AWS D1.1/D1.1M:2010
ANNEX N
WELDER, WELDING OPERATOR, OR TACK WELDER QUALIFICATION TEST RECORD
Type of Welder ________________________________________________
Name _______________________________________________________ Identification No.____________________
Welding Procedure Specification No. _________________ Rev ___________________ Date ___________________
Record Actual Values
Used in Qualification
Qualification Range
Variables
Process/Type [Table 4.12, Item (1)]
Electrode (single or multiple) [Table 4.12, Item (7)]
Current/Polarity
Position [Table 4.12, Item (4)]
Weld Progression [Table 4.12, Item (5)]
Backing (YES or NO) [Table 4.12, Item (6)]
Material/Spec.
to
Base Metal
Thickness: (Plate)
Groove
Fillet
Thickness: (Pipe/tube)
Groove
Fillet
Diameter: (Pipe)
Groove
Fillet
Filler Metal (Table 4.12)
Spec. No.
Class
F-No. [Table 4.12, Item (2)]
Gas/Flux Type (Table 4.12)
Other
VISUAL INSPECTION (4.9.1)
Acceptable YES or NO _____
Guided Bend Test Results (4.31.5)
Type
Result
Type
Result
Fillet Test Results (4.31.2.3 and 4.31.4.1)
Appearance _________________________________
Fillet Size ____________________________________
Fracture Test Root Penetration ___________________
Macroetch ___________________________________
(Describe the location, nature, and size of any crack or tearing of the specimen.)
Inspected by __________________________________
Test Number ___________________________________
Organization __________________________________
Date _________________________________________
RADIOGRAPHIC TEST RESULTS (4.31.3.2)
Film Identification
Film Identification
Number
Results
Remarks
Number
Results
Remarks
Interpreted by _________________________________
Test Number ___________________________________
Organization __________________________________
Date _________________________________________
We, the undersigned, certify that the statements in this record are correct and that the test welds were prepared, welded, and
tested in conformance with the requirements of Clause 4 of AWS D1.1/D1.1M, (__________ ) Structural Welding Code—Steel.
(year)
Manufacturer or Contractor _______________________
Authorized By __________________________________
Date _________________________________________
Form N-4
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