FORM U-1 MANUFACTURER'S DATA REPORT FOR PRESSURE VESSELS As Required by the Provisions of the ASME Boiler and Pressure Vessel Code Rules, Section VIII, Division 1

1. Manufactured and certified by(Name and address of Manufacturer)

2. Manufactured for(Name and address of Purchaser)

3. Location of installation(Name and address)

4. Type(Horizontal, vertical, or sphere) (Tank, separator, jkt. vessel, heat exch., etc.) (Manufacturer's serial number)

(CRN) (Drawing number) (National Board number) (Year built)

5. ASME Code, Section VIII, Div. 1[(Edition and Addenda (date)] (Code Case number) [Special service per UG-120(d)]

Items 6-11 incl. to be completed for a single wall vessels, jackets of the jacketed vessels, shell of heat exchangers, or chamber of multichamber vessels

6. Shell: (a) Number of courses (b) Overall length

Courses Material Thickness Long. Joint (Cat. A) Circum. Joint (Cat. A, B & C) Heat Treatment

No. Diameter Length Spec./Grade or Type Nom. Corr. Type Full, Spot, Non Eff. Type Full, Spot, None Eff. Temp. Time

7. Heads (a) (b)(Material spec. number, grade or type) (H.T. - time and temp) (Material spec. number, grade or type) (H.T. - time and temp)

Location (Top, Thickness Radius Elliptical Conical Hemispherical Flat Side to Pressure Category A

Bottom, Ends) Min. Corr. Crown Knuckle Ratio Apex Angle Radius Diameter Convex Concave Type Full, Spot, None Eff.

(a)

(b)

If removable, bolts used (describe other fastenings(Material spec. number, grade, size number)

8. Type of jacket Jacket closure(Describe as ogee weld, bar, etc.)

If bar, give dimensions If bolted, describe or sketch.

9. MAWP at max. temp. Min. design metal temp. at(Internal) (External) (Internal) (External)

10. Impact test at temperature of

(Indicate yes or no and the component(s) impact tested)

11. Hydro., pneu., or comb. Test pressure Proof test

Items 12 and 13 to be completed for tube sections.

12. Tubesheet[Stationary (material spec. no.)] (Diameter (subject to press.) (Nominal thickness) (Corr. allow.) (Attachment (welded or bolted)

[Floating (material, spec., no.)] (Diameter) (Nominal thickness) (Corr. allow.) (Attachment)

13. Tubes(Material spec., no., grade or type) (O.D.) (Nominal thickness) (Number) [Type (straight) or U]

Items 14-18 incl. to be completed for inner chambers of jacketed vessels or channels of heat exchangers.

14. Shell: (a) No. of course(s) (b) Overall length

Courses Material Thickness Long. Joint (Cat. A) Circum. Joint (Cat. A, B & C) Heat Treatment

No. Diameter Length Spec./Grade or Type Nom. Corr. Type Full, Spot, Non Eff. Type Full, Spot, None Eff. Temp. Time

15. Heads: (a) (b)(Material spec., number, grade or type)(H.T.- time and temp) (Material spec., number, grade or type)(H.T.- time and temp)

Location (Top, Thickness Radius Elliptical Conical Hemispherical Flat Side to Pressure Category A

Bottom, Ends) Min. Corr. Crown Knuckle Ratio Apex Angle Radius Diameter Convex Concave Type Full, Spot, None Eff.

(a)

(b)

If removable, bolts used (describe other fastenings)

(Material spec., number, grade, size, number)

Form U-1 (Back)

16. MAWP at max. temp. Min. design metal temp. at

(Internal) (External) (Internal) (External)

17. Impact test at temperature of

(Indicate yes or no and the component(s) impact tested)

18. Hydro., pneu., or comb. Test pressure Proof test

19. Nozzles, inspection, and safety valve openings:

Purpose Diameter Flange Material Nozzle Thickness Reinforcement How Attached Location(Inlet, Outlet, Drain) No. or Size Type Nozzle Flange Nom. Corr. Material Nozzle Flange (Insp. Open.)

20. Supports: Skirt Lugs Legs Others Attached

(Yes or no) (Number) (Number) (Describe) (Where and how)

21. Manufacturer's Partial Data Reports properly identified and signed by the Commissioned Inspectors have been furnished for the following items of the report (list the name of part, item number, Manufacturer's name, and identifying number):

22. Remarks

All diameters specified are on Inside Diameter Basis.

CERTIFICATE OF SHOP COMPLIANCE

We certify that the statements in this report are correct and that all details of design, material, construction, and workmanship of this vessel

conform to the ASME BOILER AND PRESSURE VESSEL CODE, Section VIII, Division 1.

U Certificate of Authorization Number Expires

Date Name Signed(Manufacturer) (Representative)

CERTIFICATE OF SHOP INSPECTION

I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and/or the State or Province

of and employed by of

have inspected the pressure vessel described in this Manufacturer's Data Report on , and state that, to the best

of my knowledge and belief, the Manufacturer has constructed this pressure vessel in accordance with ASME BOILER AND PRESSURE VESSEL CODE, Section VIII, Division 1.

By signing this certificate neither the Inspector nor his/her employer make any warranty, expressed or implied, concerning the pressure vessel described in this Manufacturer's Data Report.

Furthermore, neither the Inspector nor his/her employer shall be liable in any manner for personal injury or property damage or the loss of any kind arising from or connected with

this inspection.

Date Signed Commission

(Authorized Inspector) [National Board (incl. endorsements), State, Province, and number]

CERTIFICATE OF FIELD ASSEMBLY COMPLIANCE

We certify that the statements in this report are correct and that the field assembly construction of all parts of this vessel conforms with the requirements of

ASME BOILER AND PRESSURE VESSEL CODE, Section VIII, Division 1. U Certificate of Authorization Number Expires

Date Name Signed

(Assembler) (Representative)

CERTIFICATE OF FIELD ASSEMBLY INSPECTIONI, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and/or the State or Province

of and employed by

of , have compared the statements in this Manufacturer's Data Report with the described pressure vessel

and state that parts referred fo as data items , not included in the corticated of shop inspection, have been

inspected by me and to the best of my knowledge and belief, the Manufacturer has construction and assembled this pressure vessel in accordance with the ASME BOILER AND

PRESSURE VESSEL CODE, Section VIII, Division 1. The described vessel was inspected and subjected to a hydrostatic test of

By signing this certificate neither the Inspector nor his/her employer makes any warranty, expressed or implied, concerning the pressusre vessel described in the Manufacturer's Data Report.

Furthermore, neither the Inspector nor his/her 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.

Date Signed Commissions

(Authorized Inspector) [National Board (incl. endorsements), State, Province and number]

FORM U-4 MANUFACTURER'S DATA REPORT SUPPLEMENTARY SHEET

As Required by the Provisions of the ASME Boiler and Pressure Vessel Code Rules, Section VIII, Division 1

1. Manufactured and certified by

(Name and address of Manufacturer)

2. Manufactured for

(Name and address of Purchaser)

3. Location of installation

(Name and address)

4. Type(Horizontal, vertical, or sphere) (Tank, separator, jkt. vessel, heat exch., etc.) (Manufacturer's serial number)

(CRN) (Drawing number) (National Board number) (Year built)

5. ASME Code, Section VIII, Div. 1 [(Edition and Addenda (date)] (Code Case number) [Special service per UG-120(d)]

Data Report

Item Number Remarks

Certification of Authorization: Type No. Expires

Date Name Signed

(Manufacturer) (Representative)

Date Name Commissions(Authorized Inspector) [National Board (incl. endorsements), State, Province, and number]

FORM U-1A MANUFACTURER'S DATA REPORT FOR PRESSURE VESSELS

(Alternative Form for Single Chamber, Completely Shop or Field Fabricated Vessels Only)

As Required by the Provisions of the ASME Boiler and Pressure Vessel Code Rules, Section VIII, Division 1

1. Manufactured and certified by(Name and address of Manufacturer)

2. Manufactured for(Name and address of Purchaser)

3. Location of installation(Name and address)

4. Type(Horizontal or vertical, tank) (Manufacturer's serial number) (CRN) (Drawing number) (National Board number) (Year built)

5. The chemical and physical properties of all parts meet the requirements of material specifications of the ASME BOILER AND PRESSURE VESSEL

CODE. The design, construction, and workmanship conform to ASME Rules, Section VIII, Division 1Year

to[Addenda (date)] (Code Case numbers) [Special service per UG-120(d)]

6. Shell(Material spec. number, grade) (Nominal thickness) (Corr. allow.) (Inner diameter) [Length (overall)]

7. Seams[Long. (welded, dbl.,sngl., lap, butt)] [R.T. (spot or full)] (Eff., %) (H.T. temp.) (Time, hr) [Girth (welded, dbl., sngl., lap, butt)] [R.T. (spot or full)] (Eff., %) (No. of courses)

8. Heads: (a) Material (b) Material(Spec. no., grade) (Spec. no., grade)

Location (Top, Minimum Corrosion Crown Knuckle Elliptical Conical Hemispherical Flat Side to Pressure

Bottom, Ends) Thickness Allowance Radius Radius Ratio Apex Angle Radius Diameter ( Convex or Concave)

(a)

(b)

If removable, bolts used (describe other fastenings)(Material spec. number, grade, size number)

9. MAWP at max. temp.(Internal) (External) (Internal) (External)

Min. design metal temp. at Hydro., pneu., or comb. test pressure

10. Nozzles, inspection, and safety valve openings:

Purpose Diameter Nominal Reinforcement How

(Inlet, Outlet, Drain) Number or Size Type Material Thickness Material Attached Location

11. Supports: Skirt Lugs Legs Other Attached(Yes or no) (Number) (Number) (Describe) (Where and how)

12. Remarks: Manufacturer's Partial Data Reports properly identified and signed by the Commissioned Inspectors have been furnished for

the following items of the report:(Name of part, item number, manufacturer's name and indentifying stamp)

CERTIFICATE OF SHOP/FIELD COMPLIANCE

We certify that the statements in this report are correct and that all details of design, material, construction, and workmanship of this vessel

conform to the ASME BOILER AND PRESSURE VESSEL CODE, Section VIII, Division 1. "U" Certificate of Authorization Number

expires

Date Co. name Signed

(Manufacturer) (Representative)

CERTIFICATE OF SHOP/FIELD INSPECTION

Vessel constructed by at

I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and/or the State or Province of

, and employed by

have inspected the component described in this Manufacturer's Data Report on , and state that,

to the best of my knowledge and belief, the Manufacturer has constructed this pressure vessel in accordance with ASME BOILER AND PRESSURE VESSEL CODE, Section VIII,

Division 1. By signing this certificate neither the Inspector nor his/her employer make any warranty, expressed or implied, concerning the pressure vessel described in this Manufacturer's

Data Report. Furthermore, neither the Inspector nor his/her employer shall be liable in any manner for personal injury or property damage or the loss of any kind arising from or

connected with this inspection.

Date Signed Commissions

(Authorized Inspector) [National Board (incl. endorsements), State, Province, and number]

FORM U-2 MANUFACTURER'S PARTIAL DATA REPORT A Part of a Pressure Vessel Fabricated by One Manufacturer for Another Manufacturer As required by the Provisions of the ASME Boiler and Pressure Vessel Code rules, Section VIII, Division 1

1. Manufactured and certified by(Name and address of Manufacturer)

2. Manufactured for(Name and address of Purchaser)

3. Location of installation(Name and address)

4. Type[Description of vessel part (shell, two-piece head, tube bundle)] (Manufacturer's serial; number) (CRN)

(National Board Number) (Drawing number) (Drawing prepared by) (Year built)

5. ASME Code, Section VIII, Div. 1[(Edition and Addenda (date)] (Code Case number) [Special service per UG-120(d)]

Items 6-11 incl. to be completed for a single wall vessels, jackets of the jacketed vessels, shell of heat exchangers, or chamber of multichamber vessels

6. Shell: (a) Number of course(s) (b) Overall length

Course(s) Material Thickness Long. Joint (Cat. A) Circum. Joint (Cat. A, B & C) Heat Treatment

No. Diameter Length Spec./Grade or Type Nom. Corr. Type Full, Spot, Non Eff. Type Full, Spot, None Eff. Temp. Time

7. Heads (a) (b)(Material spec. number, grade or type) (H.T. - time and temp) (Material spec. number, grade or type) (H.T. - time and temp)

Location (Top, Thickness Radius Elliptical Conical Hemispherical Flat Side to Pressure Category A

Bottom, Ends) Min. Corr. Crown Knuckle Ratio Apex Angle Radius Diameter Convex Concave Type Full, Spot, None Eff.(a)(b)

If removable, bolts used (describe other fastenings(Material spec. number, grade, size number)

8. Type of jacket Jacket closure(Describe as ogee weld, bar, etc.)

If bar, give dimensions If bolted, describe or sketch.

9. MAWP at max. temp. Min. design metal temp. at(Internal) (External) (Internal) (External)

10. Impact test at test temperature of

(Indicate yes or no and the component(s) impact tested)

11. Hydro., pneu., or comb. test pressure Proof test

Items 12 and 13 to be completed for tube sections.

12. Tubesheet[Stationary (material spec. no.)] (Diameter (subject to press.) (Nominal thickness) (Corr. allow.) (Attachment (welded or bolted)

[Floating (material, spec., no.)] (Diameter) (Nominal thickness) (Corr. allow.) (Attachment)

13. Tubes(Material spec., no., grade or type) (O.D.) (Nominal thickness) (Number) [Type (straight or U)]

Items 14-18 incl. to be completed for inner chambers of jacketed vessels or channels of heat exchangers.

14. Shell: (a) No. of course(s) 2 (b) Overall length

Course(s) Material Thickness Long. Joint (Cat. A) Circum. Joint (Cat. A, B & C) Heat Treatment

No. Diameter Length Spec./Grade or Type Nom. Corr. Type Full, Spot, Non Eff. Type Full, Spot, None Eff. Temp. Time

15. Heads: (a) (b)(Material spec., number, grade or type)(H.T.- time and temp) (Material spec., number, grade or type)(H.T.- time and temp)

Location (Top, Thickness Radius Elliptical Conical Hemispherical Flat Side to Pressure Category A

Bottom, Ends) Min. Corr. Crown Knuckle Ratio Apex Angle Radius Diameter Convex Concave Type Full, Spot, None Eff.

(a)

(b)

Form U-2 (Back)If removable, bolts used (describe other fastenings)

16. MAWP at max. temp. Min. design metal temp. at

(Internal) (External) (Internal) (External)

17. Impact test at test temperature of(Indicate yes or no and the component(s) impact tested)

18. Hydro., pneu., or comb. Test pressure Proof test

19. Nozzles, inspection, and safety valve openings:

Purpose Diameter Flange Material Nozzle Thickness Reinforcement How Attached Location(Inlet, Outlet, Drain) No. or Size Type Nozzle Flange Nom. Corr. Material Nozzle Flange (Insp. Open.)

20. Identification or part(s)

Name of Part Quantity Line No. Mfr's. Identification No. Mnfr's. Drawing No. CRN National Board No. Year Built

21. Supports: Skirt Lugs Legs Others Attached(Yes or no) (Number) (Number) (Describe) (Where and how)

22. Remarks

CERTIFICATE OF SHOP/FIELD COMPLIANCE

We certify that the statements in this report are correct and that all details of material, construction, and workmanship of this pressure vessel part conform to the ASME

BOILER AND PRESSURE VESSEL CODE, Section VIII, Division 1.

U Certificate of Authorization Number Expires

Date Name Signed(Manufacturer) (Representative)

CERTIFICATE OF SHOP INSPECTION

I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and/or the State or Province

of and employed by of

have inspected the pressure vessel part described in this Manufacturer's Data Report on , and state that, to the best

of my knowledge and belief, the Manufacturer has constructed this pressure vessel part in accordance with ASME BOILER AND PRESSURE VESSEL CODE, Section VIII, Division 1.

By signing this certificate neither the Inspector nor his/her employer make any warranty, expressed or implied, concerning the pressure vessel part described in this Manufacturer's Data

Report. Furthermore, neither the Inspector nor his/her employer shall be liable in any manner for personal injury or property damage or the loss of any kind arising from or connected with

this inspection.

Date Signed Commissions

(Authorized Inspector) [National Board (incl. endorsements), State, Province, and number]

CERTIFICATE OF FIELD ASSEMBLY COMPLIANCEWe certify that the statements in this report are correct and that the field assembly construction of all parts of this vessel conforms with the requirements of

ASME BOILER AND PRESSURE VESSEL CODE, Section VIII, Division 1. U Certificate of Authorization Number Expires

Date Name Signed

(Assembler) (Representative)