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Pressure Vessel Inspection Report

(Not Applicable for Certified Owner/User Inspections) the pressure equipment safety authority

AB-12 2004/09

A Number: Owner ID Number: Date of Inspection: Recommended Next Inspection Date: Recommended Interval:(yrs):

Vessel Description: Vessel Location Vessel Mfg.: Owners Name: Owners Address: Service: Air LPG Oil Sweet Gas Min Temp ID No. Sour Gas (H2S) Set Pres Cyclic Vibration Other: Service Date Service Interval Serial #: Vessel Has Manway: Yes No

Vessel Data MAWP Max Temp Shell Side Tube Side

Safety Valve Data Capacity Location Units

Examination Methods (Identify Visual and other NDE performed and Extent):

Internal Condition (Indicate Inaccessible Areas, continue on the other side if needed):

External Condition:

Pressure Test: (if performed) Indicate test pressure and medium and reason for test. Remarks:

I certify that the above examinations were completed in accordance with ABSA Inspection and Servicing Requirements Document and the Safety Codes Act. Name of Inspector:

Employed by: Signature: Date:

Alberta In-Service Inspector Certificate #

Accepted by:

ABSA Safety Codes Officer