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Name of Company
Add.:
Tel.: Fax.: Email: .

WELDER & WELDING OPERATOR PERFORMANCE QUALIFICATION TEST RECORD

(IN ACCORDANCE WITH AWS D1.1 2015)
PHOTO Name : Record No.:
Employee ID. : ABS Report No.:
Welder ID. : Witnessed by:
Approved WPS: : Test Date:
Employer :
Welding carried out at: on date

BASE METALS Specification Type or Grade AWS Group No. Size (NPS) Schedule Thickness Diameter
Base Material
Welded to

VARIABLES ACTUAL VALUES RANGE QUALIFIED

Type of Weld Joint

Base Metal

Groove Fillet Groove Fillet

Plate thickness
Pipe/Tube Thickness
Pipe Diameter

Welding Process
Type (Manual, Semi-automatic, Machine,
Automatic, )
Backing
Filler Metal (AWS Spec.)
AWS Classification
F-Number
Diameter
Position
Groove Plate & Pipe 600mm
Groove Pipe < 600mm
Fillet Plate & Pipe 600mm
Fillet Pipe < 600mm
Progression
GMAW Transfer Mode
Single or Multiple Electrodes
Gas/Flux Type
Other
TEST RESULTS
Type of Test Results Date Report No. Authorized by:
Visual Inspection
Radiographic test
Bend test
Fracture test
Macro-etch test
Other
We certify that the statements in this record are correct and that the test welds were
prepared, welded, and tested in accordance with the requirements of Clause 4 of AWS
D1.1/D1.1M (2015) Structure Welding Steel. Name:
See overleaf side for prolongation record every six (6) months. Date:
 PROLONGATION RECORD
Certificate No.:
Original Test Date:
Prolongation for qualification every six months

Date Signature/Stamp Date Signature/Stamp

New prolongation records sheet: Yes No

Revocation or Expiry of Qualification on: / /

Signature and Stamp:

Name: