Application Form

API 510, Pressure Vessel Inspector Certification Program New Certification

Personal Data
Name (First, Middle, Last) Social Security Number

Recertification
(Please allow at least 6 weeks for processing)

Home Address (Number and Street)

Home Telephone Number

City, State and Zip Code

Date of Birth

Country

Home Email

Employer Data
Employer Work Telephone Number

Employers Address (P.O. Box or Number and Street)

Fax Number

City, State and Zip Code

Business Email

Country

Cell Phone or Pager Number

Please indicate at which address you wish to receive API-related materials:

Home

Work

How did you hear about the Inspector Certification Programs?

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Education and Training

API 510, Pressure Vessel Inspector Certification Program High School
Name Location Year Graduated
(Not Required for Recertification or if API has another application on file with this information)

Name

Location

Year Graduated

Trade School
Name Location Field of Study Year Graduated

Name

Location

Field of Study

Year Graduated

Name

Location

Field of Study

Year Graduated

Name

Location

Field of Study

Year Graduated

College
Name Dates Attended Major Degree Type Year Graduated

Name

Dates Attended

Major

Degree Type

Year Graduated

Name

Dates Attended

Major

Degree Type

Year Graduated

Name

Dates Attended

Major

Degree Type

Year Graduated

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Inspection Employment History

API 510, Pressure Vessel Inspector Certification Program
(Last three employers or at least the last three years)

1.

Name and Address of Employer (Current) Employer Mailing Address (Number and Street) City, State and Zip Code

Date of Employment From: ____________________ To: ____________________ ____________________ Employers Telephone

Job Title/Brief Description

2.

Name and Address of Employer Employer Mailing Address (Number and Street) City, State and Zip Code

Date of Employment From: ____________________ To: ____________________ ____________________ Employers Telephone

Job Title/Brief Description

3.

Name and Address of Employer Employer Mailing Address (Number and Street) City, State and Zip Code

Date of Employment From: ____________________ To: ____________________ ____________________ Employers Telephone

Job Title/Brief Description

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Qualification Method
API 510, Pressure Vessel Inspector Certification Program (Not Required for Recertification)

Please place a check by the method under which you are qualified to be certified as a pressure vessel inspector.

A. Written Examination Under API Standard 510 (Complete Test Registration Form next page) B. Successfully passed exam for the National Board of Boiler and Pressure Vessel Inspectors Owner-User Commission or Certificate of Competency. In which jurisdiction did you take the test? Please provide: Proof that candidate has successfully passed the exam for NB commission, OR A copy of your Commission or Certificate of Competency; AND A completed PVICP Application Form; AND A notarized Employment Reference Form to verify work experience. (A form for each employer is required.); and The applicable certification fee in U.S. dollars, payable to the American Petroleum Institute. Date:

ATTENTION: NATIONAL BOARD CERTIFICATION QUALIFICATION METHOD IS VALID ONLY FOR THE FIRST-TIME 510 APPLICANTS

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API 510 Test Registration (Your Name :

)
for a retest. Charges apply; see page 5 for details.

(Not Required for Recertification) Form may also be used to reschedule a test or register Examination Locations and Dates Please indicate method of payment using page 37.
Please indicate which API 510 Inspector Certification Examination you wish to take: June 5, 2002 (Application Deadline March 30, 2002 for credit card and check payments) December 4, 2002 (Application Deadline September 20, 2002 for credit card and check payments) Please note that the application deadlines are firm no exceptions are made. Please indicate your preferred testing location. (Every effort will be made to assign you to the location of your choice. Seating is limited; apply early to get the location of your choice . Site may be changed

after deadline; see details in front of application package.

* A sitting fee will be required at these locations.

Alaska: Anchorage* California: Oakland* California: Los Angeles Florida: Tallahassee* Georgia: Atlanta* Illinois: Springfield* Canada Alberta: Edmonton*

Indiana: Indianapolis Louisiana: Baton Rouge Maryland: Baltimore* Minnesota: St. Paul* Oklahoma: Oklahoma City* Pennsylvania: Harrisburg*

Texas: Corpus Christi Texas: Houston Utah: Salt Lake City* Washington: Seattle 1 West Virginia: Charleston* Wisconsin: Madison*

British Columbia: Vancouver*

Elsewhere: (please contact API to verify availability of these sites) Bahrain Singapore ATTN: API can organize a test site anywhere in the world if there is sufficient interest. Please contact us for details, if your preferred location is not on the list. Please provide: A notarized Employment Reference Form to validate work experience. (A form for each employer is required.); A notarized copy of diplomas or school transcripts to validate educational requirements; and The certification fee in U.S. dollars, payable to the American Petroleum Institute.
1

Trinidad

Candidates must also take the Washington State Boiler/Pressure Vessel Law Examination. Call 360-902-5270 to register.

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Inspector Agreement
API 510, Pressure Vessel Inspector Certification Program
The applicant (the inspector) agrees to the following conditions: 1. The API 510 Pressure Vessel Inspector Certification Program is designed to assist users in identifying inspectors who have satisfied the minimum qualifications specified in API Standard 510. API does not warrant or guarantee the competency of any inspector certified under this program. The inspector agrees not to mislead customers or the public about the scope and purpose of this program. 2. API may terminate an inspectors certification if API determines that the inspector has made material errors, omissions, or misrepresentations on the application or in documents submitted to API. 3. The inspector agrees to submit any supplemental information or documents deemed necessary by API to verify an inspectors qualifications. 4. API shall be the sole judge of whether the inspector has the appropriate qualifications to become certified. 5. The inspector authorizes API to release information to regulatory agencies, current or potential employers, or other interested parties concerning the inspectors certification status. 6. The inspectors certification will not be renewed unless the inspector submits the appropriate application and renewal fee to API prior to the expiration of the initial certification. 7. An inspectors certification will only be renewed if the inspector fully complies with subsequent revisions to API 510, interpretations of API 510, and additional requirements imposed by API in subsequent renewal applications. 8. API will attempt (but assumes no duty) to notify inspectors of significant changes to the program at the inspectors last known address. It is the responsibility of the inspector to notify API of address changes. The failure of API to notify an inspector of a renewal date or modification of the program does not relieve the inspector of the responsibility to file a timely renewal application or to comply with new certification requirements. It is the responsibility of the inspector to obtain this information from API. 9. API may terminate the program at any time and for any reason deemed appropriate by API. 10. Upon receipt of notice of decertification by API, an inspector agrees to return all certification documents to API within 30 days.

I, the undersigned, certify that I have read and fully comprehend this form in its entirety and agree to comply with the conditions specified above. I certify that the information herein provided is true and complete to the best of my knowledge.

___________________________________________
Signature of Applicant

_________________________
Date

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Inspector Agreement (Page 2)

API 510, Pressure Vessel Inspector Certification Program
The applicant (the inspector) agrees to the following conditions: 1. Each new application remains valid for a period of 18 months from the date of receipt by API. API administers ICP exams every 6 months. Therefore, API grants each applicant three consecutive attempts during the 18-month period to sit and pass the test, starting with the first exam administration the applicant registers for. Applicants must pass the exam within these three consecutive exam administrations. If an applicant fails to appear for the test, cancels his/her appearance and reschedules, or takes the exam and fails it, it will count as an official attempt. If the applicant does not obtain a certification within this period of time and still wishes to obtain the certification, they must start the application process again, including re-submission of a full fee and a complete new application. All requests for refunds must be submitted in writing by mail or by fax to API no later than 1 year from the date payment was received by API. Requests for refunds received after this one-year period cannot be fulfilled. An applicant is entitled to a full refund of the application fees only if API receives the refund request prior to the exam application deadline (usually 11 weeks before the exam date). An applicant is entitled to a 50% refund of the application fee if the refund request is received by API within 1 year from the date payment was received by API. No refunds will be made if an applicant has taken the test and failed. API must receive recertification applications prior to the current certifications expiration date. Recertification applications must be mailed, as API requires the original of the notarized page. Recertification applications received by API within three months after the expiration date will be processed, but a $150 late fee is required. API will attempt (but assumes no duty) to notify all inspectors of their approaching certification expiration dates at their last known address. It is ultimately the responsibility of each inspector to notify API of address changes. The failure of API to contact an inspector does not relieve the inspector of the responsibility to file a timely renewal application with API.

2.

3. 4. 5. 6. 7. 8. 9.

10. Circumstances beyond APIs control (e.g., heavy work schedule, work in other countries) do not relieve the inspector of the responsibility to file a timely renewal application. 11. Inspectors who do not file for recertification within three months after the current certification expiration date will be decertified.

I, the undersigned, certify that I have read and fully comprehend this form in its entirety and agree to abide by the policies and regulations specified above.

__________________________________________

_______________

Signature of Applicant

Date

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Employment Reference Form

API 510, Pressure Vessel Inspector Certification Program
Note: This form applies to API 510 and must cover an aggregate of the required amount of experience based on education. This experience must be current to within 3 years of expected certification (5 years for those without high school education). This form may need to be updated if the experience is no longer current relative to certification date. Applicants Name: Social Security Number: Company:

Name of Supervisor Address Affirms that Name of Applicant from

Title Telephone Number worked for Company to

Beginning Date

Ending Date

Please check the box of the applicable statement. 1. For first time applicants only: During this period the applicant has one of the following experience/education combinations in:
Education
BS or higher in engineering 2-year degree or certificate in engineering or technology High school diploma or equivalent None

Minimum Experience Required

1 year 2 years

Skill
Design, construction, repair, operation or, inspection of pressure vessels, of which 1 year must be in supervision or performance of inspection activities.

3 years 5 years or more

2.

For re-certification applicants only: During this period the applicant has been employed as a Certified Inspector under API Standard 510. ALL APPLICANTS MUST HAVE THE AREA BELOW COMPLETED AND NOTARIZED

__________________________________________
Supervisor's Signature

_______________________
Date

Subscribed and sworn to before me the ___________________ day of ________________, ______.

Notary's Signature My commission expires _________________________.

Notary Public 12/01 For Accounting Use Only: SS-2100-D9200-7110

Date

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Supplemental Information
API 510, Pressure Vessel Inspector Certification Program

1.

Do you currently have an active API certification? If yes, enter your certification number and expiration date. If you answer yes, you need not complete the Education and Training Form.

Yes

No

510 Certification Number 570 Certification Number 653 Certification Number 2.

Expiration Date Expiration Date Expiration Date Yes No

Are you currently a full-time, non-contract employee of an API member company? If yes, please enter the company name.

3.

Please check the box that correctly describes your organization type.

CHEMICAL CONSULTING/CONSTRUCTION INDIVIDUAL CONTRACTOR INSPECTION COMPANY OTHER PETROLEUM

Discounts for the API Inspector Certification Program are being offered if the applicant meets one of the following criteria: 1. 2. Currently certified as an API Authorized Inspector in either API 570 or API 653 programs. A full-time and permanent employee of a company currently paying membership dues to the American Petroleum Institute.

If your company does not meet criteria #2, you must pay the nonmember price.

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API 510 Initial Certification Fees

API member rate applies to full-time, non-contract employees of API-member companies.

API Member
Number of other API Certifications you already have No other current API Certifications Current 570 or 653 API certification Certification Fee 500 450

Non Member
Certification Fee 750 675

API 510 Recertification Fees

API member rate applies to full-time, non-contract employees of API-member companies.

API Member
Number of other API Certifications you already have No other current API Certifications Current 570 or 653 API certification Recertification Fee 400 350

Non Member
Recertification Fee 600 525

Payment Type
Charge Card : Card Number: Name as it appears on card Signature Check Purchase Order
P.O. Number

Visa

American Express Expiration Date: ______________________________________

MasterCard

_______________________________________

Total Submitted
Certification fee Penalties/Other Bank fee (if wired) Total:

Wire Transfer to Citibank, F.S.B. Washington, DC 20036-0967 ABA Routing No. 254070116 Credit to: American Petroleum Institute Account No. 6672-0060 Reference: Applicants name and SS-2100-D9200-7110 For wire transfers please make sure to include pertinent bank fees

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Publications Effectivity Sheet

API 510, Pressure Vessel Inspector Certification Exam For Exam Administration: June 5, 2002

Listed below are the effective editions of the publications required for the June 5, 2002 API 510, Pressure Vessel Inspector Certification Examination. API Standard 510, Pressure Vessel Inspection Code: Maintenance Inspection, Rating, Repair, and Alteration, Eighth Edition, June 1997, Addendum 1 (December 1998) and Addendum 2 (December 2000). Global Engineering Product Code API CERT 510 API Recommended Practice 572, Inspection of Pressure Vessels, First Edition, February 1992. Global Engineering Product Code API CERT 572 API Recommended Practice 576, Inspection of Pressure-Relieving Devices, Second Edition, December 2000. Global Engineering Product Code API CERT 576 Guide for Inspection of Refinery Equipment, Chapter 2* Global Engineering Product Code API CERT GUIDE IRE CH2 *Note: This publication is a reference document intended only for Inspector Certification applicants. To obtain a copy please inform the person taking your order that you require this publication for the API 510 Inspector Certification exam. American Society of Mechanical Engineers (ASME), Boiler and Pressure Vessel Code, 1998 edition with July 1999 and July 2000 addenda. i. ii. ASME Section IID, External Pressure Graphs only ASME Section V, Nondestructive Examination, Articles 1, 2, 5, 6 and 7

iii. Section VIII, Rules for Construction of Pressure Vessels, Division 1, UG, UW, UCS, UHA, Appendices 1-4, 6, 8 and 12 iv. Section IX, Welding and Brazing Qualifications Global Engineering Product Code for the ASME package API CERT 510 ASME. Package includes only the above excerpts necessary for the exam.

API and ASME publications may be ordered through Global Engineering Documents at 303-792-2181 or 800-8547179. Product codes are listed above. Orders may also be faxed to 303-397-7935. More information is available at http://www.global.ihs.com. API members are eligible for a 50% discount on all API documents; exam candidates are eligible for a 20% discount on all API documents. When calling to order, please identify yourself as an exam candidate and/or API member. Prices quoted will reflect the applicable discounts. No discounts will be made for ASME documents. For the complete sets of ASME documents including future addenda, please contact ASMEs publications department at 1-800-843-2763. In Canada, ASME publications are available through Power Engineering Books, Ltd. at 1800-667-3155 or 403-458-3155.
Note: API and ASME publications are copyrighted material. Photocopies of API publications are not permitted. CD-ROM versions of the API documents are issued quarterly by Information Handling Services. Be sure to check your CD-ROM against the editions noted on this sheet.

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API 510 Certification Program Pressure Vessel Inspector

Checklist

Your completed application package must include all of the following:

1. 2. All pages of the application filled out completely. A notarized Employment Reference Form for each employer. If you have a high school education, you MUST provide AT LEAST THREE YEARS of documented experience. A copy of your school transcripts or diploma (if you have less than five years of relevant experience). Both pages of a signed Inspector Agreement Form. The certification fee.

3.

4. 5.

Mail credit card payments, purchase orders, check, or money orders (please include candidates name(s) on all payments) and your application to:
American Petroleum Institute Inspector Certification Programs (SS-2100-D9200-7110) P.O. Box 1425 Merrifield, VA 22116

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