
~~CERTIFICATE OF INSERVICE INSPECTION~~
~~~a=~--c,,,.....~e?~L--. 19 l/ [~~
I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State Virginia and employed by HSBI&I Co* of
-----------,,,-1-/+-"a~t-t-6 ......o~"'~d""'-..,,-c=-f~.-----:----=:-----have inspected the components described in this Owner's Report during the period S:- I- 90 to S:-/D - 'i L/ , and state that to the best of mv knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owne~*s Repo~ in accordance with the requirements of the ASME Code, Section XI.
~~By signing this certificate neither the rnspector nor his employer makes any warranty, expressed or implied, concerning the~~
~~~M*:~:;:::***;,;.~;;~~.;~~-~.*~~:~~.*~,~*~~~~~~~~,.~~
~~examination,s and corrective measures described in this Owner's Report. Furthermore, neither the Inspector* nor'his employer~~
~~~:~:~::b~f Date_ _ _ _x....~--j-~=.-19 er/~~
1. Owner FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI Vir5:inia Electric and Power Co, Data AUhz ,for 2,.1 , I '11 t Name 5000 Dominion Blvd., Glen Allen, VA Sheat ____l.___of _ _:1_________
~~Addr.. 23060 Unit _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __~~
2. Plent Surry Power Station Name P.O. Box 315, Surry, VA 23883 :l"ob No, 38@@@9(p5f:;t;.12r??tq1-75 Repair Orvanlzlltlon P.O. No., Job No., ate.

3. Work Perfonnedbv Virginia Power Type Code Symbol Stamp NIA Name Authorization No. _ _ _.&;N-,',_.IE\.,___ _ _.;...;;.;_ __
1 P.O. Box 315, Surry, VA 23883 Expiration Oate _ _ ___.Nua.,./.6.._______ Addraa System __........8.u."~s:....r.r..o&""""'Jj"'~/.,__.l/e~,,.,,<<5,,..,<-f_.,,_fG~e 1
4. Identification of ....rn~t2.....,v?.L;.aw/~--------------

5. (al Appli~able Construction Code B3 l. 1 1 9 ~ Edition,_...;N;.;./:...;A;.;;...._ _ _ Addende, N-1, N- 7 (bl Applicable Edition of Section XI Utilized forRepein or Replacements 1980W80

6. Identification of Components Repaintd or Repleced end Replec:ement Components ASME Coda Natlonel Repaired, Stamped Name of Name of Manufacturer Board Other Year Replaced, (Yn Component Manufacturer Serial No. No. Identification Built or Replacement or Nol 5,VD5 /HlklfOI<- );f)/ftJt(~ 9¥ ~h/69-1 z. I N/A :i.-RH -8' IJIIIIUICIOII l\t.P LPIGb ~o*
~~S,Vl:>5 au~1:>1N1J-L .INb~~
~~Hr :f:f Pl(tl.bllCT :rNc. 88 G'i 13"1 I N/A PO .. t:-f)/~~
~~'3 2.J'fC)b-S- /79tJ ~~U\CS'tl>>.\T ~o I~~
tJIITS VNk:.NOW1U <,WkAJt'JW,f' I N/A 2 -RI-I-&' 11~\t~ II.El) l.t\CEb NO 1-\RRbCol)~ .. - 1-1--r ,t\ Po,t c~y Nrrf5 Sl'fl\AL-fY com ~CJ't I N/A. '3 ~'tSf'f.--il 19 it ~1.fK'E:1'1\1:.N'T NO Dui1 .
~~7. Description of Work. _ _--,./f,+'":'1"a.._/a....._.,.c"".P""'J""""~~
~~_ ...1..... f:_5:..._~g...._1,"""'i?"'-µ;L..,ls1-..________________ _.a 7 j .....~~
8. Tests Conducted: Hydrostatic O Pneumatic O Nominal Operating Pressure Q-Other O Pressure _ _ _ _ _ psi Test Temp. _ _ _ _ _° F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided 111 size is 8% in. x 11 in., 121 lnforma-tion in items 1 through 6 on this repon is included on each sheet, end (31 each sheet Is numbered and the number of shfftl ii recorded at the top of this form .
* (12/821 This Form (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017
~~FORM NIS-2 (Back)~~
~~9. Remarks ----'~U.S=a.M:E~""-s::::'--.......~~
Applicable Manufacturer', L:=---------------------- C...a.,.DF-.---'--""'Ci"""'""Asu...;...s........ Data Reporu to be an.ached CERTIFICATE OF COMPLIANCE We certify that the natements made in the report are correct and this ~ceo+eArr: conforms to the rules of the ASME Code, Section XI. repair or repracement Type Code Symbol Stamp __N_/_A_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ Certificate of Authorization No __N---"-/_A_ _ _ _ _ _ _ _ _ _ _ _ Expiration Date _ _N""'/_A _ _ _ _ _ _ _ _ _ _ __ Signed ~~ 1 6T
~~~ ~ r or Owner' 1 Oaslgnff, Title &lfzt4if#I?~~
CERTIFICATE OF INSERVICE INSPECTION Date _ __,_,a..,..TJ="'f-<--'.....e?"-' I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the Stet.I orProvinceof Virginia andemployeclby HSBI&I Co.
. .. I___ , 19 91 of fd4,. T fay.d , ct have inspected the components described in this Owner's Report during the period S::-J - 9D to S::- /O -'1'{ , and statll that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section XI.
By signing this certificate neither the Inspector nor his employer makes any warranty. expressed or implied, concerning the examinations_ and corrective measures described in this Owner's Rep0rt. Furthermore, neither the Inspector nor his employer inspection.
.* *-~J&*I~ 'h 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 Commissions_..,V_A__5_4_3________________
~~I napector'1 Signature National Board, State, Province, and Endorumentl Date---~--~:J..~l_ 1 9 q/~~
~~FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI~~
1. Owner Virginia Electric and Power Co, Date Au6iusr 2.3 1 I qq I N11m11 5000 Dominion Blvd., Glen Allen, VA Addrea 23060

2. Plant Surry Power Station Unit _ _" " " " ' " " ~ - - - - - - - - - - - - - -
~~Name P.O. Box 315, Surry, VA Addrea 23883 Jbb b:)c 3~0(l)j 0553 C::. Rep111r Org11nlz11tion P.O. No., Job No., ate.~~
~~/2gfq1=72-,~~
~~3. Work Performed by Virginia Power Type Code Symbol Stamp ____ "-:l=-,f-/_._f't...__ _ _ __~~
N11me 1 Authorization No. _ _ _ _ __,_S\',._)+l_.14i-+------ P.O. Box 315, Surry, VA 23883 Expiration Date _ _ _ _ _ _ _N,__,,,,;~/..,A""l-,_ _ __ Addresa
4. Identification of System CQ:l'"J\\a':CroO. ,y):\--: C0-0 \ ~ *0 J

5. (al Applicable Construction Code B31. l 19~Edition,_N~/_A_ _ _ _ Addenda, N-1, N-7 Code Case (bl Applicable Edition of Section XI Utilized for Repairs or Replacements 1980W80

6. Identification of Components Repaired or Replaced and Replacement Components
~~Name of Component Name of Manufacturer Manufacturer Serial No.~~
~-
~~National Board No. Other Identification Year Built Repaired, Replaced, or Replacement or No) ASME Code Stamped (Yes~~
~~~r,-R'bl~l'tL :Q\.l.h 1-\1' :U \>o~ r.sy t'-J\)""fS P'Rt>b)}C-r<; * ~ - C. i::i +'2. q N/R 3 D 8" ,;-i,/ - 2 1c;9() REfi.JKffVIG\lT NO~~
7. DascriptionofWork WLACEP lB'" Vfil:VE-) \ 11 r," STut:>5 [ ~ 1 t-.luTS

8. Tests Conducted: Hydrostatic D Pneumatic D Nominal Operating Pressure ~ .
Other D Pressure _ _ _ _ _ psi Test Temp. °F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (11 size is 8% in. x 11 in., (21 informa-tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form *
~~(12/82) This Form (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017~~
~~FORM NIS-2 (Back)~~
~~9. Remarks -~WS...-=..._[\:\...,_t.-=-__C_.,0~D~E-~___,C{Ab=-"-~-S~~.3""'---------------------~~
Appllcable M11nuf11cturar's D11t11 Reports to be attached CERTIFICATE OF COMPLIANCE We certify that the statements made in the report a.:e correct and this PE.PLAc~tc conforms to the rules of the ASME Code, Section XI. repair or replacement Type Code Symbol Stamp __N_/_A_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ Certificate of Authorization No,_N_/:...A _ _ _ _ _ _ _ _ _ _ _ _ _ Expiration Date _ _N_/_A _ _ _ _ _ _ _ _ _ _ __ Signed uf14-~:n,,. , -::CST Ovlfzrn(Eff' l2t..ner or Owne,.;t Deslgnee, Title orProvinceof Virginia CERTIFICATE OF INSERVICE INSPECTION andemployedby HSBI&I Co. Date _ _a.,..... 0
~~. , ,. ~.~..2...:3~---,~~
I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State 9'...../__ 19 .... of _________._H....,_.,ll.""-"-r-T ........E....,.f)<..t-,_,,d,,,_,Jf--'c_~L---------=------have inspected the components described in this Owner's Report during the period _ _ _ _ _ _ _ _t;~-......l_-~9~t-?~to 5'-/0-</f , and state that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section XI. By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector_ nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connecteci with this inspection.
~~-----'~'l-l<C>j'-'--=;__--c--->f.'--.-->~-=----Commissions __V_A __5_4_3________________~~
~~lntpector'sSignature National Board, State, Province, and Endorsements Date~~
~~FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI~~
~~1. Owner Virginia Electric and Power Co, Date Au~U$T J=:, 1 /'J'f /~~
Nama 5000 Dominion Blvd., Glen Allen, VA Sheet _ _..:,!.___ of _ _..,,l...=---------- Address 23060
~~2. Plant Surry Power Station Unit--------------------~~
Name P.O. Box 315, Surry, VA 23883 Address Repair Organization P.O. No., Job No., etc.
3. Work Performed by Virginia Power Type Code Symbol Stamp bl / A Name Authorization No. _ _ __..N._,/._.A..,___ _ _ _ _ __
~~P.O. Box 315, Surry, VA 23883 Expiration Date _ _ _ __.N""'-1-/.,_8.___ _ _ _ _ __ Address~~
~~4. Identification of System _ _ _ _ ~-=J.Ltp. .o....b...,:...n....:t...,,___C ..Q""Q"""""l...1...D . . . , ~ , - - - - - - - - - - - - - - - - - - - - - -~~
5, (a) Applicable Construction Code B31. l 19§1._Edition,_N-"-/_A_ _ _ _ Addenda, N-1 N-7 Code Case (b) Applicable Edition of Section XI Utilized for Repairs or Replacements 1980W80
~~6. Identification of Components Repaired or Replaced and Replacement Components~~
~~Name of Component Name of Manufacturer Manufacturer Serial No.~~
National Board No. Other Identification Year Built Repaired, Replaced, ASME Code Stamped (Yes or Replacement or No) N;).rl.I Si\.J't)S r~rin,) \\'!:~\\Y ~<!~~ I N/A J..- C.(- \~S' ()l\)~11\Vtilr-.} f!..E:Pl.J'icED ~o Cd,-\ 1.1"\o\. \,\,~ f'o ,\\ csy S'TtH)S N/A [qqo ll.'f:P LY\ ~MEN; ~o
~~?ro&.u..c\:~ ~. ~'84Pd3'\ I !>\I ':\-'-t'J. - I l3 l.7iTI:RFL,}'~~
V Pt\.-V I:; r\~RY ~R?ITT' VNl',.Nt:,l&lr,.) N/A l.-c.c -t'6'S VNICNetatv N'::~L~Ccb NO HS!llt\'r PAA1T t-ff~ PO~ .ssy VPIL\/1:: CO, l~l-1~4{. N/A .;-3 'f %05-\ [111 ~PIPr~T NO NUTS VNl<.Nov.,r,J \)1'11(113~1\l Nl/A.. l_-((- l~ (]N~ Rt? Lf)<I:t> t\\o
7. Description of Work-£..,~.:i:e.,.1,""A""C.c:EC?=--..:.l'o.>e--"-Vl!.!f'L-<l=:s::::...i1--1..l1_,f5..._'_'...:'5:...if:..::VP~?"'-"'[a:.;3i.,.~]~A1'.Jc:;,~~..11\l~u!!...il'S,2,__.- - - - - - - - - - - -

8. Tests Conducted: Hydrostatic D Pneumatic D Nominal Operating Pressure W Other D Pressure _ _ _ _ _ psi Test Temp. _ _ _ _ _° F NOTE: Supplememal sheets in form of lists, sketches, or drawings may be used, provided (1) size is 8% in. x 11 in., (21 informa-tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form .
(12/821 This Form (E000301 may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017
FORM NIS-2 (Back)
~~9. Remarks ....~=.:.':>=S'--',3~----------------------~~
-~--1Pr~S::...JME-:'-""'"----'c""'*.O'"'"""'li)t-:""'---'c Applicable Manufacturer's Data Reports to be attached CERTIFICATE OF COMPLIANCE We certify that the statements made in the reoort are correct and this !ZE0.ACf;MefJ:T: conforms to the rules of the ASME Code, Section XI. repair or replacement Type Code Symbol Stamp __N_/_A __________________________________
~~Certificate of Authorization No. _N....;../_A_____________ Expiration Date _.....;N..;/'-A'-'------------- Signed l / ~ ~ ;;r::sr b,1/5zWffF£~~
~~~r or Owner's Designee, Title or Province of Virginia CERTIFICATE OF INSERVICE INSPECTION and employed by HSBI&I Co*
~~Date _ _'J-..a-'<~~-'---"'~=3::___ , 19~~
~~; Q I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State CZ!~~
of
~~-------Lf:-"/"",c,"'ll"_T_._..f..D""'"r""'d~J1---C_._f_________________ have inspected the components described in this Owner's Report d unng~~
~~r::- / -.~~
the perio d _ _ _ _ _ _ _ _ _J.,__....__...,..2_.,_"--to 'h._t 9...o _ __.:i.:.__,_.__,,,:__~J.-:+-~* r-..10- - - - - - - - , and state that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in acc.ordance with the requirements of the ASME Code, Section XI. By signing this certificate neither the Inspector nor his employer makes any warranty, expr.essed* or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable 'in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspection. ______,Q~....~--"'Inspector's
~~----'--c'""=":...,.i'"'.'---*....~~
~~Signature~~
~~~..c.=...,' :c.:;....c__ _ commissions _ _ V_A_5_4_3_ _ _ _ _ _ _ _ ___;__ __~~
~~National Board, State, Province, and Endorsements Date~~
1. Owner FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS Vireinia Electric and Power Co, As Required by the Provisions of the ASME Code Section XI oate A:u0ut>t

2.,()

I qq \
Name 5000 Dominion Blvd., Glen Allen, VA Sheet ____ l__ of_ _-=1'---------- Addr- 2)060
~~2. Plant Surry Power Station .. Unit _ _ _.-.,_ _ _ _ _ _ _ _ _ _ __~~
Neme P.O. Box 315, Surry, VA 23883 ;Iol, I\\,, 3 '6 ll:Hr e£i9 .1 3 @ot=:C\ L--S'o Repelr Orgenlzetlon P.O. No ** Job No., nc.
~~3. Work Performed t,v_-'V..::i:..:r_.g..,iaaan_i;:..;a;;;,,..aP;..;o::;,.;w;;.;e-r::.-_ _ _ _ __ Type Code Symbol Stamp NIA~~
~~Neme Authorization No, _ _ _..1,N:a.,,,...t&~-------~~
~~P.O. Box 315, Surry, VA 23883 Expimlon Oate _ _ __....N!>>f-/-"'A.._______ Addrea~~
4. Identification of Svstem _ __.S""o.:"":5~d~y-.::I:.1.l'L.1.j\J<-'c...+/-l,.;~...,c::n"'-"'1,-,- - - - - - - - - - - ' - - - - - - - - , , - - - - - -

5. (al Applicable Construction Code B31. 1 1 9 ~ Edition,_N_/_A;..;...._ _ _ Addenda, N-1, N- 7 (bl Applicable Edition of Section xi' Utilized for.Repain or Replicements 1980W80

6. Identification of Components Repaired or Replaced and Replecement Component*
~~Name of Component Name of Manufac:tu rer Manufacturer Serial No.~~
National Board No. Other Identification Year Built Repaired, Replaced, or Replacement or Nol ASME Code Stamped (Y11 Nl.5TS lJJ')~OWN u t.:i l<'N <,(,&) ~ I N/A l-~:r-s-c,, Ul\ll\NC'IOII ~Pl.J'Kib l'\O
~ ... '1 ll¢qlt.)t{f\l..,, \\T ~ PO .. lSY NVT5 .$, :ti..}-C.. bf3 C. I N/A 314 :.U& -I l'l'l 0 ~~U\<Bl\ai, ~o i .5Tu ~.s. f\t.o&Ko rz UN ~Net.t,11.::,1 N/A 'l-<o1:-S1 11"11l\10i:I~ P.J:I) 1.1\C:.Sb NO ~Tubs ~\!'-)Al .!N-t:> H'f'"
~~l'R.cil)l.i'c(S I1Jc., 80 13 £. "E-J#-o I N/A. Po-.\11 C..'::. y 3'2.l-O't3- l l~tCf ~lhC'E:1'1\~N"T NO~~
7. Description of Work _ _R_~""f'""4&f ..........J""-......I..C""2~0L..).J.-...;S~+/-~,l,QJ,.W:..:.:;.,S,_--1..e&~-'ci...'t~O-)J_..J)Q,l:l....!:\11.+/-l..,.;;s,i__---1.{..ic_".,/,)_____

8. Tests Conducted: Hydrostatic O Pneumatic O . Nominal Operating Pressure ia--
Other O Pressure psi Test Temp. °F NOTE: Supplemental sheets in form of lists, sketches, or dniwings may be used, provided 111 size is 8% In. x 11 in ** 121 lnforma-tion in it8ffll 1 through 6 on this repon is included on each sheet, and (31 each sheet Is numbered and the number of sheets i1 recorded at the top of thi1 form .
~~112/821 This Form (E000301 may be obtained from the Order DePt., ASME, 345 E. 47th St., New York, N.Y. 10017~~
~~FORM NIS-2 (Back)~~
~~=--Cl-AS--'......;;;;...;;;:~:...-....:.0=---------------------~~
~~9. Remarks _ ___,t\-...._S...:..i;t::\r'.~---"'-.,.C=Ct:::,~~
APPlicable Manufacturer, Data Rapom to be attached CERTIFICATE OF COMPLIANCE We cenify that the statements made in the repon are correct and this .~~ conforms to the rules of the ASME Code, Section XI. repair or re1:11acament Type Code Symbol Stamp __ N_/_A-------------------------------- Cenificate of Authorization No. _N___ /_A____________ Expiration Date _ _N....;/_A____________
~~~ ,J Signed or Province of a:) ~ re - neror Owner's kOetlgnn, Virginia SL &J 6t~F£,?.-~~
~~Title Date _ _ _.... CERTIFICATE OF INSERVICE INSPECTION~~
~~°'n=---oi____~~
c ___ , 19 I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State and employed by HSBI&I Co* 9t of da..r d T'For- J Cf. have inspected the components described in this Owner's Repon during the period S:- f --jo to f-/l) -'1'{ , and state that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Repon in accordance with the requirements of the ASME Code, Section XI. By signing this cenificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Funhermore, neither the Inspector nor his employer
*shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this * "'-'~-*-=,--=--""'.'-f=-::-':---~'"""""""".
i_n_sp_ec_~_io-'*B.,.*
~~.. --...---a.___ commissions __V_A_-'5_4_;.3________________~~
~~I nspector'1 Signature National Board, State, Province, and Endonament1 Date*-----~---~_, _ _19 qI~~
,. Owner FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI Virginia Electric and Power Co, Date AvG.u:;:,r 2,( 1 l q 'J (
Name 5000 Dominion Blvd., Glen Allen, VA Sheet _ _...,l____ of ____l ~ - - - - - - - - - Addrea 23060
~~2. Plant Surry Power Station Unit _ _. . . . , , ~ - - - - - - - - - - - - - -~~
Name P.O. Box 315, Surry, VA 23883 J'ob No 3Re>QH2>9ID9s::t\ eett:t(-55" Repair Or;anlzatlon P.O. No., Job No., etc.
~~3. Work Performed by __V.. .;1.;;..*r"-'-'g_i""'n""i~a;a.....P--a.ow~e_r_ _ _ _ _ __ Typa Code Symbol StamP~hl-/~A---~~
Nam* Authorization No. _ _ _.......,N.../uE\..,_________ P.O. Box 315, Surry, VA 23883 Expiration Date _ _ _ __,N.-.+/. A._ . . _______ Addrea
4. Identification of System_~\\_eC\~CITl~~c-~C ....<'~=~*~..1g_Yl~:\:-.------------------------

5. (a) ApplicableConstructionCode B31.1 19~Edition,_N_/_A_ _ _ _ Addenda,N-1, N-7 CodeC-(bl Applicable Edition of Section XI Utilized for Repairs or Replaeernfflts 1980W80

6. Identification of Components Repaired or Replaced and Replacement Components
~~Name of Compon.ent Name of Manufacturer Manufacturer Serial No.~~
National Board No. Other Identification Year Built Repaired, Replaced, ASME Coda Stamped (Yl'II or Replacement or Nol I~" NUTS ,:of£$..., 1111 LeRN i-IRGt-1¥; ! N/~ ,._-Rc-1-ic.4'-?SS(.C. 1//vkl\)C(c,,J Rk'PlJKEI'=- ~o {J/f?J;:(fV/1/, :ff\l'iz:> t-1-(::fl P() :# CSY
~~/I Nv1S PRobVtfJ .:tNr. C'2-z.:n_a( I N/A 3 "33S"i.lf /19/ RE)"l.M:MtNT ~o i~~
~~I I I \,,~~
7. Description of Work _ _ ~R~fl-=i¥2f-""/ac=-',e=u-J=------"""n_lA_+ . . . ~. .___(a......;.'7-"')-,~-----------------

8. Tests Conducted: Hydrostatic O Pneumatic O Nominal Operating Pressure ~
Other O Pressure _ _ _ _ _ psi Test Temp. _ _ _ _ _* F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is 8% in. x 11 in., 121 lnforma-tion in items 1 through 6 on this repo" is included on each sheet, and 131 each sheet is numbered and the number of sheets is recorded at the top of this form *
* (12/821 This Form (E000301 may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017
~~FORM NIS-2 (Back)~~
~~9. Remarks ___,_ _,A.........,,S:;.M ........f___..._C....n....e>E-.-:;;;.__._C_.1....bu-::.S=---=------------------~~
Applicable Manutacnirer'1 Data Raporu to be anacheel "1*"\,.** * -*:: ; . CERTIFICATE OF COMPLIANCE wa cenify that the statements made in the repon are correct and this f§Pu\C!:i£ACC conforms to the rules of the* ASME Code, Section XI. repair or rei,1acement Type Code Symbol Stamp __N_/_A _____________- - - - - - - - - - - - - - - - - - - - - - - Certificate of Authorization No. _N ___/_A____________ Expiration Oate _ _N...;/_A ____________ Signed . r/5v1 ~ . ) XST Jiivb!Alff? fiwi;;, or Owner's DeslgnH, Title orProvinceof CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel lnsPectors and the State Vir inia andemployedby HSBI&I Co. Date {2,tJ, .z; , 19 'zl
~~' of~~
_ _ _ _......."""'""...r......'""fi_c .....r'""d=t-"""""""-"------------::=--~~---have inspected the components described in this Owner's Repon during the period _ _ _ _ _ _ _..,,.... S;_-'""/_-......9_0_to 5--:-/o-'ltf , and state'thet to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's .Repon .in accordance with the requirements of the ASME Code, Section XI. By signing this cenificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations_ ~nd corrective measures described in this Owner's Report. Funhermore, neither the Inspector nor his employer shall be liable in any manner for any personal. injury or propeny damage or.a loss of any kind arising from or connected with this
~~..* ..,*-"'*<,.;;;..,..~~n-ap_ec:,:~~
~~i_n_sp_ect--io_M~* .......a..o-:r'-11/'/;:S':"'l;-n...~-u"'r~~
...e.....~"==---Cominissions !!1o~!!oarc:1, State, Province, and Endonamenta Oate*_ _ _ _Q)=---~d:....,,b'-_19 q/
1. Owner FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI Vir~inia Electric and Power Co, Oat, A;u6HJ5T: 2.. l

l '19. l Name 5000 Dominion Blvd., Glen Allen, VA ShHt _ _..l.___ of _ _.=l:.___ _ _ _ _ _ __
~~Addr- 2)060~~
~~2. Plant Surry Power Station Unit _ _.....,._ _ _ _ _ _ _ _ _ _ _ __~~
~~Neme P.O. Box 315, Surry, VA 23883~~
~~-- Addrlll Repair Organization P.O. No., Job No.,~ .~~
J. Work Perfonnedby Virginia Power Type Coda Symbol Stamp N / A N1m1 Authorization No. _ _ _..,Na:,-IP,g,,.....,.__ _ _ _ __ 1 P.O. Box 315, Surry, VA 23883 Expimion Date _ _ _ _..,,N..,/...AL-______ Addrw S....
~~4. Identification of System _ _.... <1...,:\.£...,+/-'-'ur"'"'l......,ru'-t.... f ...c..,+...,~...N1\.~~
~~J ":J~~
5. (al Applicable Construction Code B3 l. 1 19~ Edition,__:N:..:../:...;A;.:...._ _ _ Addend11, N-1, N- 7 (bl Applicable Edition of Section XI Utilized for.Repain or Replacements 1980W80

6. Identification of Components Repaired or Repleced and Replacement Components ASME Code N1t1on111 Repaired, Stamped Name of Name of Manufacturer Board Other Year Replaced, (Yn Component Manufacturer Serial No. No. ldantific:ation Bullt or Replacemant or Nol l\"s,Ot:>5 (I JVf,.JIJc,t,) I/) PNKAJ(J't(/A} !- N/A -.2-s1-Mov-28t.rr Ulll~IIOICII ~PU'IGb 1-\0 II:.'-~ OtJqtN/!ef?IN~ H"f":R PO°*
. ~o " s-rut> 5 :It-, :£Ne !5'"tstf'I Ij N/A 3 l SO~l.-) /'/'JO ~p I.I\CSl\11,.\j 1% t\:l lJ rs VNfftv~N f/NICNDU.JN I N/A l*S1-IVID11'* 2.ll.rl 111\lK~tl 11.J:f) J.I\CS'.b NO ~fllcD/tl/Rl JNb H1-tf Po -.\ii II il,j Vi~ fR_l)f>t/CTS .2ll) C "f 3o3 8'9 I N/F\ '2.(S2'+S-I !93'7 ~lhC'E:1'1\ENT NO I : ;_ /~ i)IR.1.
~~7. Description of Work _ _,1..lf.-"',,..,:;,""""'/a...,...cc...=e.&::,;;~~----'/'---'1Yec:......_..;:a$w-6~ua.:o"'J."":a.'ii--'A?.Qi:..~n;L,jd~,(:.:;+/-!.:.;c;a._...;.._ _ __.!._ _ _ _ _ _ __~~
7
8. Tests Conducted: Hydrostatic O Pneumatic O Nominal Opemi~ Pressure G:J-Other D Pressure _ _ _ _ _ psi Test Temp. OF NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided 111 size is 8% in. x 11 in., 121 lnfonne-tion in items 1 through 6 on this repon is included on each sheet, and 131 each sheet Is numbered and the number of sheets_ is recorded at the top of this fonn .
* (12/821 This Form (EOOOJOI mev be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017
~~FORM NIS-2 (Backl~~
~~9. Remarks --~~S""~---"'-*_Co=.:a::r.:s:..:~~_,WY;:,""""'i..:..:::"'"S:.._.;.;2,;;._________________________~~
Applicable Manuf1cturer'1 01t1 Repc,ru to be attached CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and th is f2eeHf;'.M£.N, -r conforms to the* rules of the ASME Code, Section x I. repair or r11i:111eem1nt .... Type Code Symbol Stamp __ N_/_A____________- - ~ - - - - - - - - - - - - - - - - - - - Certificate of Authorization No, _N-'-/_A____________ Expiration Date _ _N-'/_A ____________
~~,.... ~.b.";5.,.S;~ Sta,~~~
CERTIFICATE OF INSERVICE INSPECTION Date _ _ ......,a...~_. . ._¢....,/---. 19 q I I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel lnsPectors and the State or Province of Virginia and employed by HSBI&I Co* of t/'l..l"'Tf"p.-d.J ef, have inspected the components described in this Owner's Report during the period S- /-:9'.0 to S-/ O - CJ'-/ , and statu that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's .Report
~~. .in accordance with the requirements of the ASME Code, Section XI.~~
~~By signing this certificatu neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations. . and~~
~~' correcti)le . . . measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer ~~~
~~shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or _connected with this~~
~~'""'~'*"*~, &Jk Commissions __V_A_...;c5_4_3:;....________________~~
I napector'1 Signature ill1tlon11 Board, State, Province, and EndorAment1 Date_ _ _ _...... 2_-~1.=-J-t--_19 q/
FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI
1. Owner Vininia Electric and Power Co, Date f\ugl)S, 2..1 1 I'1q I Name 5000 Dominion Blvd., Glen Allen, VA AddrW 23060 Sh11t _ __.l.__ of. _ _-=l'----------
~~Unit _ _ _o,:,,._ _ _ _ _ _ _ _ _ _ _ __~~
2. Plant Surry Power Station Neme P.O. Box 315, Surry, VA 23883 1okRapalr No,Organization 380009:;3 l©5 -WGJ \-\le P.O. No., Job No., ate.

3. Wort< Perfonned t,v Virginia Power Type Code Symbol Stamp N / A Name Authorization No. _____.N_,./... A.._________
~~P.O. Box 315, Surry, VA 23883 Expimion Date _ _ _ _.,.N..,,,...ta...__ _ _ _ _ __ Addrna~~
~~4. Identification of 5Ystem _ _ _.S...crf~~
~~......~"""+..._,__L...')'+;.._e....c...£,..,\....CO:J.....,._ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __~~
7
~~5. (al APPlicableConstructionCode B31.l 19§1._Edition,_N-'/__A _ _ _ _ Addenda,N-l, N-7~~
~~Code~~~
~~(bl Applicable Edition of Section XI Utilized for.Repain or Repl~ts 1980W80~~
6. Identification of Components Repaired or Replaced and Replacement Components ASME Codi Natlonal .Repaired, Stamped Name of Name of Manufacturer Board Other Year Replaced, (Yn Component Manufacturer Serial No. No. Identification Built or Replacement or Nol
%" S,o r:,.s t//111(Ille?Ze/11.J tiNkll.ffi.)/U I N/A 2..-s.:r:- ~V-)/628 U~l\'IIOICII ~PIJ\Gb KO ,, s-n>t> s c/M/)1/V/lt .tNb P/?fJ/)/)Cf'J .IJVC f,/1'-:# .fi't'J/S'j I N/A PO-3.lfo't't-0-1 t?'?/ ~PIJ\(Sf\!t,.\i ~o I ~"
~~g- "1\lTS cl NkN fYW1v' t/NkllJP/()11/ ' N/A 2-Sf-/l?t't/,.2.1t 2.!l~~
~~~ -......: .~~
~~V~lC~" P,EI) l.t\CSb NO~~
}I/IRO'<.Jf/Rc:- H1'-* Po ,\'I " tv'0TS ff,Q9L1"/ {/J :PJf;. 3;:;-R-.,K I N/A. ~~0%21- 2. /'1%8 ~UKl:1'1\i.N"T NO ......~...' 6...,u
7. Description of Work _ _ __,,fi......,,.,.P""-f--h,,,_..c...e'"'-"'cL.""_.f ...~"" ......._.,.t!..._..::011=..:l-__,:s::.*..,,_ _ _ _ _ _ _ _ _......;._ _ _ _ __

8. Tests Conducted: Hydrostatic O Pneumatic O Nominal Operating Pressure 8-0ther O Pressure _ _ _ _ _ psi Test Temp. _ _ _ _ _* F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (11 size is 8}i In. x 11 in., (21 informa-tion in items 1 through 6 on this report is included on each sheet, and (31 each sheet Is numbered and the number of sheen is recorded at the top of this fonn . /
~~(12/821 This Form (E000301 mey be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017~~
~~FORM NIS-2 (Back)~~
~~9. Remarks ___ __..&..."=> ___e.~_....c~~
~~.........M . .c.....S>=E-~___.C........£...Afa......a.?=---"'2.-"""----------------------~~
Applicable Manufacturer', Oat* Repom to be attached CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and t h i s ~ conforms to the rules of the ASME Code, Section XI. repair or replacement Type Code Symbol Stamp __ N_/_A--------------------------------- Certificate of Authorization No __N_/_A____________ Expiration Date _ _N_/_A _____________ Signed orProvinceof (.1fi-vvi ~ d~Owner'ioesiinn, Title Virginia
~~-=t:":;J EN 61111tEt;:.?~~
CERTIFICATE OF INSERVICE INSPECTION* Date _ _ __.0t,_......,_.,"'""*--=¢.._7 I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel lnsPectors and the State andemployedby HSBI&I Co. __ , 19 9 t of Ha..rTfur-d) ct. have inspected the components described in this Owner's Report during the period - _ _ _ _'1L'.._-....:(_-_. 0 .J)e--to 7.J_ :"-/O 2 _ _aI 1-1.
-,- , and state that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section XI.
By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, ~ncerning the examinations. ~nd corrective measures described in this Owner's Report. F11rthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspec~ion. O~ J). /i) (\
~~----~lf-4'""'---":':;;...a~~.,,h'=:'--.:,~~'-"=:;..;..---COmmissions __v_A...;;...:.5_4....;3;;___ _ _ _ _ _ _ _ _ _ _ _ _ __~~
~~ln1Pector'1 Signature National Boara, State, Province, ana enaorHment* Date_ _ _ _-"'$' ---.....j..._._7__19 qf~~
~~FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI~~
,. Owner Virginia Electric and Power Co. Date A1lfrJ12$T 2 Name 5000 Dominion Blvd., Glen Allen, VA Sheet _ _ ....,!l.__ ot _ __,l=-----------
~~Address 23060~~
~~2. Plam Surry Power Station Name Unit _ _ _ -=........,-------------~~
P.O. Box 315, Surrv, VA 23883 :Sak Na. 3'80@@9.S: 9 l-\:2.. ee-:'11-1t.1-Addrea Repa1r Orgnnizetion P.O. No., Job No., etc.
3. Work Performed by Virginia Power Type Code Symbol Stamp bl / A Name Authorization No. ---..JN..,..,./cif\;i.________
~~P.O. Box 315, Surrv, VA 23883 Expiration Date _ _ _ __.N....,_/.._A,.________ Addrea~~
~~..f....______________________~~
4. Identification of System _ _..J/?.c...µ;P;....,.:,CY....<.C-P.L...L.n:....-C<---*~{c.""~'"":...µ.4.t..<.0'.a..&Z=......

5. (a) Applicable Construction Code B3 l. 1 1 9 ~ Edition,_N:..:..:../:;;.;.A:......._ _ _ Addenda, N-1 N- 7 Code Casa (b) Applicable Edition of Section XI Utilized for Repairs or Replacements 1980W80

6. Identification of Components Repaired or Replaced and Replacement Components I
ASME Code National Repaired, Stamped Name of Name of Manufacturer Board Other Year Replaced, (Yes I Component Manufacturer Serial No. I No. Identification Built or Replacement or No) I I I I 3 ,, I
!~ l'-'.llJT I Vi::1..flN I Vfvkl\l t;i.; I\.) I N/A J.-Rl-fJ\O\l-2'S3S :Ut.ll\N0\011 PJ:.P~b ~o i %r, I\JllT ,,...,.~ '[Nf;,INE£k1Nf IH 1' =t1 N/A PO~
~~\qq l ~~ IJ'l<B'ti'l:~i NO i 11- . :Jt.. 1 :.fNv RmD931 I '3 31.\-'-\ 25?, -,~~
~~i' 3 'I R.tib~~
~~~ VNKN1.nu1\l I l?N k.N 01,;,~ l!~~
~~N/A .2-1\<..-1"'-0 V-2S 35" !IJ lllK~~tJ P.1::Hl\C.t;:b NO C~Rt,\1-,rftL :J.N}) I,\"(' .,,j:J i f>o-:\1 CS'j~~
~~~I{~~
~~I/ Rot.:) Pl'\DbllCTS .Jll c..., ~ IZJC) 1- 'L'j(..,I N/A 34-~CJ"Z.+-\ II l9°1/ ~PUKE:Tl\1:.N'T NO I~~
~~/} 3 ,, / /~~
~~7. Description of Work_--1,R......,e-,h.,_,,_./g"'-'"'C-'-<"'-"o:(:.,__ __;~:c_---'-D,""vl"'-'-f_,sc_:::.{!../-"2..::.]..1-_d,~:=.!;/Lf.--f-(.!=Oc.:!e{i;:::L,!!;,;;,..*~{6...!/.!2.::..c.)~--------~~
/
~~8. Tests Conducted: Hydrostatic O Pneumatic O Nominal Operating Pressure W----~~
Other O Pressure _ _ _ _ _ psi Test Temp. _ _ _ _ _°F NOTE: Supplememat sheets in form of lists, sketches, or drawings may be used, provided (1) size is SY.. in. x 11 in., (21 informa-tion in items 1 through 6 on this report is included on each sheet, and (31 each sheet is numbered and the number of sheets is recorded at the top of this form . (12/82) This Form (E000301 may be obtained from the Order Dept.* ASME, 345 E. 47th St., New York, N.Y. 10017
FORM NIS-2 (Back)
~~9. RemarKs -~..LA-...L.::s:::c..!.fv\....:.bE.-==-,-,_ __.C-""o""'-"'D""'E~--c"'-"_l--A:::;,o.J.._,_'5..,___....,____________________~~
APPiicabie Manutacturer's Data Reports to oe anacned CERTIFICATE OF COMPLIANCE We certify that the statements made in the reoort are correct and this gEPLA(f?Mfci\/T conforms to the rules of the ASME Code, Section x I. repair or rep1acement Type Code Symbol Stamp __N_/_A ____________________________________ Certificate of Authorization No. _N...;./_A_____________ Expiration Date _ _N_/c_A_____________ Signed L/c//VlfL,,,..,.,__
/t;.J.r or Owner's 6esignee, Title or Province of Virginia -::LSI fu6,t,Jfili,L CERTIFICATE OF INSERVICE INSPECTION Date _ __.~==,.i-.._,_.....,J""'J..._ _ _ _ , 19
1. the undersigned, holding a valid commission issued by the National Board of Boiler ano Pressure Vessel Inspectors and the State and employed by HSBI&I Co*
~~qI of~~
-------b"-f.'-'tt"'-r,_T_,_...f-'o"'-'-,.-=cl:...\rC=-f.___________,=-----:=-----have inspected the components described in this Owner's Report during the oeriod 1)" CJ O 10 _ _ 5:_-~/~o'--__.-l. .t/..._ . ____ , and state thet to the best of my knowledge and belief, the Owner has pertor!l)ed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section XI.
By signing this certificate neither the Inspector nor his employer makes.any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this insoectW I 3;/L Commissions __V_A_5_4_3_________________
. I nspoc,:or's Signature National Board, State, Province, and Endorsam11nt1 Date_ _ _ _...:£?c.--....a~'--=-i _,s 9/
~~FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI~~
~~1. Owner Virginia Electric and Power Co, Name~~
~~5000 Dominion Blvd., Glen Allen, VA Address 23060~~
~~2. Plant Surry Power Station Unit _ _ _..:..2..,. ______________~~
Name P.O. Box 315, Surry, VA 23883 Address Repair Organization P.O. No., Job No., etc.
~~3. Work Performed by Virginia Power Type Code Symbol Stamp_--'-.;;;...,..'---------~~
Name Authorization No. -----P/--1:1--------- P.O. Box 315, Surry, VA 23883 Expiration Date _ _ _ _ _-,,,..µ.. ________ Address
4. Identification of System _.JM~P,.,,1...i.,,.__,'51:::....,..,,,lc-af'i'L..i.:.Cv\..__ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __

5. (al Applicable Construction Code B31. l 19§l___Edition,_N:..:..!../.:cA:...___ _ _ Addenda~ N-1, N-7 Code Case (bl Applicable Edition of Section XI Utilized for Repairs or Replacements 1980W80

6. Identification of Components Repaired or Replaced and Replacement Components
~~Name of Component Name of Manufacturer Manufacturer Serial No.~~
~~National Board No. Other Identification Year Built Repaired, Replaced, ASME Code Stamped (Yes or Replacement or No) NON. e£Tl)4! V/!rU/E..~~
~~~~- ~t>qLWat-- fu, lu./llMO(N/\'.l* Nl/\ 62-m":) *A//2.1/-2.o/B . - ... et:FJH~ /Jo~~
7. Description of Work \,Jp .p ~ffltf?-. ON. LN,EfVZ...:tNQC/'111 ONS, NOT T HfZC,utnH lJA-u....

8. Tests Conducted: Hydrostatic O Pneumatic O Nominal Operating Pressure 0 Other O Pressure _ _ _ _ _ psi Test Temp. °F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is BY. in. x 11 in*., (2) informa-tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form *
(12/82) This Form (E00030) may be obtained from the Order Dept'., ASME, 345 E. 47th St., New York, N.Y. 10017
FORM NIS-2 (Back)
~~9. Remarks -~--_,_f\,......,,5""M.-=E..-=-_,_(..,.o=D""'lc-:=-___,,(...1...,,8S......._S-___.,L-=-------------------------~~
Applicable Manufacturer's Data Reports to be attached CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this IZe.pe,g... conforms to the rules of the ASME Code, Section XI. . repair 'or replacement Type Code Symbol Stamp __N_/_A _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ Certificate of Authorization No. _N....;./_A_ _ _ _ _ _ _ _ _ _ _ _ _ Expi.ration Date _ _N_/_A_ _ _ _ _ _ _ _ _ _ _ __ Signed L~(}J.L ::::C::SI
~~~l{er or Owner'~ Designee, Title £rJ6LrJE£1?.: Date_~{l..,,....~=<!-~--'Z="-2_ _ _ , 19 ...9~/__~~
CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State or Province of Virginia and employed by HSBI&I Co* of
----------+fl~a..,r'-Tf+'f..J""""'""-"d.::...1~C...:..f:..______~---=--------,have inspected the components desc,ribed in this Own~r's Report .during the period-,-~-----'._"'_._f_-_'i'-"'o'--_to. '5-/D-'t'f . , and state that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section XI.
By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furtherinore, 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.
~~--~+'-"b'4....-R~tJ"=.........-':-'.{"'-~~~
~~lnspactOr's Signawe~~
~~. .~ . .......~ ..........~-Commissions_VA_S4_3 _ _ _ _ _ _ __~~
~~National Board, State, Province, end Endorsements Date_ _ _ _ f{_-~d-~7__19~~
qJ

FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI
~~1. Owner Virginia Electric and Power Name Co, Date -~Jl . . . . . =)L~'{.___-=2=-'t-L+-/......( ....,q'-'j.,_,_(- - - - - - -~~
5000 Dominion Blvd., Glen Allen, VA Sheet _ _,:,.1_ _ of_--=1.:c___ _ _ _ _ _ _ __ Address 23060
~~2. Plant Surry Power Station Unit _ _.!e>..----------------~~
Name P.O. Box 315, Surry, VA 23883 3'ob )\'.lo. "3&oo\ I r:f-0'6: gt:J=k,1-J'-15 Address Repair Organization P.O. No., Job No., etc.
~~3. Work Performed by Virginia Power Name Type Code Symbol Stamp _ _ _ __._N=-,f_.A:'-'------ ,~~
Authorization No. _ _ _ _ _ _....i.;N:..,/!...!:Al----- P.O. Box 315, Surry, VA 23883 Expiration Date _ _ _ _ _ _ _...N..,,_,,,_J...A.,_____ Address
4. Identification of System _ ___,F_\::-.._..l;..,l::)....,,Lt._)""f'tu...cTE:1-1oo...S.=------------------------------

5. (a) Applicable Construction Code B3 l. 1 1 9 ~ Edition,_N~/.::.;A:c___ _ _ Addenda, N-1, N- 7 Code Case (b) Applicable Edition of Section XI Utilized for Repairs or Replacements 1980W80

6. Identification of Components Repaired or Replaced and Replacement Components
~~Name of Component Name of Manufacturer Manufacturer Serial No.~~
National Board No. Other Identification Year Built Repaired, Replaced, ASME Code Stamped (Yes or Replacement or No) NUT VNl\~owrJ VNIC~ N/~ :l..- rot='H -2. vtollt~ R.Ef'Ll\C&t:, No 1\8.lli laN(jl!ll~l'I<; K'f JI i>O~ c.sy
~~\ ,, NIA.+ -:ir.. ! -:J'.'.NC., ~(, (l31 N/P.,~~
~~l ':\-?>'t(f8'- I t '1i-i ~l..fl(.E!f\1:NT NO I :r-{." I /~~
~~7. Description of Work _ _R~e-r~~\&\.~C~ep\~--,,.-="o_ __.V\~\.l:,,_+/-.....___.Q.u.:,N,___,fi...,__._M'-'--='b"'1.!efu?=::......----_.:_------------~~
8, Tests Conducted: Hydrostatic O Pneumatic D Nominal Operating Pressurefr ~ ~ / . , ; OtherO Pressure _ _ _ _ _ psi TestTemp. _ _ _ _ _ _°F Af/If NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is BY:. in. x 11 in., (2) informa-tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form . (12/82) This Form (E00030) may be obtained from the Order Dept., ASME, 345 E, 47th St., New York, N.Y. 10017
FORM NIS-2 (Back)
~~9. Remarks _...,A'-'-""S'--'M-U.£=-__..C....-6=D=E:.-=-__..CUl:2=~5""'--..c.;L-,:..._ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __~~
Applicable Manufacturer's Data Reports to be attached CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this ffiLACE,.Mf;.AII conforms to the rules of the ASME Code, Section XI. repair or replacement Type Code Symbol Stamp __N_/_A __________________________________ Certificate of Authorization No. _N_/_A_____________ Expiration Date _ _N_/_A_____________ Signed
~~&a,: L .~~
L./mcir Owner's De.lignea, ,T.5T Title CERTIFICATE OF INSERVICE INSPECTION Date--~91)~~~_.<ef=-':/~--. 19 9/ I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State orProvinceof Virginia andemployedby HSBI&I Co. of f/q_r-Cfor cl I c.f
bave inspected the components described in this Owner's Report during the period -f J-'f / , and state that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in *this
~~. Owner's Report in accorda.nce with the requirements of the ASME Code, Section XI.~~
By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspection.
~~-----~+-'"""'"':-~---:-=-:-f_.--'~.....c--'~----Commissions _ _ V_A___5_4_3_________________~~
~~Inspector's Signature National Board, State, Province, and Endorsements Date_ _ _ _ __,7._-__.i'"c.(__.__19 '( f~~
~~FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI~~
~~1. Owner Virginia Electric and Power Co. Date_=- __r_-_V'_--_1-'-/_______~~
~~Name 5000 Dominion Blvd., Glen Allen, VA Sheet _ _~/__ o f ~ - L - - - - - - - - - - - Addre11 23060~~
~~2. Plant Surry Power Station 1._~~
~~Neme P.O. Box 315, Surry, VA 23883 Addren~~
~~3. Work Performed by Virginia Power Type Code Symbol Stamp_*~N""/~A~-------~~
~~Name Authorization No. -~N"'"/~A~--------- P.O. Box 315, Surry, VA 23883 Expiration Date _ _.,_N,_,./_,_A_,___ _ _ _ _ _ _ __ Address~~
~~4. Identification of System t(C<,,), fuJ. ( Lt;~ ).... "'V1 6/.M:1c:J.,/r:b }~~
~~R_(1'R._ (_ ,I 3~~
5. (al Applicable Construction Code B31.1 19_§l_Edition,_~N..,_.__/A~---Addenda,N-l, N- 7 Code Case (bl Applicable Edition of Section XI Utilized for Repairs or Replacements 19 80W80

6. Identification of Components Repaired or Replaced and Replacement Components
~~Name of Component Name of Manufacturer Manufacturer Serial No.~~
~~National Board No. Other Identification Year Built Repaired, Replaced, ASME or Replacement _or Nol Code Stamped (Yes~~
~~)-wfp}-1+,)- /$~~
('
)/JvJb..e-,; 1-11 6,t,~'1-tl( /vtr A/I}- rv-01,-1) 8°) /&.JJU"'-tn1 a-!J /.Jo ') :(l.{,/ ..-;110, .)_
~~suv.hb-w frn J,, ,..,, ~ii((; '-'i f/fJ-. M!J ( {v/ (; ') '{ ) Ai( ,{,;-pt.w,.J /JV IJ~~
7. Description of Work ~ ; [{,t,/) 15G ~\Jv,.,

8. Tests Conducted: Hydrostatic O Pneumatic O Nominal Operating Pressure D Other [%j ;:_ressre psi Test Temp. °F
~~"~-1"-.l f.1,<<-~~
NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is 8% in. x 11 in., (2) informa-tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form .
* (12/82) This Form (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017
~~FORM NIS-2 (Back)~~
9. Remarks ~,...;::.e_,'(,..___"'_l_V11--"-,...-v_.L.._--'ac--'~~t-"_V__,_/o_l_Vb Applicable Manufacturer's Data Reports to be attached CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this 8vnUMR-W<4conforms to the rules of the ASME Code, Section XI. repai~or replacement
~~Type Code Symbol Stamp _ _~+->-~-----------------------------------~~
_ _N__:/_A _ _ _ _ _ _ _ _ _ _ Expiration Date_..;;N.;..i/c.cA....:......_ _ _ _ _ _ _ _ __ CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State or Province of VA and employed by HSBI&I Co. of Hds -r "1' f o"' cl >C f have inspected the components described in th is Owner's Report during the period q- I 'f- f'l to ~- / S' - '1/ , and state that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section XI. By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspection.()~!. II) n
~~----t-lf::t-'--'.._~__,,'----~fLL....;.__~---':e.....:::.._ _ _ _ _ commissions _ _,V'-'A_.__..,.5:..c4u3"'------------------~~
~~lnspector's Signature . National Board, State, Province, and Endorsements Date_ _ _ _ ~7_-~//__19 q {~~
~~FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI Co. ~6'--l/~L~IR'-+(~9'~/_______~~
~~1. Owner Virginia Electric and Power Name Date _ _~~
~~r I 5000 Dominion Blvd., Glen Allen, VA Sheet _ _ _ _ _ o f _ ~ - - - - - - - - - - - Address 23060~~
~~2. Plant Surry Power Station Unit _ _ _. . . , . . . " " - - - - - - - - - - - - - - -~~
~~Name P.O. Box 315, Surry; VA 23883 Wo"* 1120?9 Address Repair Organization P.O. No., Job No., etc.~~
~~3. Work Performed by Virginia Power Type Code Symbol Stamp _ _/>.._f_..(A- _ _ _ _ _ _ __~~
Name Authorization No. _ _ _ _..,_J.J,......{wA'--------- P.O. Box 315, Surry, VA 23883 Expiration Date _ _ _ _ _..,,AJ""'""/µ.Pr_,__ _ _ _ _ _ __ Address
4. Identification of System _....,,/'l\o,"""""',..i'-,.....'---.S-\C.....,,e.o...='-'-rr:::,-"--'-------------------------------

5. (a) ApplicableConstructionCode B31.l 19~Edition,_N~/_A_ _ _ _ _ Addenda,N-l N-7 Code Casa (b) Applicable Edition of Section XI Utilized for Repairs or Replacements 1980W80

6. Identification of Components Repaired or Replaced and Replacement Components
~~Name of Component Name of Manufacturer Manufacturer Serial No.~~
National Board No. Other Identification Year Built Repaired, Replaced, ASME Code Stamped (Yes or Replacement or No) f2f;l..lt* lf.LJL-VE 6/.lvrre* /!c.eelllllq I J.,,, QIAIA Afl/J- 02. -rns-E.11"'2.o/C- lNIWCWJI l?t~pl);RfiO Uvt.N<W/1./
8. Tests Conducted: Hydrostatic O Pneumatic O Nominal Operating Pressure 0 Other O Pressure _ _ _ _ _ psi Test Temp, _ _ _ _ _ _° F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1 I size is BY. in. x 11 in., (2) informa-tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form .
(12/82) This Form (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017
FORM NIS-2 (Back)
~~9. Remarks ---=CL,A=c...'-5"'--'::>__"T ____W_D_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __~~
Applicable Manufacturer's Data Reports to be attached CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this j2e:PP1'2- conforms to the rules of the ASME Code, Section XI. repair or replacement Type Code Symbol Stamp __N_/_A _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ Certificate of Authorization No __N_/_A_ _ _ _ _ _ _ _ _ _ _ _ _ Expiration Date _ _N_/_A _ _ _ _ _ _ _ _ _ _ _ __ Signed v~fii~ 1'&,;,ne(or Owner's oeiignee, Title X'SI° CERTIFICATE OF INSERVICE INSPECTION Date-~~""'--.:...'-~!.....~ - - - - , I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State 19 91 or Province of Virginia and employed by HSBI&I Co* of fl et t' I fe, ed. J cf, have inspected the components described in this. Owner's Report.during the-period 5"-/-90 .to £-{C,- 99 , and state that to the best of my-knowledge and belief, the Owner .has performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section XI. By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this
~~'"'"'"' "* ~ f &LL Commissions_....,v.,..A....,.._5_4.,...3_ _ _ _ _ _ _ _ _ _ _ _ _ _ __~~
~~Inspector's Signature National Board, State, Province, and Endorsements~~
~~'oate_ _ _ ....,f. . .*--=-{)__7_19 q /~~
1. Owner FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI Virginia Electric and Power Co, Nam*
~~5000 Dominion Blvd., Glen Allen, VA Sheet _ _ _ l___ of _ _ _l__________ Addr- 23060~~
~~2. Plant Surry Power Station Unit _ ____......__ _ _ _ _ _ _ _ _ _ _ _ __~~
Nam* P.O. Box 315, Surry, VA 23883 Sri'b No 3 B00 ll?,e:i '1 ~ @t?+/-: 'I 1-RaJ>a1, Organization P.O. No., Job No., ate.
~~,~s-~~
~~3. Work Performed by __V_1._*r__....g_i_n__i__a_P_o_w_e. r. ._______ Type Code Symbol Stamp .-N...,,~(aA_~~
Name Authorization No. _ _ __.N~/..a.F\.,_________ P.O. Box 315 2 Surry, VA 23883 Expiration Date _ _ _ _....N..,_l..,.A...________ 1 Add,-
4. Identification of System _ _.._l'f)-"""a ....'.,_,o~_S...,,c\:_,_,_e.,.LA~/1()\\.....___________________________

5. (al Applicable Construction Code B3 l
~~1 19§.Z__ Edition, _N_/;...A""-_ _ _ Addenda, N-1 , N- 7 Code Case (bl Applicable Edition of Section XI Utilized for Aepain or Repiaee,nents 1980W80~~
~~6. Identification of Components Repaired or Replaced and Replacement Components~~
~~Name of Component Name of Manufacturer Manufacturer Serial No.~~
~~National Board No. Other Identification Year Built Repaired, Repleced, ASME Code Stamped (YN or Replacement or Nol~~
])\5 c.. rn um- l<oERT-11\l 6 ONKl\l0(0N ! N/A .2.-l'\S-R11-io1B ON ICl'IOl>lll R.fi'l.PICI: ~ ~o ~~T&IVI.P.. Wi~ fO~
~~SS')'~~
~~"J)\SL ISCHUm.tJWERTll--'.lllt 1001-\-~ I N/A 33~8~-+ 1'\'1 I Ri:\"I.Pia:MtNT ~o i~~
~~I I~~
8. Tests Conducted: Hydrostatic O Pneumatic O Nominal Operating Pressure 0 Other O Pressure _ _ _ _ _ psi Test Temp. _ _ _ _ _* F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1 l size is 8% in. x 11 in., (2) Informa-tion in items 1 through 6 on this repon is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form .
* (12/821 This Form (E00030l mev be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017
~~. FORM NIS-2 (Qack)~~
~~9. Remarks -.s.A1..<S.=1.&==---'C""':.Pu.P,.,,..,,-=._....C....J,..l't';,......,...,g_ _,_&=----------------------------~~
App1icable Manuf11cturer'1 Data Repora to be attached CERTIFICATE OF COMPLIANCE - We certify that the statements made in the report are correct and this l?f[PfW: l~onforms to the rules of the ASME Code, Section XI. repair or rap1acament Type Code Symbol Stamp __ N.;../_A_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ Certificate of Authorization No __N....;../_A____________ Expiration Date _ _N-'/_A..;..___________ Signed l/VYl ~:n c I.S-t; &./6 IAJFJe_
~~/)f..,;,t.r or Ownar's DHlgnN, Title orProvinceof Virginia CERTIFICATE OF INSERVICE INSPECTION Date _ __._a. . 43-.:;;.;-_*___,e{a..o-=O........_ _, 19 9/~~
1, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State andemployedby HSBI&I Co. of T...... _ _ _ _ _ _ _ _tl,.....,a.""'"r... B.::o""'r-'d=-..,*~CT;,.__.,..,,*______-=,.....,=-=-------,have ins;iected the components described in this Owner's Report during _the pe~od _ _ _ _ _ ___,,.s..,-;...-_,_/_-_9._o=--tO S-/O -9'1 * . and state thet to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section XI. By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be li~ble *in any manner for any personal. ia:iiurv or property damage or a loss cit any kind arising from or connected with this inspection.. ~ /t). 11 ___._._.,._~~:;..* ""'7---"-::-=-_.f=:.:"---~"""'"- -a..;=-"-----Commissions __V_A _ _;;5_4_3'----------------- 1napactor'1 Sl11natura National Boarel, State, Province, anel Endorsements
~~,Oate*_ _ _ _.... 5?__-~~--7____.19 q /~~
~~FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI~~
1. Owner Virginia Electric and Power co, Date Avc-uST 20 1 l q 'l I Nama 5000 Dominion Blvd., Glen Allen, VA Sheet _ _..,1..__of _ _ _l ___________
~~Addrw 23060~~
~~2. Plant~~
~~Surry Power Station Unit _ _-=......- - - - - - - - - - - - -~~
~~Nama it P.O. Box 315, Surry, VA 23883 :5:obRepairNoOrganization 38Q/@ll:l.S:39 RQ 'f<-13..f P.O. No., Job No., ate.~~
~~3. Wortc Perfonned t,y_...;V..aia..ar"-'g*1.;;;;.*n=i_a~P...o::-cw'""'e""'r;.. . ______ Type Code Symbol Stamp NIA~~
~~Nama Authorization No. _ _ __.N .. ,.,..,w&-------~~
~~P.O. Box 315, Surry, VA 23883 Expiration Date _ _ _ _...,"1~/...A...________ Addraa~~
4. Identification of System,.. _____ dta-.......1...~...._--(~f-...ea_=n2--~-------------------------

5. (a) Applicable Construction Code B3 l. 1 19§1__ Edition,_N_/__A _ _ _ _ Addenda, N-1, N- 7 Codi Casa
~~.... (bl Applicable Edition of Section XI Utilized for Repairs or Replaceimmts 1980W80~~
6. Identification of Components Repaired or Replaced and Replacement Components ASME Codi National Repaired, Stamped Name of Component Name of Manufacturer Manufacturer Serial No.
~~I Board No. Other Identification Year Built Replaced, or Replacement or Nol (VII~~
~~- I -Pl~ c..- 5 C,(-1()7( C, &, /! lcRTJ/llf:,.;~~
~~VIV k./l)t7W/v ! N/A 2.-ms-lt v- 2~1,9 ONJ</lJPltJA. P.k:l'lACI:: [".', ~o ftJ/1171£' 3:, $0 ,# P<'..# ss-y~~
~~'J;>IV. °"j;:)I 5 C- /".O'i/l.1i NI, e,o'f2....CJ 2.0 I N/A 3'.3ST57-~ /?J; RI:\" I.Acl:M'f NT ~o I~~
I
*a. Tests Conducted: Hydrostatic O Pneumatic O Nominal Operating Pressura 0 OtherQ Pressure ______ psi TestTemp. _ _ _ _ _°F I.
NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1 I size is 8% in. x 11 in., 121 informa-tion in items 1 through 6 on this report is included on each sheet, and (31 each sheet Is numbered and the number of sheets i1 recorded at the top of this form. (12/821 This Form (E000301 may be obtained from the Order Dept., ASME, 345 E. 47th St., New Yortc, N.Y. 10017
FORM NIS-2 (Backl
~~9. Remarks -.....-'~:.....:..;;....:.I\A,lc.-="----Qo=-::=iE-=--C._,.1...,4=>i:,;....:=S,__2-Applicable Manufacturer, Data Aeporu to be attached l -:-* ,.: _~~
_* _ _ . CERTIFICATE OF COMPLIANCE*- * * * - --- - We cenify that the statements made in the re~on are correct and this ASME Code, Section XI. f!tmrz-/~
~~~epa1r or rei:uacement conforms to the rules of the Type Code Symbol Stamp __N_/_A _ _ _ _ _ _ _ _ _ _ _ _ _- - - - - - - - - - - - - - - - - - - - - - - - -~~
~~Cenificate of Authorization No __N __/_A_ _ _ _ _ _ _ _ _ _ _ _ Expiration Date _ _N...;./_A _ _ _ _ _ _ _ _ _ _ __ Signed fknL_~~
~~,&!,;{, or Owner, Oesignn, Title ;rProvinceof Virginia J -xsr;.~~
CERTIFICATE OF INSERVICE INSPECTION Date---4c,,---=..,........._ ....,;?,~o~--, 19 I the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State andemployedby HSBI&I Co.
?I of /.la..,. J ! fo'"' J Cf, have _inspected the components described in this Owner's Repon during the period £-(- C/O to 5 ... ID - 9'f , and state that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's .Repon_in accordance with the requirements of the ASME Code, Section XI.
By signing this cenificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations a11d corrective measures described in this Owner's Report. Funhermore, neither the Inspector nor his IIITIJ)loyar shall be li~ble 'in any manner for any personal injury or propeny damage or a loss of any kind arising from or connected with this inspection. _ . _*_ _ _ ~
~~- -.th..c..o.....-'-~~'!"£. .,_-'~~-------Commissions-'--V_A_5_4_3_ _ _ _ _ _ _ _ _ _ _ _ __~~
~~I napector's Signature National Boara, State, Province, and Endorsements Date_ _ _ _ ...;:t:;..__,-:J..._]-'--_19 Cf/~~
~~FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI~~
~~1. Owner Virginia Electric and Power Co.~~
Nam* 5000 Dominion Blvd., Glen Allen, VA Addrea 23060 Unit _ ___....__ _ _ _ _ _ _ _ _ _ _ _ __
2. Plant Surry Power Station Name P.O. Box 315, Surrv, VA 23883 1ob No 3S(b(')0536~C. (?e.:tlc"if~f2"1 AddrllSI Rei:,elr Organiz11ti~i, P.O. No., Job No., etc.

3. Work Performed by __V;.. 1.;:;.*r=.....ig..;;:ic.:cn;..;;i;..;;a;....;P;_o;;..wc;...;;:;e..;;:r_ _ _ _ _ __ Type Code Symbol Stamp _N&&.o</...A"---
N11ma Authorization No. _ _ _.....uN1.-t/uf:l:1-_ _ _ _ _ __ P.O. Box 315 2 Surrv, VA 23883 Expiration Date _ _ _ __.N...-,./...Bl--------- Addrea
4. Identification of System _ __,$.,,::E,..,\:l.."'..,.V_..IC...:frw:..._,1..,t,}"-1.A._~ .......B-...::,.._ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __

5. (a) Applicable Construction Code B31. l 19~Edition,_N-'-/_A_ _ _ _ Addenda, N-1, N-7 Code Case (bl Applicable Edition of Section XI Utilized for Repairs or Replacements 1980W80

6. Identification of Components Repaired or Replaced and Replacement Components
~~Name of Component Name of Manufacturer Manufacturer Serial No. I I~~
~~National Board No. Other Identification Year Built Repainid, Replaced, ASME or Replacement or Nol Coda Stamped (Yes b" IM~ I~~
=t\\' ; I i-s.w ~s-1~ IIJ lllW.tlOlllN I ~ R.ot,5 ial)R.N 5b0 I N/A P.t. p l.J\Cl:b ts\O I
~~i ,, ISl-ll>"-K\)T I U~lfl\lf)~N I N/A f'O "* c.sy I~~
~~~o R.ot,S S\J PPL)' CO"-.f', '31-\4°\ 1':f--1 ) 19 41 \\'cP~c!.\T i~~
~~5{' NllTS L>N't<~ I VN"\<..NOU,,-J I I N/A ~-sw-s-2..~ 1/N\(~t,I P.!:Ht\~l:I NO~~
,, l'r P(;', ~',l~ffl\l~I . \,\'\":.\\ Po~ l'i,y NVTS :IL ) :I:~. RN 11-(::. ').. I N/A J;.Lf O ::(-b"i;-) . lq°' l ~Pl.hC'E:1'111:.NT NO 11
7. Description of Work _ __,R.,""'e"""'~.J.:\a,.,,..,cep,\-~__;C.~%~)..::...............:~-'Kl..._ -....JJ'J)l..:I.UdA..;:$.___:&,~_Y)M;~...i.T...;;';i~c...::i_::::"):..1--_ _ _ _ _ _ _ _ __

8. Tests Conducted: Hydrostatic D Pneumatic O Nominal Operating Pressure W--
Other D Pressure _ _ _ _ _ psi Test Temp. _ _ _ _ _* F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided 11) size is BY.. in. x 11 in., (21 lnforma-tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form . (12/82) This Form (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017
FORM NIS-2 (Backl
~~9. Remarks f}:? tJ\ E...~~
APPiicabie Manuracturar's Data Reports to be attacned CERTIFICATE OF COMPLIANCE We certify that the statements made in the reoort are correct and this :l?eP/AG e Me IT conforms to the rules of the repair or reo1acamen't ASME Code, Section XI. Type Code Symbol Stamp __N_/_A ____________________________________ Certificate of Authorization No. _N_/_A_____________ Expiration Date _ _N_/_A_____________ Signed 7 l4a~ :;r;:sI wner or Owner's Designee, Title b,JmtA/ffFL CERTIFICATE OF INSERVICE INSPECTION
~~/1 Date---,µ<.!,.-~""~--'==----.~~
1. the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel lnsoectors and the State orProvinceof Virginia andemployedby HSBI&I Co.
~~do 19/ 9 of~~
--------.Lf(.-'-"4~r~T,_,_6-=o'-r-'--"J'--J)'-'Cc......Lf-'-.- - - - - - - : : - - - = - - - - - h a v e insoected the components described in this Owner's Report during the period _ _ _ _ _ _ __.,y.,_-_.(_-_,'f_o ___ to _ _:5'..._-_/.....,D:.....-_9-'-'/.,______, and state that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section XI.
By signing this certificate neither the Inspector nor his employer makes any warrantV, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor -his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this insoection. fl_ /0~
-----~f---!=:...U.:~""--~-:--::-!"J-_*___,~"""'-------Commissions __V_A__:5_4_3-'---------------- ~Signature National Bonra. Stat*, Province, and Endorsements Date f-ct:7 19_q........, _
1. Owner FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI Viuinia Electric and Power. Co, Date_,../Ju'""'""m"-"",2""0-;.,,_.l_'l._9~,,-I_ _ _ _ _ _ __
Name 5000 Dominion Blvd., Glen Allen, VA Shtet ____...l......_~of ___""l......_____________ Addr- 23060 Unit _____..;;;cfl _____________________
2. Plant Surry Power Station Name P.O. Box 315, Surry, VA 23883 Repelr Organization P.O. No ** Job No ** etc.

3. Wortc Performed by Virginia Power Typ1 Code Symbol Stamp H/ A Name Authorization No. _____...N..,,,_.1A ____________
~~P .'o. Box 315, Surry, VA 23883 Expiration Dtte _______.N~/.6.....____..,....____ Addrea~~
4. Identification of System _ _ __.R. . e....o.....c-:b-..,,.r:.___~(-OP~\-0,_x,,__-\-______________________________

5. (al Applicable Construction Code B31. l 19~Edition,_N ....../_A______ Addende, N-1, N-7 lb) Applicable Edition of Section XI Utilized for.Repain or Replacements 1980W80

6. Identification of Components Repaired or Replaced and Replacement Components
~~Name of Component Name of Manufactuntr Manufac:tuntr Serial No.~~
Natlonal Board No. Other Identification Year Built Repaired,*. Replaced, ASME Codi Stamped (VII or Replcement or Nol (?,ol'vNtl Vt.LAN IINl<.,N'OT.J,l N I N/A 2.-RC.-9 $' Ul.llUIOICII "t.PJ..Aab ~o
~~!~T!:;P,.'::>Tf\'Th '\,{i ~ PO~ SY~~
~~{?)ONt-:l°E-T ST£l: L SllPPLY co, ~l9 "tl.'8' I i N/A o9b°:f-3 l~'is'4 ~PU\CBl\!).\T *NO~~
')" ~\Pf: c.~~ U~~N0[1!)1\'.) or,.;1<.Y.::,etu...:i I N/A l -~C:'lS' IIN\t~ "1:~ 11\C!:b NO 2 PIPt C~?
~~fOHN \.\ tR\SUll<bP.l~~
;J"R.. >I~*
~~K,~ ~\O-'g3\b I N/Fl Po~ c.sy 1no ~~C'E:1'1\1:.tJT NO 3 I 02.13-3~~
7. Description of Work _ _ R-:e"'llr-'"-~Ce..=o\~--i'~...\"""o..,....t...f--O.....Ae,"""J.........-1"f-'-It"'f'""':_..,.c.,..pi.....f"f-+*1.........f:>>...0:~ad~....:*'---------

8. Tests Conducted: Hydrostatic O Pneumatic O Nominal Operating Pressure @---
Other O Pressure ______ psi Test Temp, °F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided 111 size is 8% In. x 11 in** (21 Informa-tion in items 1 through 6 on this repon is included on each sheet, and (3) each sheet Is numbered and the number of shNtS is recorded at the top of this form .
* (12/821 This Form (E000301 may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017
~~FORM NIS-2 (Backl~~
~~9. Remarks _._.....__:.NS..;..=:;...:.fl,\_£=----=Coce:==='--.._c-"",,b:';6.c;......__"'----------------------------~~
Applicebl\l Manufacturer's Data Reporu to be attached CERTIFICATE OF COMPLIANCE Wa certify that the statements made in the report are correct and this §;PLN:c.Me./JT conforms to the rules of the ASME Code, Section XI. repair or replacement Type Code Symbol Stamp __N...;../_A_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ Certificate of Authorization No._N....;../_A_ _ _ _ _ _ _ _ _ _ _ _ Expiration Date _....;;.N~/....;A"'------------- Signed ~ ~ (L .::r5T .G,/6tAIE/=l?- 1 ~ 0 w n e r ' s Deslgnn, Title or Province of Virginia Date--~ae:..,i,::;::i,....!..' CERTIFICATE OF INSERVICE INSPECTION _*.:::.1.:-1..--, 19 9(
1. the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State an!mployed by HSBI&I Co* of fl CA.rT rP ""4 Cf. have inspected the components described in thi~ Owner's Report during the period S::-/ - 9 D to . S:::- /0 - 94 , and state thet to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's _Report.in accordance with the requirements of the ASME Code, Section XI ..
By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable 'in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspection. . . . l 4- 17) /)
~~-*--*-*-~~=*=:u.~..;..;;;;:....-'-:-~f~*-~-e-~----Commissions __V_.;.;A;....;;5....;4.;..;;:.3_ _ _ _ _ _ _ _ _ _ _ _ _ __~~
~~lnapector'a Signature National Boara, State. Province, ana EnaorAment1 Date,_ _ _ _.... ~._-_.1:.__7"--_19 Cj f~~
~~FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI 1:2....~~
~
1. Owner Virginia Electric and Power Co, Date _....:St=...,u:ceL::...'<l....:al:trj.:..L..,~....!....lCf.!..'j..L.L.I_ _ _ _ _ __
Name 5000 Dominion Blvd., Glen Allen, VA Sheet _ __;i;;;..__of _ _-=i=---------- Address 23060
~~2. Plant Surry Power Station Unit _ _.....,,___ _ _ _ _ _ _ _ _ _ _ __~~
Name P.O. Box 315, Surry, VA 23883 Jc\, No "3~0(,,)j 09'f,l;'f, l<~""'fH.25" Addresa Repair Organization P.O. No., Job No., etc.
~~3. Work Perfonned by Virginia Power Type Code Symbol Stamp _ _--1:N~,t-LJ::A-i:.------~~
Name Authorization No. _ _ _ _ _-'-'N'4-l.x:.Bi...._ _ _ __ P.O. Box 315, Surry, VA 23883 Expiration Date _ _ _ _ _ _ _[\..,.1..,l.......:G1-._ _ __ Addresa I
~~4. Identification of System _ _ _C=.b:.,;g...m ........~~
~~,*ca.....,.\_....:::~:.........~~
~~V...ou.\,. 11,...xn.......,f~......:::Cs=n""'k..,.r""o.._\- - - - - - - - - - - - - - - - -~~
5. (al Applicable Construction Code B31. 1 19§1._ Edition,_N...;../:..;A;;.;;...._ _ _ Addenda, N-1 , N- 7 Coda Casa (bl Applicable Edition of Section XI Utilized for Repairs or Replacements 1980W80

6. Identification of Components Repaired or Replaced and Replacement Components
~~N*ame of Component Name of Manufacturer Manufacturer Serial No.~~
National Board No. Other Identification Year Built Repaired, Replaced, or Replacement or Nol ASME Code Stamped (Yes Nu.*\-s CRcS~Y .N/~ i-Q.\-~Y~')J - - l\~~\ll\.._e._c\ NO
~~\<.OR~F, Se>L"T HT~ po.,\!!~~
N\,lt; .Ill)t>, CO, LTl>, RR \:l.'l'x/~b N/R 3~~'i>1'(d 11 no R~\>\C\~~nt NO S-h~.cls N/A .2.~oH,Y-i"bi:;i.1, -- R(c.?\°'~J No (Q.~\M-1 ~. 1-\T-:\\ PO~ S-h.J..>/ ~J 'fr., 1. *:1'"':. !.nc, 80':l (,',-Ji.o N/Pt 3'.?tC>C\ b-.;t 1qqJ ~tq,\c...cem~ 'K\O
7. Description of Work_...w&.cet"p\ll<o.c~e~v:ouuf'~IQ.i..tl--..!,0.:...\11...---l.N.:.1..lh'.~t1.;$2.__~t:.._;ss,L+:UV!.Alci~s....;(1::--==5~/L8L::)::::....._ _ _ _ _ _ _ _ __

8. Tests Conducted: Hydrostatic D Pneumatic.O Nominal Operating Pressure D Other EJ Pressure N 6 -P psi Test Temp. A""el:ie.NJ: °F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1 I size is 8% in. x 11 in., (2) Informa-tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this fonn .
(12/821 This Form (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017
FORM NIS-2 (Back)
~~9. Remarks -~_,_A_S_IV\_E:..- __~Ce~D~i::-'-'-----"'C.=(.a--1'6...:..=c.:'5=-----L,---------------------~~
Applicable Manufacturer's Data Reports to be attached CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this ~~§-tJ'.:C: conforms to the rules of the ASME Code, Section XI. repair or replacement Type Code Symbol Stamp __N....:/_A _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ Certificate of Authorization No __N.....:../_A_____________ Expiration Date _ _N_/:....:c;A:.______________ Signed--,1;~'>,,..:t!&r}~~~a.==---------Date iD'o/n~r's Deslgnee, Title CERTIFICATE OF INSERVICE INSPECTION v
~~/{)A (j~~
~~I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State~~
~~, 19 9/~~
~~or Province of Virginia and employed by HSBI&I Co* of~~
--------Hf-..L'a.....c_:t'_,___,fi'---"e'"".,.._d=--il-c..........t ~ - - - - - - - - - - = - - - - - h a v e inspited the components described in this Owner's Report during 'the* period _ _ _ _ _ _ _q..._-.../_q,_-.....,8---C-,_to (o-('$ - Cf , and *state that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section XI.
By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective meas~res des.cribed in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspection.
~~-----.ll.~..=c.i.c...-'----:-7."l._.__,~z:::;..::c....:=*=----Commissions _ _ V_A__:5:....4..:...-=.3_ _ _ _ _ _ _ _ _ _ _ _ _ __~~
~~Inspector's Signature National Board, State, Province, and Endorsement* Date,_ _ _ _ _7---'--.-_/_~ __19 Cf/~~
~~FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI~~
1. Owner Vir~inia Electric and Power Co. Date _ _-:::r;-=-il"")L='[_.__-=2..c....l..f-'--j.1__,_1_q,_q...,__,_\- - - - - -
Name 5000 Dominion Blvd., Glen Allen, VA Sheet ~ of_~~---------- Address 23060
~~2. Plant Surry Power Station Unit----!~----------------~~
Name P.O. Box 315, Surry, VA 23883 .:ro'-2 No "3\S: o o lo 3 G, I{, 'Zf',#91-tJ..'-/- Address Repair Organization P.O. No., Job No., etc.
~~3. Work Perfom,ed by Virginia Power Type Code Symbol Stamp ____,N...,.._,f-/.,_fi"'-------~~
Name 1 Authorization No. _ _ _ _ _ _N.,__,,_1-/-1-A:i.._ _ _ __ P.O. Box 315, Surry, VA 23883 Expiration Date _______N'-"'-+l..,Aw.._____ J Address
4. Identification of System _ __,s~e....'f....F=-c:f1,-l.f'.-'1----=.:r:,::.,cN:e..J.......,;E-~(-I....i...:lL...1<C1..1.N.,.___ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __

5. (a) Applicable Construction Code B31.1 19§1._Edition,_N:..:..!./.::.A:.__ _ _ Addenda,N-l, N-7 Code Case (b) Applicable Edition of Section XI Utilized for Repairs or Replacements 1980W80

6. Identification of Components Repaired or Replaced and Replacement Components
~~Name of Component Name of Manufacturer Manufacturer Serial No.~~
National Board No. Other Identification Year Built Repaired, Replaced, ASME Code Stamped or Replacement or No) (Yes p, 2, G, B\!~1~$Jt,ll 1-\'1" ~ po-:\\ csy STL/b~ ;n: ~ (, 9 2.S ;l ~/Pr ~ ')..40C\\-, l49D IQ:1'~1 tJo [i:i..J [!2] \ 1
~~7. Description of Work_:?._.,8:a..P , =e~c~.EJ>~~-O"',,..sc~~
~~...... .....<"',]1--'l>,.,,l...\/c.:.l_,,S"--.,_IIM)"-=-lo.,__...C$=-..cTuDS.:....==---"(""'/L._y....L.....'_,.'J'-----------------~~
~~8. Tests Conducted: Hydrostatic O Pneumatic O Nominal Operating Pressure ~~~
Other O Pressure _ _ _ _ _ psi Test Temp. _ _ _ _ _ _°F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is 8% in. x 11 in., (2) informa-tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form . (12/82) This Form (E00030) may b~ obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017
FORM NIS-2 (Back)
~~9. Remarks -~~A1"'2:::JM'--'--"E:::=-__._C-"'n,.._,_D"-'e~__,Ll-fl""""'=.-SS=-__,________________________~~
Applicable Manufacturer's Data Reports to be attached CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this '.e.a:A::FMfnb:: conforms to the rules of the ASME Code, Section XI. repair or replacement Type Code Symbol Stamp __N_/_A __________________________________ Certificate of Authorization No. _N.....;.../_A_____________ Expiration Date _ _N""'/_A _____________ Signed t.lm~
~~~:..;;;I or Owner's Dbsignee, Title J::5T Date _~~
CERTIFICATE OF INSERVICE INSPECTION __,.~,;,:.:;..:.4-----=o?:;.,.....oz'.'.' -----, 19 t!l_J I, the undersigned,.holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State or Province of Virginia and employed by HSBI&I Co* of _ _ _ _ _ _ _...i.-,u,o,,L-.1~-"'-'--'-Yf,-',----'------------,---:r1:..-----~have inspected the components described
, - I 'fl _q I , and state that to the best of my knowledge and 'belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section XI.
By signing this certificate neither the l_nspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspection. ~ J>_ t:) (\
~~----'Qµ~~F------~-:-:-Inspector's Signature '--~-------Commissions __V_A_5_4_3 ________________~~
~~National Board, State, Province, and Endorsements Date_ _ _ _ _7_,__-~j.~~~-19 q,/~~
~~~-----~~~
~~FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI~~
1. ov,mer Virginia Electric and Power Co, Nam*
Date _ __,JL . . . .1.L,.'"'-'{----"2=t./_,_,._,..,_(...,_CJ_.Cf..1.I_ _ _ _ __ 5000.Dominion Blvd., Glen Allen, VA Sheet _ _ _,,l....__ of _ _-=,,..__ _ _ _ _ _ __ 23060
~~2. Plant Surrv Power Station Name Unit _ _ .m,,---------------~~
~~P.O. Box 315, Surrv, VA 23883 Aapalr Organization P.O. No., Job No., ate.~~
~~3. Work Performed by Virginia Power Type Code Symbol Stamp __.N~/""A._________~~
Nam* Authorization No. ----1.llN.,i/uA:i._________ P.O. Box 315, Surrv, VA 23883 Expiration Date _ _ _ _...t:-l~/J;;;.BL-------- Addrea
4. Identification of System _ _.... s~e...E_f-.__,.!.-.1'(_ _.:r..o=.~=-.:::S:.......R.c:..T....._\'"'O=.:.N.=._____________________

s. (al Applicable Construction Code B31. l i9~Edition,_N_,.;../...;A~___ Addenda, N-1, N-7 (bl Applicable Edition of Section XI Utilized for Repairs or Replacements 1980W80

6. Identification of Components Repaired or Replaced and Replacement Components
~~I I~~
Name of Component I Name of Manufacturer I I Manufacturer I Serial No. I i I National Board No. Other Identif.ication Year Built Repaired, Repl acec:I, or Replacement or Nol ASME Code Stame>ed (Yes i I I I "1:, \ Sc... I Vl\:l~o-z.ur.J i Uf\lkl\)owr,l i N/F\ J.. - ~:r.-~, IV llll\MOll.lN ~ p l..f'ICl: b I ~o I I"El.fi-ls) 1->.lt.~ 6-~ I PO~ ~>'
~~)) \c;.c.. V 1\-)..V'l:-~~
c..o l,\.f' t&10'fo.oo3-<!> ra) I N/A o,si:i.-/ I 11 r't ~PU>iCstl'E:~i NO I UNKl\lCrt.aH.l I; N/A
~~' l'-1 VTS I II f\l k_N ~ I\)~~
~~I l-SI-~'-\-\ lu~K"1Cla:IN P.cf) LI\ Cl:b NO~~
! I C~Rt,IN'ffi. l:Nb I\-1.f ~ f>o~ cs.y ' Nll'TS I ?R.obl/CTs INc. e..'l-rl-'.2..9 i N/A. 1-'1 s '.l..CtS -3 I \~'(;~ .P.i:P.IJK'E:1'1\\:.1'11' NO N/ 'A .l.-~:\:. -1.~'
I STUt)~ ON'1~:N-et,0~ I IJN~~ow-N t1Nkt,;Jo10oll Ra'LA<:t-!:> !\so [iz] [!;z] 1
~~7. Description of Work _ _ _~\s.,...e ~ll"\"'"c,.,.c..i;:~J4...._.,.J~,i.;:Su.,_ J --1J\'44:.:l....l+/-s..:5-:a1-_-.:&,~___:sl.::\:l...wl1b:"'J~s.-{wl.::14:t,.'....~~
~~1 7 1~~
~~')!.-__________~~
~~8. Tests Conducted: Hydrostatic O Pneumatic O Nominal Operating Pressure ~~~
Other CJ Pressure _ _ _ _ _ psi Test Temp. °F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided '1 I size is 8% in. x 11 in., (21 infomia-tion in items 1 through 6 on this repon is included on each sheet, and (3) each sheet is numbered and the number of sheeu is recorded at the top of this form . (12/821 This Form (E000301 mav be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017
~~9. Remarks _ _~~
~~FORM NIS-2 (Back)~~
~~,_f}'-S-'-m-'E=-_{;_O'-D"-=E__.._C.=?A'-'-*.,...7....-S~_.....I"-__________________~~
Acclicac111 Manuracturar's Data Reports to ca attacnaa CERTIFICATE OF COMPLIANCE We cert1tv mat tne statements made in tne reoort are correct ana this ?f:e4\C:E-Me.,.rf conforms to the rules of the reca,r er rec1acamenY ASME Code. Section XI. NIA Tvoe Code Symbol S t a m D - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Certificate of Authorization No. _N_/_A_____________ Expiration Date --~-/~A____________ i/~ ~ _,.~.,.,.,.=+--',a""""""f'-----* 19 r( Signed 1 +SI GtGt11/,f;a- Date _ _ 1')1;;,;ar or Owners Designee, Title CERTIFICATE OF INSERVJCE INSPECTION 1, the undersigned, holding a valid commission issued by the National Board of Boiler ana Pressure Vessel Inspectors and the State orProvinceof Virginia andemo1oyedby HSBI&I Co. of _ _ _ _ _ _ _ _...ldu..a.;.;;...r_f..:.....,M)....:...:.t"_,d=-+J..,,c=-i+/-c..*-------=---~-=-----.have i nsoecteO the components describeO in this Owner's Aeoort during the oeriod ________q...._-~/-q~--8".~CJ ......_,o_....:c~-*-'-(""g_-_q......,.*(_ _ _ _ _ _ , and statll that to the best of my knowledge ana belief, the Owner nas pertormea examinations and taken corrective measures described in this Owner's Report in accordance with the reauirements of the ASME Code, Section XI. By signing this certificate neither the Inspector nor his employer makes any warranrv, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, nenher the Jnsoector nor his employer shall be liable in anv manner for any personal injury or property damage or a Joss of any kind arising from or connected with this inspection. fl-I-. ~~ ____a.it---'...~--:-'._-'-::--::--:/::-*--~-=""""'------Commissions __V_A_5_4_3________________ I n1Qac:tor'1 Signature National Boara, State, Province, and Endor11ament1 Date 7- cl: s- 19,_q~'-
~~FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI~~
~~1. Owner Virginia Electric and Power Co.~~
~~Name 5000 Dominion Blvd., Glen Allen, VA Address 23060~~
~~2. Plant Surry Power Station Unit _ _ _ _.2..._______________~~
Name P.O. Box 315, Surry, VA 23883 Job l\'lo :S ~ ~ () e) 8 '6 '1 £2...P... '.f:P' qi- /).,3 Address Repair Organization P.O. No., Job No., ate.
~~3. Work Performed by Virginia Power Type Code Symbol Stamp _ _ __,._N=-,...1.._A_.__ _ _ __~~
Name Authorization No. _ _ _ _ _ ____.N~I...B:_.___ _ _ __ P.O. Box 315, Surry, VA 23883 Expiration Date _ _ _ _ _ _ _'N._:>L'.,._/..,A'"-'------ Address 7
~~4. Identification of System _ _ s__a. EE~:r~~
~~. .......'f_~:t=N~-.:r...1::=-...c~:::r. . . .1~0~(\,~f_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __~~
5. (a) Applicable Construction Code B31. l 19§.l___Edition,_N~/_A_ _ _ _ Addenda, N-1, N-7 Code Case (b) Applicable Edition of Section XI Utilized for Repairs or Replacements 1980W80

6. Identification of Components Repaired or Replaced and Replacement Components
~~Name of Component Name of Manufacturer Manufacturer Serial No.~~
National Board No, Other Identification Year Built Repaired, Replaced, or Replacement or No) ASME Code Stamped (Yes 1:>l 5 c.. (/ N I< N"O""W"N 1- %l-o-tt N/A J. -$1:-14 01\lKl\!Oall\l R\;\'.'Lf\ CE'-D No VE~N \/fT\Xl:: I',\\(.<\\ c;-~ N/A po &Y No
~~):)l ~c.. ~ ti;i.b'l,-M,._.., 17,' 0'1.l:.'-62.-1 \'\t~ ~L_A-lc{Y\~~~
~~7. Description of Work _ _ ~~~'t:-1'21'"\+'p~,ce-.J.,_~~
~~.. ...J""'\,._5..,_c..__ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __~~
8. Tests Conducted: Hydrostatic O Pneumatic D Nominal Operating Pressure W Other O Pressure _ _ _ _ _ psi Test Temp, _ _ _ _ _ _° F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is BY. in. x 11 in., (2) informa-tion in items 1 through 6 on this repon is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form .
(12/82) This Form (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017
FORM NIS-2 (Back)
~~9. Remarks _ M &=--------'-c..../§)£==-----'Ce'"""'""-frS""'-'=5--'-/_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __~~
___,/ls'-'--!:'--'.......... Applicable Manufacturer's Data Reports to be attached CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this f?a>LA(f;,MEN'.[ conforms to the rules of the ASME Code, Section XI. r~pair or replacement Type Code Symbol Stamp __N_/_A __________________________________ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Expiration Date _ _N_/_A_____________ CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State or Province of Virginia and employed by HSBI&I Co* of Ho..-\ Fe. ..--d, ct. have inspected the components described in this Owner's Report during the period 9- f9-ff9 to b -( 8- (( f , and state that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section XI. By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this i_n_s_p-ec-t-io_n_._\i+-'~ 3
~~.....~l-n-=-sp-e_c_t'""o-:r'-s-=s7ig""'!'-a-:-u""r~='-Jk.~~----Commissions __N_V_!-i-o-~-!--B-o-ar-d-,-S-t-a-te-,-P-r-o-v-in-c-e-,-a-nd_E_n_d_o_r_se_m_e-nt_s__~~
~~Date _ _ _ _ _ 7.L..---=j'--"5--_19 q-f~~
~~FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI~~
1. Owner Virginia Electric and Power Co, Date -::I( lbY'. (5,I 1qq1 Nam*
5000 Dominion Blvd., Glen Allen, VA Sheet _ _...,!.___ of _ _...:l=---------- Addrea 23060
~~2. Plant Surry Power Station Unit .,----<Z'-------------'---~~
Name P.O. Box 315, Surry, VA 23883 :5ak No, 3'MZ>0@'6'6:<is:60 :Re~q\-1:2..z. Addrea Repair Organization P.O. No., Job No., ate.
3. Work Performed by Virginia Power Type Code Symbol Stamp N / A Neme Authorization No. _ _ _ _NU-t/~Ps:1..-_______
~~P.O. Box 315, Surry, VA 23883 Expiration Date _ _ _ __.N>>+/.L..f\L-.------- Addrea~~
4. Identification of System ---=S;.:.l:)...,F..,!::.._T.!..4-Y-=.I...,l\J.,::.,.:SwE=C'-'T..,\....,()::...1'0:.=._ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __

5. (a) Applicable Construction Code B3 l. 1 19§2__ Edition, __ N..;./_A____ Addenda, N-1, N- 7 Code Case (b) Applicable Edition of Section XI Utilized for Repairs or Replacements 1980W80

6. Identification of Components Repaired or Replaced and Replacement Components
~~Name of Component Name of Manufacturer l~~
~~I: Manufacturer i I I Serial No. I I National Board No. Other Identification Year Built Repaired, Replaced, or Rei,lacement or Nol ASME Code Stamped (Yes I~~
~~~oLTS VN'l\1-:>~N j \J~'t::.NOWN ! N/A .:i.-SI- .1"39 IUllll\111011:lN ~PIJKJ:l:> ~o I~~
I f\lb~ Bilr,JI\J$Jtc>g 1 1-\T -a\\ C..krl PO~ C.S'j N/A ~~ lJ'IC.El'I\E;).\j NO 1i,ci L"T~ Jt. - :u...:ic.. I
~~" ~ .'.l6 '.l. I -:Slio'l H 11~90 i~~
(\Jl}'f"., l/l\JKNl5WN i I lJ~~NOWN I I N/A l-ST..-2."3'\ Ill!ll\(\10,:,t,I P.I:Ht\c.t;l:I NO lS)' NlJ",~ tveJVf\ PP.bb\kr~ N\~i~E. Ct>!U> II \.\,.00q3,l3
~~"\I i I N/A.~~
~~f>o -;\!I "311 I :2.1:,:i- ~ ;:).. ~q~i ~PJ.fKE:l'l\~NT NO I~~
~~7. Description of Work _ _.......R~~
\ ll(I"***) \ ....= c\""..,.___....,_r...1:i......:').........,N'"""""'""'""s'--_ _,_,,en.___(1,..\1.,'2::.a).L....--1b.l.!o~\u:r..;S~-~-~*..!,'....:.------- .=..e,'t'~-"Q,C.f' _l O
~~8. Tests Conducted: Hydrostatic O Pneumatic 0 Nominal Operating Pressure G3"'~~
Other O Pressure /'(Op psi Test Temp. /}:1>181&,a: °F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is 8% in. x 11 in., (21 informa-tion in items 1 through 6 on this report is included on each sheet, and (31 each sheet is numbered and the number of sheetS is recorded at the top of this form . (12/821 This Form (E000301 may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017
FORM NIS-2 (Back)
~~9. Remarks ----i/Jw.-2=flll'-"£"""-__._C...,n=Dc...E:..=-__..C~LA:2~6~__/_______________________~~
APPiicabie Manufacturer's Data Reports to t>e attached CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this f?r::P~/l,<£NI conforms to the rules of the repair or rec1acement ASME Code, Section XI. Type Code Symbol Stamp __N_/_A ____________________________________ Certificate of Authorization No. _N_/_A_____________ Expiration Date _ _N_/_A_____________ or Province of Virginia CERTIFICATE OF INSERVICE INSPECTION 1, the undersigned, holding a val id commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State and employed by HSBI&I Co* of _______,.f/..-L.Ca.~i,.~7'......f~o~r-d_-i)rc~*~t-------------:---=::;:::----:-have inspected the components described in this Owner's Report during the period q- /'{- .a, tO--='~~-----'"-'{s"'-~---"q_(______ , and state that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section XL By signing this certificate neither, the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspection.
--.lf-D....~~=-:---':-:--::~i'-:::*.::-:~~-=------Commissions_V_A_54_3_ _ _ _ _ _ _ _ __ \{L~,::;Sig~ National Boero. State, Province, and Endorsement*
~~Date_ _ _ _ _ 7~--/_b __l9 1/~~
~~FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI~~
1. Owvner Virginia Electric and Power Co, Date --~=*::...*=U=LY_,___.I.... B~,_\._'1...,__,q'--~~-----
~~Nam* 5000 Dominion Blvd., Glen Allen. VA Sheet _ _..,.l'-_ot _ _""'l"---------- Addrea~~
~~23060~~
~~2. Plam Surrv Power Station Name Unit _ _ _ -=-------------~~
P.O. Box 315, Surrv, VA 23883 :1ok No 3%0 0 ( 1 1C S .2. ?@il;g H;U Addraa Raoalr Organization P.O. No., Job No., ate.
~~3. Work Performed by_...,;V...:i::.ar:...i;ga,.;1.;;;.;*n=i.;;;;a....:;.P..;:;o...;.;w""e:..;;r'-------- Type Code Symbol Stamp _N,_/..,.A.________~~
Nam* Authorization No. ---..JN'..:£.f/..i:1:\1....-_______ P.O. Box 315, Surrv, VA 23883 Expiration Oate _ _ _ _...,N...,/'-"A..,__ _ _ _ _ __ Addl'flS
~~4. Identification ot svstem --Rl,,>,'-c:...c...1.1.lR,...C-l\""'J.L..cP.::.i."t"~)..1.:~:::...,.4+-........~~
~~s...,e....R,µ,.J.&""'-'Y:.-.. _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __~~
s. (al Applicable Construction Code B3 l. 1 19§.Z_Edition,_N;....;_/A-'--_ _ _ Addenda, N-1, N-7 (bl Applicable Edition of Section XI Utilized for Repairs or Replacements 1980W80

6. Identification of Components Repaired or Replaced and Replacement Components
~~I I~~
Name of Component I Name of Manufacturer I Manufacturer I Serial No. I I National Board No. Other Identification I Year Built Repaired, Replaced, or Reolecementl or Nol ASME Code Stamped I (Yes I I I I I I I NViS ! Vl\:l l<:."1 tjt,J i Vl\l~C,-WtJ I N/f\ l--Ri -I; - .1 c ! U1111\tlClllll ~PL.f'IC&b i I
~~--\0 I~~
~~. (~Rt>INP,-2. ::tm>I \.11" ~ i *po~~~
~~l\cP U\C8'ti'f:).\, I~~
~~~UT5 I t'~l::\1/.q"S ~(. C2. 't ~ ~°l i N/A I ~lA-'l.-fu1'.l,-2-l i q iCf f\:JO~~
~~~TVl::>5 I~~
! UN"Khl O'W1\l I .lJNKN,~N Ii N/A l.-RS -i;; - i.e.. \11~1{~:* ,~, P-c~ 1.1\CEb NO ! I !\)OVA Vl\~I~'& I \-lT""t/LOT~ i /Fl.
f>o~ STUt)s I PP-.oblX,T<:. to~P. :;:s -s '3":1-ooq I N 3'+ )15"~-'J I 1991 ~PUK1::1'\~t-rr NO i I
~~7. Description of Work _ _.,R"'""'t'~..... , a,....c;e,. .J~. -__._c.:::2...a..G<..,;)....:~~
~~.... 1~~
~~_..,:b.:,:0::..1.\:t....i.....:,,&....,_,__i.,:&.:,...._....;(~':IJ...,;1::i:=,.)....,L_...[b:U\A;b;:\::3;_:...:.:S:i..._~(-11_;: 0!.. ,'.'.1. .)_ _ __~~
a. Tests Conducted: Hydrostatic O Pneumatic~ Nominal Operating Pressure 0 Other O Pressure 45 psi Test Temp. llmBJt£C *F NOTE: Supplememal sheets in form of lists, sketches, or drawings mav be used, provided (1) size is 8% in. x 11 in., (21 informa-tion in items 1 through 6 on this repon is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form .
(12/821 This Form (E000301 mav be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017
FORM NIS-2 (Backl
~~9. RemarKs _J.-A.JJ.~e:::..!..:.M~/£'==-~C..../)..,_,l)..._£"-=-....Jcb-'{..LA:1...$....6 . . . . , _ . . . . . , 3 = - - - - - - - - - - - - - - - - - - - - - - -~~
Acclicaole Manuracturer's Data Reports to oe anacneo CERTIFICATE OF COMPLIANCE We certifv that the statements made in me reoort are correct .ana this ~Pt,AQ!;M&rT"'conforms to the rules of the ASME Code, Section x I. repair or reo1acament Type Code Symbol Stamp _ _ NIA ;_;:;;...__ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ Certificate of Authorization No. _N_/_A_____________ Expiration Date _ __;N,;../;..;.:A;..._____________
~~~b,,,.£1,,r.~~
s;,oed l=A,/611\ tEE-& !8 '19 9( CERTIFICATE OF INSERVICE INSPECTION I the undersigned, holding a valid commission issued by the National Board of Boiler ana Pressure Vessel Inspectors and the State
~rProvinceof Vir inia andemp1oyedby HSBI&I Co. of --------L...i~a=i-._T..l.....1....1..u.....:::::.....+-.w:::....1._ _ _ _ _ _-=---=------,. have inscectea the components describea in this Owner's Reoort during the oeriod _ _ _ _ _ _ _ q~~-fCf.._*__.?f......,_to,_..£,._-_/,._8'.._-_9L-'-_______ / , and state that to the best of my knowledge ana belief, the Owner nas Periarmea examinations and taken corrective measures described in this Owner's Report in accordance with the reauirements of the ASME Code, Section XI.
By signing this certificate neither the Inspector nor his employer makes any wa"antV, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inSDection. _/)* ~ 1
----~-Id--'-----'----~~* _ ......_
~~_,~ --Commissions __V_:..;A~5;_4,;..3~---------------~~
~gnature Netion111 Boera. State, Province, and Endor1ement1 Date,_ _ _ _ _j..__-_.._f_.q__ ,g tf/
~~FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI~~
1. Owner Virginia Electric and Power Co, Name 5000 Dominion Blvd., Glen Allen, VA Sheet_--=i=---- of _ __;:t:,..._ _ _ _ _ _ _ _ __
~~Address 23060~~
~~2. Plant Surry Power Station Unit---=~---------------~~
Name P.O. Box 315, Surry, VA 23883 "Jo'o ~o 3Se01e:is05l-ge..~1-1m Address Repair Organization P.O. No., Job No., etc.
~~3. Werle Performed by Virginia Power Type Code Symbol Stamp _ __,_N.::..+/-'ALL_____~~
Name Authorization No. _ _ _ _ _....(\)=-t/<....1..&.1-._ _ _ __ P.O. Box 315, Surry, VA 23883 Expiration Date _ _ _ _ _ _J..CN"'-,[.>....La!.....__ _ _ __ Address
4. Identification of System _--'£=.uA:....f__,_,l:;~T,._'(....__'):J\-.,..)...,Tc.aE:'"'""=CT,.......1~Au..>.;N,,,__ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __

5. (al Applicable Construction Code B3 l. 1 19§.L__ Edition,_N-'-/_A_ _ _ _ Addenda, N-1, N- 7 Code Case (bl Applicable Edition of Section XI Utilized for Repairs or Replacements 1980W80

6. Identification of Components Repaired or Replaced and Replacement Components
~~Name of Component Name of Manufacturer Manufacturer Serial No.~~
~~National Board No. Other Identification Year Built Repaired, Replaced, ASME Code Stamped or Replacement or Nol (Yes~~
~~t>, '3 C- Ve'LAN"" <;," ':\-~~t,- N/A .2.-SI.-1-~ 111\lKt-:lO(oN ~l'Lf-tQ::b NO~~
\l~~~\l YI,-}..\/~ }'\1\1'\', ~ pc :::::t-1 csy 'l::>l s c.- u,~~ b--C'SS N/A- 015", 2-1 l°I %Lt Rti'Ll'\C:l;M'i:NT No
7. Description of Work _ _R...,,_,,r..,.f,...IA~ce~J,.____.J,=~S..:.<-c......_____________________________

8. Tests Conducted: Hydrostatic O Pneumatic O Nominal Operating Pressure G:f Other O Pressure _ _ _ _ _ psi Test Temp. _ _ _ _ _ _° F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1 l size is 8% in. x 11 in., (2l informa-tion in items 1 through 6 on this report is included on each sheet, and (3l each sheet is numbered and the number of sheets is recorded at the top of this form .
(12/82l This Form (E00030l may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017
FORM NIS-2 (Back)
~~9. Remarks _ ___,._A6'-=-,_fV\.c.o,£-=-__,,_C,!>=oc=-__,.C_,£<1.-,::A::i:..""'......S_,____;__ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __~~
Applicable Manufacturer's Data Reports to be attached CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this ?,EP,JJ{E.('1f!+CC conforms to the rules of the ASME Code, Section XI. repair or replacement Type Code Symbol Stamp __N_/_A ____________________________________ Certificate of Authorization No. _N-'-/_A_____________ Expiration Date _ _N...;/_A _____________ Signed l~L 1'lfwtar or Owner's oe'signee, Title
~~---rsr &61/ttU?~~
CERTIFICATE OF INSERVICE INSPECTION Date _ _ _~()..,,,""'t:-d....;;~-..:.....L/<----, 19 (Y r1 I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State 91 or Province of Virginia and employed by HSBI&I Co* of
-------,ftf-+_a~r-t+-'.P......,o~r~cL~..)t-=c~t_*______---=_ _ _".:""""____ have insi:1ected the components described in this Owner's Report during the period 9- Jq-JPC/ to 6- 18
Cl/ . and state that to the best of my knowledge and belief, .the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section XI.
By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or impliP.d, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspection. ~.J)* ~
~~-----'~l--"--------sL~~-~-~~~~--Commissions _ _ V_A_5_4_3________________~~
~~Inspector's Signature National Board, State, Province, and Endorsements Date_ _ _ _ _ 7~-~d:~r~_19 q I~~
~~FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI~~
~~1. Owner Virginia Electric and Power Co, Date :WL'l" 24 l )Cj C\ \~~
~~Name 5000 Dominion Blvd., Glen Allen, VA Address 23060~~
~~2. Plant Surry Power Station Unit _ _ _2-- ________________~~
~~Name P.O. Box 315, Surry, Address VA 23883 .:foe Ne* .33D60' 88~5(;, f:.e-tPqJ,J/j Repair Organization P.O. No., Job No., etc.~~
~~3. Work Performed by Virginia Power Type Code Symbol Stamp _ _ ~tJ. . ./4. . . . ._______~~
Name Authorization No. _ _ _ __..,._..,___ _ _ _ _ _ __ P.O. Box 315, Surry, VA 23883 Expiration Date _ _ _ _ __,_tJ"-'-'A'--------- Address
~~4. Identification of System _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __~~
5, (a) Applicable Construction Code B31. l 19§.L__ Edition,_N;;.;..<.../_A_ _ _ _ Addenda, N-1, N-7 Code Case (b) Applicable Edition of Section XI Utilized for Repairs or Replacements 1980W80
~~6. Identification of Components Repaired or Replaced and Replacement Components~~
~~Name of Component Name of Manufacturer Manufacturer Serial No.~~
~~National Board No. Other Identification Year Built Repaired, Replaced, or Replacement or No) ASME Code Stamped (Yes~~
])I~ - 4? u VE~ U"\~t>WN rul-A 2--sr-es- J\,I.J_,.l,\w,J ~~ ND I"~"" fe-C.5B pc"" $'{
~~hl<'.:..C.- {Q l' \l.:.LAN- \/AL-vr;; f 9.z.~~ro ~~ '"!.) d/A oq5<eL ICJB1 o~,-,, ..- ..... ll'i /\lo~~
~~7. Description of Work 12.sel..fK:E::D :::b1sc.... - t,.,"~~
~~-~=~=~~-=~~~'-"----------------------------~~
8. Tests Conducted: Hydrostatic O Pneumatic O Nominal Operating Pressure ff Other O Pressure _ _ _ _ _ psi Test Temp, _ _ _ _ _ _° F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is BY:. in. x 11 in., (2) informa-tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form .
(12/82) This Form (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017
FORM NIS-2 (Back)
9. Remarks /},Sm£ CoD£- I Applicable Manufacturer's Data Reports to be attached CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this AcEa7FIVL conforms to the rules of the ASME Code, Section XI. repair or replacement Type Code Symbol Stamp __N_/_A___________________________________
~~Certificate of Authorization No. _N_/_A_____________ Expiration Date _ _N_/_A_____________ Signed ~~ , --:Z:5I 6v61N££?~~
~ wner or Owner's designee, Title Date---~-7"="'""+---4-<d~f,.___ _ , 19 CERTIFICATE OF INSERVICE INSPECTION 91 I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State orProvinceof Virginia andemployedby HSBI&I Co. of Ho.r- T for ~, Ct have inspected the components described in this Owner's Report during the period q-/C/- 11 to 6 C// , and state that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section XI.
By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspection.
~~-R~~~:--'--f' ~B~~~Commissions Inspector's Signature VA 543 National Board, State, Province, end Endorsements~~
~~FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI c__..a...n..,,d.__,Ps.,:O,..,W.=e""r__,C""o.......- -~~
0
~~1. O.vner -V,:_'laa.aa.r.1;,g...,i_..n.,.i..ia.__,..E_.l..,.euc..,t...r.._1....~~
* ... cJate _Ai...:.,:t>~6i..,,t>""~"-U::'--...,ZB"""'-+I...,\_'f._'t..l..L.(- - - - - -
~~Name 5000 Dominion Blvd., Glen Allen. VA Sheet _ _ ..,,l<-_ ot _ _..:l=---------- Addrea~~
~~23060~~
~~2. Plam Surrv Power Station Name Unit ---l.lS......--------------~~
P.O. Box 315, Surrv, VA 23883 :5ab Na 38((')002:88;.f.l J?B-~"{\-IIB Addrea Reoelr Organization P.O. No., Job No., etc.
~~3. Work Perfonned by Virginia Power Type Code Symbol Stamp -Nlll.l,{..i:81-_ _ _ _ _ __~~
Name Authorization No. _ _ __..,N'-1/c.,A:,.__ _ _ _ _ __ P.O. Box 315, Surrv, VA 23883 Expiration Oate _ _ _ _ ~+J-<--------- Addrea
4. Identification of System _....,_C.uH...E..,_M'-.LJ.l (_.A. .u. 1_&,....,___,\J'-'0'"-1-(...C...iL,;N)L.U..E--~C....nuN=..J:~R~o'-L"-----------------

5. (al Applicable Construction Code B31. l 19~Edition,_N_,-'-/_A_ _ _ _ Addenda)-1-1 N-7 (bl Applicable Edition of Section XI Utilized for Repairs or Replacements 1980W80

6. Identification of Comoonents Repaired or Replaced and Replacement Components
~~Name of Component Name of Manufacturer 1~~
Manufacturer i j Serial No. i I I I National Board No. Other Identification I Year I I Repaired, Replaced, Built or Replacement or No) ASME Code Stamped (Yes 1 STUbS \ Ul\l~J\lOWIV ' N/~ ~CJ I I CflRblN'7l 'INI:l. 1-\i
~~N/A I p~~lJ<:..TS' .IMC..,1 o-c,'1-i.z.a, o , *1t>~~
i, i j UNkl\!l~ I N/A I I ~-Cl;- 31l.. 1\/~K~!,I, I\.EHI\Cl:l::I NO WM, .tJ,JGfJJ'JEfk/Ntj, 11-1 -r 41 : I :a..) ::iN C,. RN I "1-t. 2. ! N/A . NO I I I I "I. I
7. Description of Work _ __.R......_ef\?'-"\q'""""'c,.,,:e.... J. . . _.(. \.,__....;$u.t.,.\,\.,.,J=s-.l..&:::i.....---l(...,_.1...\2/...°)...l_~)'.\.l.ll.A.=<'.),..l"t"...,'.;;,~-----------
~~..,;;r,....~~
~~8. Tests Conducted: Hydrostatic O Pneumatic O Nominal Operating Pressure G-"~~
Other O Pressure _ _ _ _ _ psi Test Temp, °F NOTE: Suppfememal sheets in form of fists, sketches. or drawings may be used, provided (1 I size is 8% in. x 11 in., (21 lnfonna-tion in items 1 through 6 on this repon is included on each sheet, and (31 each sheet is numbered and the number of sheeu is recorded at the top of this fonn . (12/821 This Fenn (E00030l mav be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017
FORM NIS-2 (Back)
~~9. Reman<s _ _.._A?-"-""'--'-tv\~t..=-_(,,..b""""j)-"¥;.."""--.,_('""~,_.,lec,~r2""'--~---------------------~~
Aoo1icao111 Manuiacturer's Data Aeoorts to oe anachaa CERTIFICATE OF COMPLIANCE We certrfv tnat the statements made in tne reoort are correct ana this l?E:PH'll£.l'MiH',ri' conforms to the ru1es of the repa1r or reo1acement ASME Code, Section XI. NIA Type Code Symbol S t a m P - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Certificate of Authorization No. _N_/_A_____________ Ex~iration Date _ _N_/_A_____________
~~
~~Signed = ;:r5T FA!a(ll(E.£e..~~
~~' ,;{!, or Owner~ Oesignea, Titlo Date _ __.~""""~-'-'---"d"'-*..;;;B____ , 19 9/~~
CERTIFICATE OF INSERVICE INSPECTION I. the undersigned. holding a valid commrssion issued by the National Board of Boiler ana Pressure Vessel Inspectors and the State or Province of Vir inia and employed by HSBI&I Co* of d(' t'for C , have inspectea the components aescribea in this Owner's Reoon during the oeriod _ _ _ _ _ _ __,.£"---'-I_-__.Z...,D""-_to _ _5:,_,_,_/.:o;..-__,1._<f-------, and state that to the best of my knowledge ana belief. the Owner nas oerformed examinations and taken corrective measures described in this Owner's Report in accordance with the reauirements of the ASME Code, Section XI. By signing this certificate neither the Inspector nor his employer makes any warrantV, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore. neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspection.
~~----~~-"'~=;;:..,=--=-~fr---"~'"'"";;....;:::c..-.:.---Commissions __V_A __S_4_3________________~~
~~I nsoector'1 Signature N11tion111 Boara, Stllta, Province, and Endo,..,..ant1 Date*-------"~'--...:;~--'g:c..-_19 qi~~
~~FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI~~
~~1. Owner Virginia Electric and Power Co, Date _ _ _ _ _.... ':/-/_...._12..~/_q.!../.___ _ __~~
7 Nama 5000 Dominion Blvd., Glen Allen, VA Sheet_--=:1.=--_ of_..:::i=------------ Addrea 23060
~~2. Plant Surry Power Station Unit---"'~--------------~~
Name P.O. Box 315, Surry, VA 23883 J"ob hlm, .3B00l\l:'1f,:). ee:i-qr 1LJ Addres1 Repair Organization P.O. No., Job No., etc.
~~3. Work Perfonned by Virginia Power Type Code Symbol Stamp _ _ _..J.N~/..1.A:i....____~~
Name Authorization No. _ _""'.'"""_ _.....1,;N4L+:F,i...._ _ __ 1 P.O. Box 315 2 Surry, VA 23883 Expiration Date _ _ _ _ _ __,,)\)""'--1/<-L...A.______ J Address
4. Identification of System _ _,,l'\....,.._eo,,d-"""'"""Q""t:'-----'("""o""C2"'"\"""0,"'pL..L..J+........_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __

5. (a) Applicable Construction Code B31. 1 19§.L Edition,_N-"/'-'A=-_ _ _ Addenda, N-1 , N- 7 Code Case (b) Applicable Edition of Section XI Utilized for Repairs or Replacements 1980W80

6. Identification of Components Repaired or Replaced and Replacement Components
~~Name of Component Name of Manufacturer Manufacturer Serial No.~~
National Board No. Other Identification Year Built Repaired, Replaced, ASME or Replacement or Nol Code Stamped (Yes 8 Ol--CS C.DPES-VU 1.CJ,N U\\.l\<11) OI..CN [\)/ I\ :i.,-P.C-\'\C.V-.'lSSl<: UN'l\t..lDt-01-:l R~\a.ce.c\. \sJO c~:rc\\V\o..\ :r:)\J. IIT:$1 S1l'{.,f '3'l po~ I\C>t> (11"-f) "r-.,J..w:.tc,. :Cnc.. 3;&g:t~io f'\/A 3:l..'ll\1-l \°tqo ~'1>\~ca.n-\: l\)Q NV1~ Ut.il<l\>>wN \JN¥-l\'IOWN -N/A J -11..c-\-\cv- ~ss-\.c:.... \Jl\)~t,:iew~ R~\O\C.~ t0o c".,;.\l'\111,\ ~ot. ~~ Po"' NV-rs (_1{":) fro..\u.c..\<.. J'.:nc.. C')..":\-'l;)..'\ \'7A :33~5l~-J. VV\\ Re~kceo\~~ NCJ
7. Description of Work Rep Ia. cecl Nu-k

8. Tests Conducted: Hydrostatic O Pneumatic O Nominal Operating Pressure 0 Other ff Pressure.......,,1,=/0;.:.P_ _ _ psi Test Temp. NDT °F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is 8% in. x 11 in., (2) Informa-tion in items 1 through 6 on this report is included on each sheet, and (3) .each sheet is numbered and the number of sheets is recorded at the top of this form .
(12/821 This Form (E00030) may be obtained from tha Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017
FORM NIS-2 (Back)
~~9. Remarks _....J-A:...::S:...:..M--=£'-------'='Ct.A==s=.s'----..!-I_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __~~
Applicable Manufacturer's Data Reports to be attached CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this 'freLIJ(WEtJI conforms to the rules of the ASME Code, Section XI.
~~repair or replacement Type Code Symbol Stamp __N_/_A _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __~~
Certificate of Authorization No. _N--'-/_A_ _ _ _ _ _ _ _ _ _ _ _ _ Expiration Date _ _N...c/_A _ _ _ _ _ _ _ _ _ _ _ __ CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State or Province of Virginia and employed by HSBI&I Co* of _ _ _ _ _ _ __,_rl...:..::o.=.r ...T-!.-.fo.,_,,~1-'-"J,"'-t)___.:;Cf::....1.._*______---:c---~---have ii:ispected the components described in this Owner's Report during*the period q-/9-1? to 6-l8~qf , and state that to the best of my knowledge and belief, the Owner has performed examinations *and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section XI. By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and c~rrective measures described in this* Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this
*in--sp-e_c_t-io_n_.~>1-==::.1<c.---=----'--'--£"-:.c:--'"!Pe:dk--' ..........*"'*_,___ _ _ _ Commissions_...,..V_A--:-_5_4_3_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
Inspector's Signature National Board, State, Province, and Endorsements Date_ _ _ _ _ ~7_-~/-~__19 qJ
I
~~FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI~~
,. Owner Vir~inia Electric and Power Co. Date '31 H ::-{ 2+/- 14q1 Nam* '
~~5000 Dominion Blvd., Glen Allen. VA Sheet l of l Addrea~~
~~23060~~
2. Plant Surrv Power Station Unit ot Name P.O. Box 315, Surrv, VA 23883 :iok Na 3%o QIQ SRTO eg_.:f:/-q1- u~
~~Addrea Repair Organization P.O. No., Job No., nc.~~
~~3. Work Performed by Virginia Power Type Code Symbol Stamp _N,....{-"A.________~~
Nam* Authorization No. _ _ _ _N..,._,./......f\~------- P.O. Box 315 2 Surrv, VA 23883 Expiration Oate _ _ _ _.. 1,_.I N.,. B~------- Addrea
4. :'\ I C....,_B:.._l,___....&....___..V. O Identification of System _ __,,(....,\.\.,.E~l'........ . .....l..,l...J.M'-'-.L..E:_ _,c. . n"'. -...t-i ...) I~B-"'()~L......___________

5. (al Applicable Construction Code B31. 1 19§l___Edition,_N--'-/A;.;;:....._ _ _ Addenda. N-1, N-7 (bl Applicable Edition ot Section XI Utilized for Repairs or Reolacements 1980W80

6. Identification of Components Repaired or Replaced and Replacement Components
~~Name of Component I Name of Manufacturer I~~
~~!i Manufacturer I Serial No.~~
I I National Board No. I Other Identification Year Built Repaired, Replaced, or Replacement or Nol ASME Code I I I StamPlld I (Yes I I I I I I i
~~' ~lJiS S" ,, ~I ! Vt,JI<~~~
I I V H IC~OW).I I N/A i-c1-H~.'l-nS-2~ul\ll\11101UN ~PLJK.;h II ~o I NUTS N/A I I I
.2-t1-t-Rv~i~izs l11~1t~N 5:,, ! ~""[Ut)S ~I CP.QSB.Y IIJNK.NotuN Ij N/A P,c\) l.Pic:.Eb I NO I
I ICf\Rb\~~L. J:l\)\:), 1 Hf ~ i f'0-;\1 .I i i I i STlJb.S m~llcn, .:i:Nc., s- o9 ~1-!to I N/Ft '3 3 ':f.0os-~ 14"! J ~PJ.IKE:1'1\i.NT NO I i I I I I I
~~,"'Qf=e.J=.,,__.,.(...,.~....,\__sW~=.$..___..,.&""---(::..l;..:{:,:::...'~~
7. Description of Work _ ____._\>s,...:eitfl..... . ).i.-...!..1Yl.ia\A...,i~.;;,.~.**~""'.,-.

8. Tests Conducted: Hydrostatic O Pneumatic 0 Nominal Operating Pressura [a-""'
Other CJ Pressure NOP psi Test Temp. /\M&1@t:* ° F NOTE: suoplememal sheets in form of lists, sketches, or drawings may be used, provided It) size is 8% in. x 11 in., (21 informs* tion in items 1 through 6 on this report is included on each sheet, and (31 eacn sheet is numbered and the number of sheea is recorded at the top of this form . (12/821 This Form (E000301 may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017
FORM NIS-2 (Back)
~~9. Remarl<s _ _,2:'.~§c:Le==C-'=E-"-'M.""'?t,l'=='._,x.......,_,_ _,_j\.,_S..:::.:...tv\.....;E-=:..._ __:c.......c,,_DE-..,,,~:."--..::C.=c...i..icAc.:.=::sS....___.2"'-<'~--------------~~
Aoplicao,e Manuracturers Data Reports to oe attacnea CERTIFICATE OF COMPLIANCE We cemtv tnat ttle statements made in tne reoort are correct ana this @fl,AC£M~ .:onforms to the rules of the ASME Code, Section XI. reoarr or reo1ecem11nt NIA Type Code Symoot S t a m P - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Certificate of Authorization No. _N_/_A_____________ Expiration Date _ _N_/_A _____________ Signed Lr(/Vl ~ +
~~~ or0wners0e1ignee, IS"C Title Date ----,C)ft~.:s.-...---=Ac..,._Lj_,___ , 19 7' I CERTIFICATE OF INSERVICE INSPECTION~~
1. the undersigned. holding a valid commission issued by ttle National Board of Boiler ana Pressure Vessel Inspectors and the State or Province of Virginia and employed bv HSBI&I Co* of
-------if/.'-'"'g=-V',_T .. ......'C..ct..,,_,1i"-""c_t:,___________=-......,-;:;--:=:-----...!i ave ........-t""'o insoectea the components descritiea in this Owner's Reoort during the oeriod __________ q-/t/-fFI b-f 0 ~0 1 ..__....,_-'-'-..,_._._to-...:==-..:...r.C!..,___J_'-'---------, and stata that to the best of my knowledge ana belief. the Owner nas performed examinations ana taken corrective measures described in this Owner's Report in accordance with the reouirements of the ASME Code, Section XI.
By signing this certificate neither the Inspector nor his employer makes any warrantV. expressed or implied, concernrng the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his emcloyer shall be liable in any manner for any personal injury or propertV damage or a loss of any kind arising from or connectea with this inspection.
~~---Yh¥-!:::::l.._~-=--'--...!....-1.~.___,,,Q_......~"'-""'=-:=.....-Commissions _ _ VA~5-'4.;:.3_ _ _ _ _ _ _ _ _ __~~
I n1D11etOr'1 Signature National Boara, Stat*. Province, and Endorsam11nt1 Date _ _ _ _ 7,,__-.,..i_4.;....-_6_19 Cf/
~~FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI~~
1. Owner Virginia Electric and Power Co, Date 11 JL'( I Bi 1991 Nam*
5000 Dominion Blvd., Glen Allen, VA Sheet 1 of l Addreu 23060
2. Plant Surrv Power Station Unit Neme P.O. Box 315, Surry, VA 23883 Jnb ~Q 3 8: eie2 j ,/a ~i\.2 ~B lCR.4" j H Is-Rl!Qalr Organization P.O. No., Job No., etc.

3. Work Performed by Virginia Power Type Code Symbol Stamp N/ A Name Authorization No. _ _ __._,Ny/uA~-------
~~P.O. Box 315, Surry, VA 23883 Expiration Oate _ _ _ _...,N,,...,./....8.._________~~
.Add"!*
4. Identification of System _ _..:C:.:.H.,_,E.:.lffi"'"""'IC:~A'""L,__.....::,&..___.\f,..O""L""lJ'"'\Y\""""'E:-..,cpN)~,.,._'T.i..8""'-0'-'l------------------

s. (al Applicable Construction Code B3 l. l 19~Edition,_N:..:...:../.;:cA:...__ _ _ Addanda, N-1, N-7 Code Case (bl Applicable Edition of Section XI Utilized fo~ Repairs or Replacements 1980W80

6. Identification of Components Repaired or Replaced and Replacement Components Name of Component I
Name of Manufacturer I I Manufacturer Serial No. I I I I National Board No. Other Identification Year Built Repaired, Replaced, ASME Code Stamped (Yes or ReQlacement or Nol NlJT5 I.JNKNOW~ Ul\l\q\)t,Wl\.l I I N/A ~' -RV-110q I 11113\\tlClllN ~PLJKl:l:> ~o I I I I~ ~ <=t ENltll\)tEi ~, ~ . PO~ C.$Y I NO
~~~\)"'t':l :Ii- .., :t.~c. RN \ 't{~ \~~
~~i N/A 1Si01-b i-, l~ ~o ~p IJ\(StiJ:).\1' I y~~
~~~01-,s I (.Rf)S,t,o I lJ i-., KNOO!>l'.l"' I I~~
N/A ~-U,\-1'V-1W':) 1/1\l\(~t,I P.E:HI\Cl:l) NO CPtlltlll\l~\. :I.l\lb, \.\i~ f>o~ lrioL,S f:>~t>Ucr<:, , INc.. io %'tl.\-t> I N/A 33':J. D'\3- 6 lqql ~PlhC.'E:t'l\~NT NO I
7. Description of Work _ ___,_~..::::e... ~"'\.,,0,..,,~="---~c...<is).,__...,f>l'.IJo.iJ\..i.:\:..;:.s_u&L...-......i..C..i.lla!o..J...L_-l.cD,..i..V,:!s.;}"1..:;$;,___ _!,..(__5. :.'/. !::Bc.. .". :t.)_ _ _ _ _ _ __

8. Tests Conducted: Hydrostatic O Pneumatic 0 Nominal Operating Pressure B--
Other O Pressure /J.D? psi Test Temp. AM& l E&T ° F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1 l size is 8% in. x 11 in., (21 lnforma. tion in items 1 through 6 on this repon is included on each sheet, and (31 each sheet is numbered and the number of sheets is recorded at the top of this form. (12/821 This Form (E000301 may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017
FORM NIS-2 (Backt
~~9. Remarks _ _A~S=-'-M...,_E..""""-_.,..C.._-D=Dt;,...~~_._C_<""'\,A-...,_,,S"-=S~=Z-=---------------------~~
APPlicacle Manufacturer's Data Reports to oe attached CERTIFICATE OF COMPLIANCE We certify that the statements made in the reoort are correct and this )9:.fµ>,(.'e.f':\§.NC conforms to the rules of the repair .o.r reo1acement ASME Code, Section XI. Type Code Symbol Stamp __N_/_A ____________________________________ Certificate of Authorization No. _N_/_A_____________ Expiration Date _ _N_/:__A_____________ n Signed c/t:C). ~ .
~~~ ' o r Owner's Designea, Title orProvinceof ViA}nia~~
~~Date CERTIFICATE OF INSERVICE INSPECTION~~
~~/8,I~~
~~r. the undersigned, holding a valid commission issued by the National Board of Boiler ana Pressure Vessel Inspectors and the State andemployedby HSBI&I Co.~~
~~, 19 9/~~
of 4 r,::Cf~:H'd. .J CT" have inspected the components described in this Owner's Report during .the period tj-/C/- l!to {;-(g-'l./ , and state thet to the best of my knowledge and beliet;"the Owner has oerformed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section' xi: By signing this certificate .neither the Inspector nor his employer makes any warranty, expressed or implied, concerning.the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for a~y personal injury or property damage ~r a loss of any kind arising from or connected wiJh this i-n-sp-ec-t-io-~.l,*d-="~,...__=:-~-:---:--:'~*-*...~
-* Commissions _ _V_A__5_4_3__________________ ~ Signature National Boara, State, Province, and Endorsem11nt1 Date_ _ _ _ 7_-_/~C/_19 C/,/
~~FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Coda Section XI~~
1. o.vner Virginia Electric and Power Co, Name 5000 Dominion Blvd., Glen Allen, VA Sheet _ _... l....__ of _ _-=l=-----------
~~Addrea 23060 Unit _ _..=;:...__ _ _ _ _ _ _ _ _ _ _ _ __~~
2. Plant Surrv Power Station Nam*
~~P.O. Box 315, Surrv, VA 23883 Repelr Or;anization P.O. No., Job No., etc.~~
~~3. Work Perfonnedby Virginia Power Type Coda Symbol Stamp __.N'£1-/..IOA.___ _ _ _ _ __~~
Nem* Authorization No. _ _ __._,NL,/'-"Ac,.__ _ _ _ _ __ P.O. Box 315, Surrv, VA 23883 Expiration Oate _ _ _ _..1.N:.&+/J:81..-_______
~~' Addrm 4, Identification of Svstem_-=cS.._'7..,f'""E-"'"""T..,Y_ _.J;N.....,...::S ......E..Cf...._..,IO"'"'"'N,._________________________~~
s. (a) Applicable Construction Code 531. l 19~Edition,_N;;.;..:../.;.;A~_ _ _ Addenda, N-1, ~-7 (bl Applicable Edition of Section XI Utilized for Repairs or Replacements 1980W80

6. Identification of Comconents Repaired or Replaced and Reclacement Components
~~Name of Come on ant Name of Manufacturer I~~
I: Manufacturer I Serial No. I I I i National Board No. Other Identification Year Built Repaired, Reolecea, or Replacement ASME Code Stamped (Yes or Nol I I I
~~' 'i':,"tUt).S !~~
I y E-Lftl\l j lJNkNOLol\l I N/A J.-S.r.- J,.i,, I) !ul\ll\MCION I ~Pl..FICJ:b ~o I RcD<; I Pit Gt '\:t)~ll\ttR11
~~lt- INL ,~~
~~H"f~ Lk~~~
*t9l.S-<. N/A IPo~"5 J...l-\-C>"'csy \ \-\ I 1'1 ~ 0 j ~PU$8fi!).\"T ~o i lJNkNe>"WN lu~K~tl NUTS NV-C:,
~~UNKNOWN l$OVf\ nob, "O'\~Jl'l)l: C.OR..~$ I H1" ~ CDf3>~13 N/A N/Ft ro~ '1. -S.I- ~'-l:D csy 3'-:\\ '.l !:,ft I l'19l P.E:P 1.1\ Cl:h~~
~~~J.fK'E:IT\~}lT NO NO~~
~~7. Description of Work_--'R..,,._e'tyl.... G...~~
~~ci.... :C.LC:.<.t,A.---><..i.!.=2..:..,)..._s.:.,.:\;~wl=..:aO..._.--l&~_(:::..\!..!:'2..::.~.::.....:n:w~1.:n1:;;,.:::.,.*_*... '),J._________ ca.-..L{~)L'b.t1..'~~
8. Tests Conducted: Hydrostatic O Pneumatic O Nominal Operating Pressure G-Other O Pressure _ _ _ _ _ psi Test Temc. °F NOTE: Supplemental sheets in fonn of lists, sketches, or drawings mav be used, provided 11 I size is 8% in. x 11 in., (21 informa-tion in items 1 through 6 on this repon is included on each sheet, and (3) each sheet is numbered and the number of sheea is recorded at the top of this fonn *
(12/B21 This Fonn (E000301 may be obtained from the Order Dect., ASME, 345 E. 47th St., New Yortc, N.V. 10017
FORM NIS-2 (Backl
~~9. RemarKs _ ___,_A_.S~iv\-'-E-=-_ __._C....o....D""-E--=C=y......_..5,.,.s"--_,1_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __~~
Aoolicao1e Manuracturer's Data Reoorts to oe enached 1 CERTIFICATE OF COMPLIANCE We cert1tv that the statements made in me reoort are correct ana this iZEPLACf:..M,E.t,(C conforms to the rules of the ASME Code, Section XI. reoaor or reooacement Type Code Symbol Stamp __N_/_A ____________________________________ Certificate of Authorization No. _N_/_A_____________ Expiration Date _ _N-'/'--A_____________ Signed L/~~ orProvinceof
,T,"'2T 9Yl;1(1f£E/? ~ . j , ~ w n e r s Oes1gnee, Title CERTIFICATE OF INSERVICE INSPECTION I, the undersigned. holding a valid commission issued by the National Board of Boiler ana Pressure Vessel Inspectors and the State Virginia andemo1oyedby HSBI&I Co. of
~~_ _ _ _ _ _ _ _ _ _H:...;..a....;;.:;r_-f".,_.fc_-o=-,,......cd.c..+J-'C=-_.f~~
~~.....'---------=-:=-----have inS?ected the components describea in this Owner's Reoort during the period q-A-'? '1 ,o ___../.._---'f"""r,"-~~
~~t'> 6 ._o I- ._I_ _ __~~
. ... , and state th at ,o the best of my knowledge ano belief, the Owner has oeriormea examinations ana taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section XI.
By signing this certificate n*either the Inspector nor hos employer makes any warrant'(, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or prooertY damage or a loss of any kind arising from or connected with this inS?ection.
~~-------~,._ _._. ._. .,___f'""'"'._""'~=-a-----~--Commissions~~
_ __V_A__;5c..4.....;:.3_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ I nsi,ector'1 Signature N11tion111 Soara. State, Province, and Endorsements Date _ _ _ _ _ 7_-~'.3-/__19 9/
~~FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI~~
1. Owner Virginia Electric and Power Co, Date --=:::r;"-"=L~'{'---'-14':,,...+l--'--ICf..,_q..._._j_ _ _ _ _ __
~~Name 5000 Dominion Blvd., Glen Allen, VA Sheet _ __ _ . _ o f _ ~ - - - - - - - - - - - Address 23060~~
~~2. Plant Surry Power Station Unit _ _ _ _?-.. _______________~~
~~Name P.O. Box 315, Surry, VA 23883 Address Repair Organization P.O. No., Job No., etc.~~
~~3. Work Performed by Virginia Power Type Code Symbol Stamp---f"-t-1-'---------~~
~~Name Authorization No.----'-"'-+'-'---------- P.O. Box 315, Surry, VA 23883 Expiration Date _ _ _~-"+'-'---------- Address~~
4. Identification of System _ _ _ _ .S...,,A"-'F_E.:=-c:r_'<-'--~IN~3"~EC=;.a:r"'"l""'D=-I..\=------------------------

5. (a) Applicable Construction Code B31. l 19§l_Edition,_N~/_A_ _ _ _ Addenda,N-l, N-7 Code Case (b) Applicable Edition of Section XI Utilized for Repairs or Replacements 1980W80

6. Identification of Components Repaired or Replaced and Replacement Components
~~Name of Component Name of Manufacturer Manufacturer Serial No.~~
~~National Board No. Other Identification Year Built Repaired, Replaced, or Replacement or No) ASME Code Stamped (Yes~~
~~\,<..li=-L-D f O Pr U/JIL/\IOWA.l 1 l"'" '"' ,~1 uJIA 1' ... SJ: - "YIOic.f./~ U'-*1Ja..J j::'.£ PA 1/2.E. D rJD~~
7. Description of Work 61i2DUl\lb OUT IND~llt>t,..l /1\.I WEL-DJ E'.E.WE L--t:>~D

8. Tests Conducted: Hydrostatic O Pneumatic O Nominal Operating Pressure 0 Other O Pressure _ _ _ _ _ psi Test Temp. _ _ _ _ _ _° F N/A NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is 811:a in. x 11 in., (2) informa-tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form .
~~'**)~~
(12/82) This Form (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 1oq_1.7
FORM NIS-2 (Back)
~~9. Remarks --../.A....!....::S:..:..M..!-'E..-=._.,_C,"-'o""D:::cE>=........1C--"1J-,...,._S.,__S..__-<..:::2-=----------------------~~
Applicable Manufacturer's Data Reports to be attached CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this R~PA l\2- conforms to the rules of the ASME Code, Section XI. repair or replacement Type Code Symbol Stamp __N....c/_A __________________________________ Certificate of Authorization No. _N...c./_A_____________ Expiration Date _ _N-'/_A _____________ Signed ~JfLc.___,. IST
~~'~m;f or Owner's Designee, Title Date _ _t/..;.9,g-,.,~~
1
~~"'"~...,----.L/. .1'.:#<i?'----, . 19 9/~~
CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State or Province of Virginia and employed by HSBI&I Co* of
/d a."' T fo rtl ., C +/- have inspected the components described in this Owner's Report during the period C/- ft;- '8 'f to f>-[ g~ q / , and state that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section XI.
By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspection.
-----~~11-~L--=-----'----'"J<.:..:-'~"""'"------'=--Commissions __V_A_S_4_3________________
~~Jnspector'sSignatur~ National Board, State, Province, and Endorsements Date,_ _ .....:__7'---{,__].....___19 j, /~~
FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI 1 . Owner _v!..' r~g...,i..,.n...i..,.a....._.E...l..,e..,c.._t.._r.._.i...c~a""n..,d.._.P""'o.._w=-e...,..r__..C...o.._*.___
1.._* Date _-:s-i=-:u:::.:1...:.'f.,_____.l_,q'-ll---..1.J. .,_9.. . 1.9. 1.I- - - - - Name 5000 Dominion Blvd., Glen Allen. VA Sheet _ _ _.l.___ ot _ _-=l=---------- Addrea 23060
2. Plant Surrv Power Station Unit _ _---111:::.____---4f?e.ic::1:::-.J,!--Lq.:..1-..!l.i..l!::::D_ _ __
~~Name P.O. Box 315, Surrv, VA 23883 Rapalr Organization P.O. No., Job No .. etc.~~
3. Work Performed by_...,;V....:i:..:r:....:g:i..:i:..:n::.1:.*a=-.:..P.:::o..::w.;:e:...:r'-------- Type Code Symbol Stamp __.N~/..:::A._________
Nam* Authorization No. _ _ _...,N..a.+/.LF\....__ _ _ _ _ __ P.O. Box 315, Surrv 1 VA 23883 Expiration Date _ _ _ _.i.;N~,r-/8i;J..._______ Addrea
4. Identification of System _ ........ C:ul:l... .....i......__,,Jt....J\'..,,:)'-'b~_...,\""')O....L.. ,(""JDYl. . . . ,....f;..__........;C.,....O..,_N"""""I....B.~a"'-'=k=---------------
~~E'Nl.t.::J.llc..G...B:~~
s. (a) Applicable Construction Code B31. 1 19§2._Edition,_..;N.;.;/;..;A~---Addenda, N-1 N-7 Code Casa (b) Applicable Edition of Section XI Utilized for Repairs or Reph1c11ments 1980W80

6. Identification of Components Repaired or Replaced and ReclllCi!ment Components
~~i I~~
I! II Name of Component I Name of Manufacturer I I Manufacturer I Serial No. I i National Board No. Other Identification Year Built Rep11inid, Replaced, or Replacement or No) ASME Code Stamped (Yes I I I I I STUDS ! JCJS'tffi OftT i Ufllkr\l-C)'W11..) I N/F\ ).. - CH - I: - c:t_ !\)11:)~NOlllll ~Pl..f\CEl:> I ~o I
~~'C~ill:)ltJflL INb I "f~~~
~~I P!tobVC..-r'.:, .]J\X, ' ~ca ,c.i 13~ I N/A~~
!Po~ csy I 1~90 ~P~E:1'.\,I r--:io S,U(:)S 3~ °I 2.1 '2.- I I Ju~IC~N I
I; N/A I\HfTS ! UN~ I ~ 2.~c.H -'£ -'2. P-1:P ll\ CJ;b NO I NI.JfS i cMl.i)l~L .!Nb J \"~tll.lc:tS :tNc.. I"*f ~
~~" 1.1*-'T'.L"1 I N/A.~~
~~f>o-:\'l,~~
~~;tbC,°lbl-\~~
c.sy I iq81 ~PlhC.ctTl\:.NT NO I I I I I R \
7. Description of Work _ _ __,~f'f\)""°'""'cgp\""'-'=;.:._.--'\.1::-2" I lr'\.1'-1'-

r...____
~~.....-'.... L \ ll (_ '-.~~
~~J__.S;""n;..,,u.""O\.~s..__-..:.¢...:......_...;::..:5~l\-.l.')~..l.b.uk\.i...I.J.. _L { j\fo\.~~
~~..:,,C,_..1.._..J.~~
~~__!=;D:........,::),_ _ _ __~~
~~a. Tests Conducted: Hydrostatic O Pneumatic 0 Nominal Operating Pressure ~~~
Other I I Pressure IJpp psi Test Temp, A:&1B!fiNT °F NOTE: Supplemental sheets in form of lisu, sketches, or drawings may be used, provided 11 l size is 8% in. x 11 in., (21 lnforma-tion in items 1 through 6 on this report is included on each sheet, and (31 each sheet is numbered and the number of sheea is recorded at the top of this form . (12/82) This Form (E00030) may be obtained from the Order Dept,, ASME, 345 E. 47th St., New York, N.Y. 10017
FORM NIS-2 (Back)
~~9. RemarKs CODE- .,,,.C.....L="-A"-'=S<-=S::...___~:.....c;..-----------------~~
Acplicac1e Manuracturer's Data Aecons to ce anacnea CERTIFICATE OF COMPLIANCE We cemfv tnat the statements made in tne recort are correct ana this 2£..puc,J;M:gNf conforms to the rules of the repair or rec1acemenT ASME Code, Section XI. Type Code Symbol Stamp __N_/_A ____________________________________ Certificate of Authorization No. N/ A Expiration Date _ _N_/_A_____________ 91 Signed{.,,/{
,~r:eawnars De1ign1111, Title r-v ,.../i.,(~1 -~ :Y$I -=£iv'-'-'-"6,..._('"'"l{Ege---'--'-------Date_---"7°'4i~~-~/.L,.;'_ _ , 1g CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issueo by the National Board of Boiler ana Pressure Vessel Inspectors and the State orPrcvinceof Virginia andemc1oyedby HSBI&I Co. of l:ldtt Fo rJ
C=--f~.------,,,-------,-----have insoectea the components described in this Owner's Aecort during the ceriod _ _ _ _ _ _ _q.._-_./._t/.,__-_g'._'f...__to _ __,,b.._--'(_,g"---9;._'/'--------, and state that to the best of my knowleage ana belief, the Owner nas certormea examinations and taken corrective measures described in this.
Owner's Report in accordance with the reauirements of the ASME Code, Section XI. By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or propeny damage or a loss of any kind arising from or connected with this insoection.
~~~~~ L !4 P. ff)~ ~,::;.;;:a-..-..;;;;;-----Commissions __V_A_S;;.._4..;;:3_________________~~
~~insi,ec,:01"1 Signature National Boara, State, Province, and Endonamanu Date 7-:l.!l 19 _q. ,. . .-~~
1. Owner FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS Virginia Electric and Power Co, As Required by the Provisions of the ASME Code Section XI Date A, >{n I 15T 28.I l'M I Name 5000 Dominion Blvd., Glen Allen, VA Sheet _____.l.___of* ___.......:l=:...._....................__....._____
~~Addr- 2JQ6Q~~
~~2. Plant Surry Power Station Unit-..........~ - - - - - - - - - - - - - - - - - - - - - -~~
Name P.O. Box 315, Surry, VA 23883 1o\, No, 38:0000 ::S<P09 UJl-1t- td\ Addr. . Repair O,vanlzatlon P.O. No., Job No., etc. J. Work Performed by _ _V __i;;.;r;;.Jg_..1_*n__i""a___P..;;;o..;;w""e;.;;r;.. . ...........------ Type Code Symbol Stamp__.N ....~(aA_ Nam* Authorization No. _______.,N~/.1.&1--...................._____ P.O. Box 315, Surry, VA 23883 N.o.,/u8..........._____________ Expiration Oate ....................... Addrea
4. Identification of System * ~a,:\e:tJ= T,,'jpc_.t-'1\;s:U\

5. (al Applicable Construction Code B31. l 19~Edition,__;N:..:...:.../A=-_ _ _ Addenda, N-1. N-7 (bl Applicable Edition of Section XI Utilized for.Repairs or Replacements 1980W80

6. Identification of Components Repaired or Replaced and Replacement Components
~~Nemeof Component Name of Manufacturer Manufactuntr Serial No.~~
~~National Board No. Other Identification Year Built Repaired, Replaced, or Replacement or Nol ASME Code Stamped (Yes~~
~,, ST\Jb5 l)i\)k_~i\5 \J~\'\NOurwj N/A ::t~"1- <> P-\'5"3 U~ll."IOICII ~PI.JKJ:b l'\O 8 ,, STtft:>5 (l',R'i:)l\\l.f'tL :(:Nt>'
~~PAtibvCtS '!.NC.. t-\1' ;:t, 31.\ '3 21"'1 I N/A PO°* C..$))~~
~~~4 3 2-"rl t, l QI I ~l> IJ\CBl\!l.\i NO ,, ~UTS. mJ 14,.:) In() \-.l VI\H,:;.Now 1\J i~~
I N/A 2.. -SI.- )'I?- \S'3 Vt,l$~~ ~l)lJ\CEb NO CJ\\'\\'::,\ \uf'l l- :cN l'.:: HT~ Po ".\'I c~y II \0lJTS \>\\l>b$L"t"S ~ e,-*2..z.Lql I N/A.
'3 Lf t 153' t 1~ I 0 ~~CI:1'1\\:.NT NO
7. Description of Work '.i2FP<-fl£J?P 0-1 "::>Tl.>D:';:, (7/p,") AND L't)Nur~ (71y/)

8. Tests Conducted: Hydrostatic O Pneumatic O Nominel Operating PressurG g--
Other O Pressure _ _ _ _ _ psi Test Temp. _ _ _ _ _° F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided 111 size ia B% in. x 11 in., (21 lnforma-tion in items 1 through 6 on this repon is included on each sheet, and (31 each sheet is numbered and the number of sheets is recorded at the top of this form .
* (12/821 This Form (EOOOJOI may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017
~~FORM NIS-2 (Back)~~
~~9. Remarks ---fl.A~S.......,.;M;.i.f;,.__ e.........,C=L,,A:$~,_,...__.,.L...._______________________~~
~~.. _~(...b...o...~~
Applicable Manufacturer', Data Reports to be attached CERTIFICATE OF COMPLIANCE We cenify that the statements made in the repon are correct and thisZfie1¥e!YFNI conforms to the rules of the ASME Code, Section x I. repair or repaacement Type Code Symbol Stamp __N_/_A_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ Cenificate of Authorization No._N...;../_A_ _ _ _ _ _ _ _ _ _ _ _ Expiration Date _ _N...;./_A ____________ Signed 1 V~~
~~%':J.r I$;/; &.lh(A/FF~~~
or Owner's 0ftignH, Title CERTIFICATE OF INSERVICE INSPECTION Date---1~-~-*_ 1, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel lnsPectors and the State or Province of Virginia and employed by HSBI&I Co* _.2'""'___
/J , 19 "If of fio.,r:TfoV'd. J c-f: have inspected the components described in this Owner's Report during the period 5',f-t:f() to £-/O- q~ , and state that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's _Repon in accordance with the requirements of the ASME Code, Section XI.
By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations_ ~nd corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this
*=-*--'-7'"-'u=-=:;,.;..~-:i_()!!t"-'"--=eiL=a---'=-----Commissions i_n_sP_ec_.~_io__n_.__~....1 *- __V_A___Sc...4_3________________
~~Imp~ knature National Board, State, Province, and Endorsamentl Date ~-1 <r 19_tt_,-~~
~~FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI~~
1. Owner Virginia Electric and Power Co, Date _ _ -=:fi~u-~~v_._.ll..._o+-I~ (Cf-"--lc.:...(_ _ _ _ __
Name 5000 Dominion Blvd., Glen Allen, VA Sheet _ _ _~ _ o f _ ~ - - - - - - - - - - - Address 23060
~~2. Plant Surry Power Station Unit _ _ _ _'.Z...._______________~~
Name P.O. Box 315, Surry, VA 23883 Woie,.;;. Oe..-#' JI 1/-f 3~ ~"* 9 l-/D8 Address Repair Organization P.O. No., Job No., etc.
~~3. Work Performed by Virginia Power Type Code Symbol Stamp _ _'--'N,.,l,._A,___ _ _ _ __~~
Name Authorization No. _ _ _ ____,,J"'"-'/A::,,________ P.O. Box 315, Surry, VA 23883 Expiration Date _ _ _ _ _-+f'-1-t-/A-..,.________ Address
4. Identification of System _ _'f;..o....c-=~"-'AC'-'='-'T{).,,*"-'e...=-_["'""'c,=o=--LA:Nt"'-'-'

5. (a) Applicable Construction Code B3 l. l 19~Edition,_N--'-/_A_ _ _ _ Addenda, N-1 N-7 Code Case (b) Applicable Edition of Section XI Utilized for Repairs or Replacements 1980W80

6. Identification of Components Repaired or Replaced and Replacement Components
~~Name of Component Name of Manufacturer Manufacturer Serial No.~~
~~National Board No. Other Identification Year Built Repaired, Replaced, or Replacement or No) ASME Code Stamped (Yes~~
~~\.<.('i::; l_f"'\ L.. vNKNoi.J~ UNl4Jo,J,J l'Jli4 3/4-fi?.C- ~~*/SO}.. Uuv,.1,,.1.1 :RE.A:\ I~J::D ,Jo~~
~~7. Description of Work (51/2 lNPG::D OUT 3/4 1~~
~~' A looP P1P1NGr.~~
8. Tests Conducted: Hydrostatic D Pneumatic D Nominal Operating Pressure D Other O Pressure _ _ _ _ _ psi Test Temp. _ _ _ _ _ _° F NOTE: Supplememal sheets in form of lists, sketches, or drawings may be used, provided (1) size is 8% in. x 11 in., (2) informa-tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form .
(12/82) This Form (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017
FORM NIS-2 (Back)
~~9. Remarks _ _---,JAL...!...=SC-Jl'!\.c....u..E...=--_.C__,,.o"".DE.""""""_....,,,c-""Lf6L..:....:!:.=S<--__,__ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __~~
Applicable Manufacturer's Data Reports to be attached CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this :RE:eA:1 g.. conforms to the rules of the ASME Code, Section XI. repair or replacement Type Code Symbol Stamp __N....;/_A __________________________________ Certificate of Authorization No. _N-'-/_A_____________ Expiration Date _ _N_/'--A_____________ Signed (/S,,r-Jure - , XS.I ro);;te:/r'ownar's Dasigi<ea, Title Date--~9-~----/_../12~-, 19 9.t e: CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State or Province of Virginia and employed by HSBI&I Co* of ftd-r'°t ~ord, Ct have inspected the components described in this. Owner's Report dur,ing *th~ .period q-{9-i to I,-/ &* '1 f , and state that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section XI. By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this i-n-sp_e_c_t-io_n_.-_~--""'"'~~---... i~.~~"""'"'~~~------Commissions _ _V_A__ S_4_3__________________ Inspector's Signature National Board, State, Province, and Endorsements Date_ _ _ _J__,_-_,(._1 _ _19 q/ '
~~FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI~~
~~, . 0.vner Virginia Electric and Power Co, Date _ _._:-J;"'-"'c,)""L-:.JY'---1'--$'"-+-I__,_I'1-L->9.'-'-l_ _ _ _ __~~
~~Name 5000 Dominion Blvd., Glen Allen. VA Sheet _ _ _.l.___ of _ _..=l:c.-_________ Addreu~~
~~23060~~
~~2. Plant Surry Power Station Unit--~"'----------------~~
Name P.O. Box 315, Surry, VA 23883 Sok No. 08 P2 0 U Q L'5S v:;e.;t:tci HC>7 Addren R11p11lr Organization P.O. No., Job No., etc.
~~3. Work Performed by __V:.. .1.=.*=.r.cgc:i:.:.n:..:i:..:a=-P::....::o..::w.=e:.:r:___ _ _ _ __ Type Code Symbol Stamp __.t,1._../.ccA1-_______~~
N11m11 Authorization No. ----'NLLf/_._A.,_________ P.O. Box 315, Surry, VA 23883 Expiration Oate _ _ _ _..1.N.>>-1-/.ufl..__ _ _ _ _ __ Addr11a 4, Identification of System _ _ _R.r.='S~IJ...c""=r-"'Q""'R~_... c...,,o'-'o.:....caLPr"-'-'\\i""-'::r~-----------------------
5. (a) Applicable Construction Code B31. l 19~Edition,_N.....:../_A.c....._ _ _ Addenda, N-1 N-7 Code Case (b) Applicable Edition of Section XI Utilized for Repairs or Replacements 1980W80

6. Identification of Components Repaired or Replaced and Replacement Components
~~Name of Component I~~
I Name of Manufacturer I Manufacturer Serial No. I I I National Board No. Other Identification I I Year Built Repaired, Replaced, or Replacement ASME Code Stamped (Yes or Nol i I
' BoL,g I \JN'°'l'>.JOU,N I l)t-\\<;N&~l\l I N/A c:t-Rc-f't.-24<?:;\ /ut.il\NOlllN ~Pl..FIO:b l'\O I"'8.Gi ~qll\lt\;Rll\\q f.11 I ~
~~N/A~~
~o~ csy \ \<\9D ~f>WB\'\c~, ~o i loOL1"S . :n: > lN-c.. cw ~5 I 3\6;}...'8'\-\
~~I Ni\)T$ I~~
~~\JNKl't0WN I lJN~~D~~~~
I I I N/A J.-l<L-n.- '.LI\%\ iv~lt~N ll..EHI\Cl:b NO I Cf\ l\.b \NI'\ L :i:r~ 1) I-IT:..; j f>o~ C:'>Y II I N\J"TS PR.o till c:-rs J'..NC. si~~1 '3C\ I N/A 3 'i 3 2..11-1 I \<\°l l ~P!.IKcl'll'E.t-tT NO I I
7. Description of Work _ ___,R_,,e"if~'°'""""'CR'"",e""'\l--__,(u;9,w\c_..,,.b,.,o-1-l:r1-s::,....__,&""'----'(""'lf,,;,.\-1--.!c!\~\/;~+/-~c.,,..__.i..t..:.'u/0i~*.,.,.)~---------

8. Tests Conducted: Hydrostatic O Pneumatic 0 Nominal Operating Pressure ~
OtherQ Pressure NOP psi Test Temp. NDf °F NOTE: Supplememal sheets in form of lists, sketches, or drawings may be used, provided (1) size is SY.a in. x 11 in., (21 Informa-tion in items 1 through 6 on this repon is included on each sheet, and (31 each sheet is numbered and the number of sheets is recorded at the top of this form . (12/82) This Form (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017
FORM NIS-2 (Back}
~~9. RemarKs -~/tc.c.::~=.f\,\c...:..:t-=---'-C""D"""D=t-:::;:.._..,,CJ""""ku...:::6~'5,____,__ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __~~
Aoplicable Manufacturer's Data Reports to be attached CERTIFICATE OF COMPLIANCE We certify that the statements made in the reoort are correct and this j<E.eLAC.EME.,...)I conforms to the rules of the ASME Code, Section x I. repair or rea,acement NIA Type Code Symbol S t a m P - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - Certificate of Authorization No. _N_/_A_____________ Expiration Date _ _N_/;__A_____________ Signed
;rProvinceof ~~ee, Title CERTIFICATE OF INSERVICE INSPECTION Date-~:;;c..,,-/_,_;_-S::~----* 19 1 the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State Virginia andemployedby HSBI&I Co.
91 of f/tl-r"tfo'f'd l C.f, have inspected the components described in this Owner's Report during the period q-('1- EI to 0- f?/- q ( , and state that to tne best of my knowledge'and* belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section XI. By signing this certificate neither the Inspector nor his employer makes any warrarirv, expressed or implied, concerning the examinations and corrective measures described in this Owner's R_epprt .. Furthermore, neither the Inspector nor his employer shall be liable in any manner. for any personal injury or property damage or a loss of any kind arising from or connected with this inspection.
~~-----l~~a.,.=.....:::.....=-::. :..-_--:--i't:-.'----'~"""'~=:o-=:;....-=----Commissions __V_A_S:__4...:3_________________~~
~~lnspector'~gnat~ National Boara, State, Province, and Endorsements Date_ _ _ ____.._7_-_(___ 6'__~~
~~° 19 q /~~
~~FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI~~
1. Owner Virginia Electric and Power Co. Date -:S-uL':/ 2.'-t 1 \ CJ "t I Name 5000 Dominion Blvd., Glen Allen, VA Sheet _ _~l__ of _ _ 1___________
~~Ad~ess 23060~~
~~2. Plant Surry Power Station Unit _ __,_!l..,___ _ _ _ _ _ _ _ _ _ _ _ _ __~~
~~Name P.O. Box 315, Surry, VA 23883 Address~~
~~3. Work Performed by Virginia Power Type Code Symbol Stamp _ _ _..,_N--+-/....,_A...,__ _ _ __~~
Name Authorization No. -------'N'-=.</_._A..,___ _ _ __ P.O. Box 315, Surry, VA 23883 Expiration Date _ _ _ _ _ ___,,N::.J.-j/:...A ......._____ Address
4. Identification of System _ _ _M.._~e~l~h,)--S-....::S:~E=---..f,-+1'1\.'-'"-~-------------------------

5. (a) Applicable Construction Code B31. 1 19§1___ Edition, __N_,_/_A_____ Addenda, N-1 N- 7 Code Case (b) Applicable Edition of Section XI Utilized for Repairs or Replacements 1980W80

6. Identification of Components Repaired or Replaced and Replacement Components
~~Name of Component Name of Manufacturer Manufacturer Serial No.~~
~~National Board No. Other Identification Year Built Repaired, Replaced, ASME Code Stamped or Replacement or No) (Yes~~
~~°)>lSc SC.1-\UTIE ~ '-'NKN~t-r N/f) ::t*tl\S-R.'i *lO\C.. l.'fiKNClbtl\ Al::P!.ACbb 1')-(J KO'i:'R: INC.~~
~~St\-\\J"'ffi ~ \-\"'( ~ fo ~ 5,s;y~~
~~'1:> I'S C... M 1.;:i:i..*n1~ Gi '1U,i":f-~ N/~ I'l.~{. 'is<is-"5 I ~'/Sf f \ ' l ; f > ~ tvd~~
7. Description of Work _ __1,..;E,,.,.e,..,?~~,..a....,.e.o,,.:::;.o.d...___.,.Jo.;1~'s.:,..,'C..;.,L....L*--------------------------

8. Tests Conducted: Hydrostatic O Pneumatic O Nominal Operating Pressure W Other O Pressure~N---D~P~_ _ psi Test Temp. Nor °F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is BY, in. x 11 in., (2) informa-tion in items 1 through 6 on this repon is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of th is fom, .
(12/82) This Form (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017
FORM NIS-2 (Back)
~~9. Remarks _ __,._8-'.....C.S-'-M--'£=----'=cJ,.,.ro""""'E--::;___c=..r=,A-,6c.,S___..aL"""-----------------------~~
Applicable Manufacturer's Data Reports to be attached CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this l;::EPLAGe;ME,at:Cconforms to the rules of the ASME Code, Section XI. repair or replacement Type Code Symbol Stamp __N_/_A __________________________________ Certificate of Authorization No. _N-'--/_A_____________ Expiration Date _ _N_/c...A _____________ Signed--1-0w:~y,p,~;,a-a,o~==+~T:.=--=SL=____../2v"""-"_..b....lA....,JE.Gt!-"""=-----Date _
~ or Owner's'Designee, Title or Province of Virginia CERTIFICATE OF INSERVICE INSPECTION and employed by HSBI&I Co*
~~_....,..~,<.-.=;;+a----=~:....:-,.'.___~~
,v Q I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State L , 19 91 of ---------~fl.'-'-'a..=1":......iT'-+f-'o,.._,.r_,d__,J.;-*-'C"""-T.._____::---=---~have inspected the components described in this Owner's Report during the period q-('l-a'l to~'-*~(...8_-_q~'------, and *state that to the best of my knowledge and belief, the Owner has performed examinations arid taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section XI.
By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or impli~d. concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspection.
~~-----~-"--=-:-'---:--:-.--"f._.~~
~~Inspector's Signature __~=~'-""=----Commissions __National V.,...A __5_4_3________________ Board, State, Province, and Endorsements Date 1-J. l( 19_q~'-~~
~~FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI~~
1. Owner Virginia Electric and Power Co. Date _ _,:r-;""-"'t.>.,.L'{_.__----1-/,,,,!::::>"--J-,_,_I9--'--l'-'-\_ _ _ _ __
~~Name 5000 Dominion Blvd., Glen Allen, VA Sheet _ __,i,.___ of 1 Address 23060~~
~~2. Plant Surry Power Station Unit _ _.....__ _ _ _ _ _ _ _ _ _ _ _ _ _ __~~
Name P.O. Box 315, Surry, VA 23883 J,.,\, ~"' 3S01H i.1.05:> /?(2.#q/-lDl Address Repair Organization P.O. No., Job No., etc.
~~3. Work Performed by Virginia Power Type Code Symbol Stamp _ _ _ _.,_N:.,,/~A~-----~~
Name Authorization No. _ _ _ _ _ ___._Ni,,,,,-1.1....A,...__ _ __ 1 P.O. Box 315, Surry, VA 23883 Expiration Date _ _ _ _ _ _ _ _N,..,._,,_/.,_P,_.____ _ __ 1 Address
4. Identification of System _ _ __,C."'O'-'-f{l-'-'?..,O""J\),,,...E.._.O\..,_,._~.,_____,(...,O..:.O""-"L..,l"'l\.,_1._.('.f+-----------------------

5. (a) Applicable Construction Code B31. l 19§.I__Edition,_N......:.../_A_ _ _ _ Addenda, N-1, N-7 Code Case (b) Applicable Edition of Section XI Utilized for Repairs or Replacements 1980W80

6. Identification of Components Repaired or Replaced and Replacement Components
~~Name of Component Name of Manufacturer Manufacturer Serial No.~~
National Board No. Other Identification Year Built Repaired, Replaced, or Replacement or No) ASME Code Stamped (Yes 1\ll)"fS CP-.1:\NS l"t':\-'lc'.Y1. N/A ;;.-a:.-).~'.). lJl'*~a.c~ REPU\CE~ NO Pl~ Gi 1:l\)~111\l;tR\ ~ 1-\1: :,a po~ csy NVTS J!- ) J:.~. RN ) "=I{, ~ N/R '340'.:I-G 'rs -l ~I> IBC£ J'l\1::1\)f NC l9'tD
~~7. Description of Work _ _ _...._R.,.e..,~~k.~~
~~fr1;\~~
~~......c:e""""'J"-'--_--'-c..i.;\tl,.,_)...,_____i_;:n.,,u:s....=1"l..l£."---ll.;~::...U.I!2..,__)~------------------~~
8. Tests Conducted: Hydrostatic D Pneumatic D Nominal Operating Pressure [3-Other D Pressure /Jop psi Test Temp. A-/1-18/f='.t,.(I ° F NOTE: Supplememal sheets in form of lists, sketches, or drawings may be used, provided (1) size is 8Y.. in. x 11 in., (21 informa-tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form .
(12/82) This Form (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017
FORM NIS-2 (Back)
~~9. Remarks -~-+A. . .6~M'---'-'E;..=-_ _,,C,....r>~D=E--=---1C=-'"1..._.A:.:....S""-S"---=.3=----------------------~~
Applicable Manufacturer's Data Reports to be attached CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this fa?e1,BceMf=,\C[: conforms to the rules of the ASME Code, Section XI. repair or replacement Type Code Symbol Stamp __N_/_A __________________________________ Certificate of Authorization No. _N"""'"/_A_____________ Expiration Date _ _N_/_A _____________ Signed 1
~
~~(,l~~
.() an4 Wn~6r Owner's Designee, Title Date---;91J-;p..=~--+,I:-<.._____ , 19 9 I CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State orProvinceof Virginia andemployedby HSBI&I Co. of ------H'-LC.:i1.=->r:c...l_,_,6,_,,,o,_r.:....;:,d,=....,J1--...C.-<..T.:.....:.'---------------~ have inspected the components described in this Own.er's. Report during the period q ... ('f- ~ to b- (~
q / , and state that to the best of my knowledge and belief, the Owner has performed examinations . and taken corrective. measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section XI.
By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this i-n-sp_e_c_t_io-~-i-1--=--=-,-.=.c..-~{......,"'.'".__~--------Commissions _ _V_A__ 5_4_3_________________ Inspector's Signature National Board, State, Province, and Endorsements
~~FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI~~
1. Owner Virginia Electric and Power Co, Date -=:T1 JI \/ )0) ) 9 C? I Name 5000 Dominion Blvd., Glen Allen, VA Sheet i of i Address 23060

2. Plant Surry Power Station Unit .t Name P.O. Box 315, Surry, VA 23883 Sob No. 3'6to(oleJ5:i01 ge-=1:!a-91-100 Address Repair Organization P.O. No., Job No., etc.

3. Work Performed by Virginia Power Type Code Symbol Stamp _ ____,_N-"~/..rE\:i.__ _ _ __
7 Name Authorization No. _ _ _ _ __,N'-¥/_,E,....______ 7 P.O. Box 315 2 Surry, VA 23883 Expiration Date _ _ _ _ _ ___i..;Nl!.,,t-1.i.1:\:..!....._ _ _ __ Address 7
~~4. Identification of System _ _ __,C......,"1,..n_..t... ~'Lm'+.l;e;..Ln.,_,_f_ __,5=-,.,/;l....c~tX>,!-'..., _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __~~
~~a.....,... I 7~~
5. (al Applicable Construction Code B31. l 19§.Z__Edition, __ N..:./_A_ _ _ _ Addenda, N-1, N-7 Code Case (bl Applicable Edition of Section XI Utilized for Repairs or Replacements 1980W80

6. Identification of Components Repaired or Replaced and Replacement Components ASME Code National Repaired, Stamped Name of Name of Manufacturer Board Other Year Replaced, (Yes Component Manufacturer Serial No. No. Identification Built or Replacement or No)
Nu.--l- (%\qx Si) TE)(~:!>. 80t-T Co UNKJA)\J'N N/~ .;t.-CS-EN(rlcil.\- Ulllkt.let.ulll R~f\°'cec\ No I ~MW,IEM'e: &f~'~ ~ Lor:#' PC:\*. c.s'{
~~ Nl!.,- (.\" - ~ ') Go. '1'ro:.. 01-8S"B N/A ~oi::i.1-~ \'lgB i\~\Qc.ern~I\~ No P--oJ. UN\<.tJO \..l:ll\J N/1' .:i.~~~l:.NC:r \Cl\ UNk\\lOtot'IJ Rer\o,ced. l\)e, CA~ct,~ 1r&ustr,o.l l.\eo..t ".\\ PO-;\\ CS'i ~od l\"1),~'t) 'i\oc\.1Acts I\'\c.. ii~C\1'5~ N/Pi 3/.\ oll-D - I 11q1 ~\o..c.ernen:t \\Jo
~~7. Description of Work. _ _. . . ,_,R. ,.e1'p""'Jo..,. c.... wl.1. 1'£,c~....~-'l)""'\:>'""ou.\1.J...f-/-'~c.,;o"'d"-------------------~~
~~ecl.......:l:i._~...N.,,_Jµ-.,.j'.l....-_,o...~~
8. Tests Conducted: Hydrostatic D Pneumatic D Nominal Operating Pressure D Other B Pressure _ _ _ _ _ psi Test Temp. _ _ _ _ _° F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1 I size is BY:. in. x 11 in., (21 informa-tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form .
(12/82) This Form (E00030) may be obtained from the Order Dept., ASME, 345 E. 47th St., New York, N.Y. 10017
FORM NIS-2 (Back) O=D'-'E-=-__,,_(_,,.LA:....,,.,::':>-$,___,:Z...'-=----------------------
~~9. Remarks -.llA..!..:C:~c.:..M:....:.:..F----=-....,C..-,....~~
Applicable Manufacturer's Data Reports to be attached CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this ?E;PLAC.E.~ conforms to the rules of the ASME Code, Section XI. repair*or replacement Type Code Symbol Stamp __N_/_A __________________________________ Certificate of Authorization No. _N....;../_A____________ Expiration Date _ _N-'/_A ____________ Signed ~ !tL?'HI
~~~lorowner's Des16nee, Title or Province of Vir~inia vI Date~~~
CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State and employed by HSBI&I Co*
~~,1s.2L_~~
~~of f/"'-r fi::. iccl J Ci-~~
have inspected the components described in this Owner's Report during the, period q- {'f-S1 ~9

6- I 8 'f (
A * * * ; and state that to the best of my knowledge and belief; the Owner has performed examinations and taken_corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code;Section XI. By signing this certificate neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. *Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arisingfrom or connected with this inspection.~ _ _ _ _* -~,i...:::.=-'---*-' _._._f-"-._*.....e""""~..,.;::a.='-----Commissions __V_A_5_4_3________________ inspector's Signature National Board, State, Province, and Endorsements Date,_ _ _ _ _ 7..__-__(_0~_19 q f
~~------------*--*---* ----------- - *-- - . -----*- *- - -~----**-------.}}~~

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ML18151A159: Difference between revisions

Latest revision as of 11:50, 17 March 2020

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