• VERIFICATION OF WELDING CONTINUITY

  • Welding Performance in the process(es) below must be verified and documented for each 6 month period based

    on the effective date and expiration date on the front of your card. This form must be completely filled out and submitted no sooner than 90 days prior to the expiration date.

  • 1st SIX MONTHS

  •  - -
    Pick a Date
  •  - -
    Pick a Date
  • **THIS SECTION IS TO BE FILLED OUT AND SIGNED BY THE PERSON(S) VERIFYING PERFORMANCE OF WELDING**

  • Witnessed By:

    I hereby verify that the above named person welded in the specified process(es) during the date range specified.

  • Clear
  • 2nd SIX MONTHS

  •  - -
    Pick a Date
  •  - -
    Pick a Date
  • **THIS SECTION IS TO BE FILLED OUT AND SIGNED BY THE PERSON(S) VERIFYING PERFORMANCE OF WELDING**

  • Witnessed by:

    I hereby verify that the above named person welded in the specified process(es) during the date range specified.

  • Clear
  • NOTE: Falsified documentation will result in revocation of qualification/certification and possible legal action.

  •  
  • Should be Empty: