Transcription of FORM R-1 REPORT OF REPAIR in accordance with …
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FORM R-1 REPORT OF REPAIR in accordance with …
This form may be obtained from The National Board of Boiler and Pressure Vessel Inspectors1055 Crupper Avenue, Columbus, Ohio 43229-1183 FORM R-1 REPORT OF REPAIRin accordance with provisions of the National Board Inspection Code1. WORK PERFORMED BY: (name of REPAIR organization) (address)2. OWNER: (name) (address)3. LOCATION OF INSTALLATION: (name) (address)4. ITEM IDENTIFICATION: NAME OF ORIGINAL MANUFACTURER: (boiler, pressure vessel, or piping) 5. IDENTIFYING NOS: (mfg.)
T or T N oar Pressur V Inspectors C Avenue Columbus O CERTIFICATE OF COMPLIANCE I, , certify that to the best of my knowledge and belief the statements made in this report are
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