APPLICATION FOR IN-SERVICE PRESSURE EQUIPMENT INSPECTOR CERTIFICATION

AB-88 2013-01

1. PERSONAL INFORMATION (Please Print)

Name of Applicant: (Surname Address: (Apt./Street) Given Name) (City) Work Phone No.:

File No: (for previous applicants only) Date of Birth: (yy/mm/dd) (Postal Code) Cell Phone No.:

Home Phone No.:

Work E-Mail Address:

Signature of Applicant:

Date:

If you are required to write the exam, pick a preferred exam month: January March May July September November

APPLICATION MUST BE SUBMITTED A MINIMUM OF 21 DAYS PRIOR TO EXAMINATION DATE . 2. SCOPE OF APPLICATION: (complete only one of the subsections)
2.1 New Certification by Examination (complete all sections of the form) In-Service Boiler & Pressure Vessel Inspector OR In-Service Pressure Vessel Inspector Fee is $259.00 2.2 New Certification without Examination as a Safety Codes Officer (complete first page of form only) Safety Codes Officer Level II OR Level III My SCO File Number: Fee is $162.00. 2.3 Rewrite Examination only (complete first page of form only) Fee is $97.00 unless you have credit with ABSA. 2.4 Upgrading your IPV certification to IBPV (Provide proof of National Board Inservice Commission examination and boiler inspection experience) Previously passed Inspector Certification Examination. Have not passed Inspector Certification Examination. Fee is $162.00 Fee is $259.00

Caution: Certificate issued may be cancelled or suspended for false statements or documentation included in this application. Application fee is $162.00 and is non-refundable. Exam fee is $97.00. GST is not required. N.S.F. cheque subject to a $25.00 charge.

Cheque payable to: ABSA, the pressure equipment safety authority 9410 20th Avenue Edmonton, AB T6N 0A4 Phone (780) 437-9100 Fax 437-7787 Exams Toll free line - 1-888-454-3926 www.absa.ca

Amount:

Cash

, Cheque

, M/C

, Visa

, Debit

Cardholder Name: Card Number: Expiry Date: Signature:

APPLICATION FOR IN-SERVICE PRESSURE EQUIPMENT INSPECTOR CERTIFICATION

AB-88 2010-03

Applicant Please submit the following mandatory documents with your application. See ABSA document AB-59 for assistance. 3. EDUCATION:
Provide a copy of the following for verification: High School diploma or General Education Diploma (GED) Equivalent Certificate Diploma or Certificate in Material Science, Mechanical or Welding Technology Second Class Power Engineers Certificate Degree in Metallurgical, Mechanical or Welding Engineering First Class Power Engineers Certificate Note: Candidates with a technical diploma or degree do not require a copy of High School Diploma or GED.

4. Technical Training in Boiler or Pressure Vessel Inspection.

National Board Inservice Commission or API 510 Certification or proof of successful challenge of National Board Inservice Commission or API 510 Certification Exam. NB API 510
Technical Training in Boiler or Pressure Vessel Inspection. Name of Course: Name of Course: Name of Yes Course: Attached copy of certificate Yes Yes

5. Pressure Vessel experience:

You must provide a detailed inspection resume, countersigned by your chief Inspector or supervisor, regarding your in-service boiler and/or pressure vessel inspection experience with your application. Application for Boilers & Pressure Vessel Certification must include 1 year of minimum experience in Boiler Inspection experience. Copy Attached Yes Qualifying areas: a) Engineering, design or design registration in Canada. b) Manufacturing, includes fabrication methods or processes (shop or field).

c) d) e) f)

In charge in the operation of a power plant exceeding 5 000 KW (Second or First Class plant). Performing repair, alteration or maintenance of boilers and/or pressure vessels. Supervising a quality control system related to boiler and/or pressure vessel manufacturing or repair. Inspection of new or in-service boilers and/or pressure vessels.( 1 year minimum experience required) g) Performing a minimum NDE Level II examiner of boilers and/or pressure vessels. To be completed by ABSA.
I have reviewed this application and my recommendation is Signature: Acceptable: Date: IPV Acceptable: IBPV Not Acceptable