UA WELDER QUALIFICATION CONTINUITY REPORT
Welder Name
*
First Name
Middle Initial
Last Name
UA Card Number
*
UA Testing Local
*
Email
WELDER CONTINUITY INFORMATION
Indicate the last date the process was used
SMAW
-
Month
-
Day
Year
*Manual Welding
GTAW
-
Month
-
Day
Year
*Manual Welding
GMAW
-
Month
-
Day
Year
*Manual Welding
Automatic or Machine Welding (GTAW):
-
Month
-
Day
Year
*This Includes Orbital
Torch Brazing:
-
Month
-
Day
Year
*Non Med-Gas
We certify that the statements made on this record are correct:
Manufacturer/Contractor Company Name
*
Manufacturer/Contractor Representative Signature
*
Signing Representatives Name
*
First Name
Last Name
Representatives Title
*
Email
*
Date
/
Month
/
Day
Year
Date
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