Sample Submission Form

1
Has this project been Quoted?* This field is required.
YESNO
2
Referenced Quote numberType in referenced quote number.
3
Company Name* This field is required.
Enter Company Name Above
4
Customer Name* This field is required.
First Name
Last Name
5
Email* This field is required.
example@example.com
6
Address* This field is required.
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Please Select
United States
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curacao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
7
Phone Number* This field is required.Enter phone number you would like to be contacted at
Area Code
Phone Number
8
Payment Information* This field is required.Select what payment type you plan to use on this project.
PO
Check
Credit Card (3.5% Service Fee added)
Cash
9
Timing:* This field is required.What is the timing of your project?
Standard Turn
Expedited
Same Day Turn
Select your timing above
10
Testing Requirements* This field is required.Select Testing Required
Mechanical Testing
PQR Testing
Metallography
QTR Testing
Training
Engineering
Consulting
ATF Testing
Non Destructive
Other Testing
11
Mechanical Testing:Select 1 or more test type needed.
Tensile Testing
Proof Load
Impact Testing
Bend Testing
Tube Tensile Test
Hardness Testing
12
Mechanical Testing Sample Information:Add sample information below.
13
Metallography:Select 1 or more test type needed.
Macro Evaluation
Case Depth
Plating Thickness
Decarburization Check
Microhardness
Grain Size
Digital Image
Image Analysis
ASTM A 262 Practice A
Macro Evaluation
ASTM A 262 Practice E
Microstructural Evaluation
14
Metallographic Testing Sample Information:Add sample information below.
15
Non Destructive Testing:Select 1 or more test type needed.
AWS Certified Welding Inspector (CWI)
Visual Inspection (VT)
Magnetic Particle Inspection (MT) - Yoke - Visible Dry
Magnetic Particle Inspection (MT) Yoke - Visible Wet
Magnetic Particle Inspection (MT) - Yoke - Fluorescent Wet
Magnetic Particle Inspection - Bench
Magnetic Particle - PQR Weld coupon
Dye Penetrant Testing (PT)
Dye Penetrant Testing - Visible Type II (PT)
Dye Penetrant Testing - Fluorescent Type I (PT)
Dye Penetrant Testing - PQR Weld coupon
Ultrasonic - Contact Straight Beam
Ultrasonic - Thickness Examination
Ultrasonic - Contact Angle Beam
Ultrasonic - Shear Wave - Phase Array
Ultrasonic - PQR Weld Coupon
Eddy Current Examination
PMI (Positive Material Identification) Inspector
Level III Consulting Services
Weld Equipment Calibration, Verification (WECV) - Arc Welding Power Source
16
NDT Testing Sample Information:Add sample information below.
17
ConsultingPlease detail the Consulting that is needed.
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Ok
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OtherPlease detail the OTHER testing that is needed.
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19
TrainingPlease detail the Training that is needed.
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20
EngineeringPlease detail the Engineering that is needed.
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21
Code: (Select One or multiple)Select Code Below.
AWS D1.1:2015 Structural Welding Code - Steel
AWS D1.2:2014 Structural Welding Code - Aluminum
AWS D1.6:2007 Structural Welding Code - Stainless Steel
ASME Boiler and Pressure Vessel Code - Section IX:2015
Do not know, need to discuss.
22
Process: (Select One or Multiple)Select process to test to.
Shielded Metal Arc Welding (SMAW)
Gas Metal Arc Welding (GMAW)
Gas Tungsten Arc Welding (GTAW)
Flux-Cored Arc Welding (FCAW)
Do not know, need to discuss.
23
Base Material: (Select One or Multiple)Select base metal to be used.
3/8" Plate
1" Plate
2 1/2" OD Pipe
4 1/2" OD Pipe
Do not know, need to discuss.
24
Backing: (Select One or Multiple)Select backing to be used.
With Backing (Including Backgouging and Backwelding)
Without Backing
25
Position: (Select One or Multiple)Select backing to be used.
Flat - 1G or 1F
Horizontal - 2G or 2F
Vertical - 3G or 3F
Overhead - 4G or 4F
Pipe Specific - 5G (Pipe Axis Horizontal - 180°)
Pipe Specific - 6G (Pipe Axis Diagonal - 45°)
Do not know, need to discuss.
26
Aditional Items: (Select One or Multiple)Select additional items needed.
SMAW/GMAW Welding Simulator (1 Hour) - Cost Per Hour
Weld Booth Practice (1 Hour) - Cost Per Hour
Practice Tets Coupons (1 Set) - Cost Per Set
Pre-Test Coaching (1 Hour) - Cost Per Hour
Additional Non-AWS Qualification Test Record - Cost Per Record
"Rush" Lab Testing (48 Hour Test Results) - Test Cost x1.5
"Double Rush" Lab Testing (24 Hour Test Results) - Test Cost x2
27
PQR / QTR Sample Information:Add sample information below.
28
Date and Time RequestSelect Preferred Day(s) and time(s) (note, additional charges for after hours and weekends may apply)
29
Any Additional information or Comments
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30
Upload Photo of samplePlease upload photo of sample(s) to be submitted.
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Max. file size: 10.6MB
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31
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32
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