GOOD LUCK ENGINEERING CO.

QMS : Document Level - IV

ULTRASONIC EXAMINATION REPORT

ISO 9001 - 2008

Clause : 8.2.4
ISO 9001 - 2008
CERTIFIED COMPANY

Monitoring and Measurement of Product

CERTIFICATE DETAIL
NUMBER

OUR W.O.No.
ISSUE DATE

GLECO / UT / J-

YOUR P.O. No.

INSPECTION AUTHORITY

MATERIAL Spec. :

P.O.
Sr.No.

ITEM DESCRIPTION

ITEM
SR. NO.

QTY.

BATCH No.

DATE OF INSPECTION

CERTIFICATE ISSUED TO

P.O.
Sr.No.

: PROOF MACHINED AFTER HEAT TREATMENT

Acceptable test standard

Surface condition

: SURFACE MACHINED TO ROUGHNESS LESS THAN 6m

Attenuator Setting

Couplant used

: MOBILE OIL (SAE 20)

Method

: A SCAN PULSE ECHO CONTACT METHOD

: EINSTEIN-II DGS

Scanning type

: 100 % WITH 25 % OVER LAPPING

Ultrasonic test standard

QA 07 USTC O8
Route

qa07ustc08

BATCH No.

:
DIRECTION OF SETTING

PATTERN

Document

ITEM
SR. NO.

QTY.

(i) : REFERENCE AMPLITUDE TAKEN FROM STD. TEST BLOCK.

Test Equipment

Doc No.

M/s.

M/s.

ITEM DESCRIPTION

Stage of examination

Sign. and Date

Authority

Test Witnessed By

dB

RANGE

STANDARD PROBE USED

OBSERVATION

PRODUCT STATUS
ACCEPTED

NOT
ACCEPTED

Inspector Testing

Doc. Rev. No. & Date

Effective Date

Doc. Retention Period

01 / 01.04. 2011

01.06.2011

05 YEARS

( Mr. Sitesh Singh

ASNT - Level - I I
Cert. No. JTS / 398 / UT )
Doc. Prepared by
MR

Incharge Quality

Doc. Approved by
Dir. Works

SEAL / STAMP

Recorded document will be prepared, updated and

maintained by Incharge Quality

as self certified authentic record from GOOD LUCK ENGG. CO.

(02) 1st Copy - Incharge Quality to maintain and preserve record (03) 2nd Copy - GM (Oprn.) / (04) 3rd Copy - MR to maintain up dated record
(01) Original Copy - Witness
Page 01 of 01

Document Issued for actual use after the CONTENTS REVIEWED AND ACCEPTED BY incharge Quality

CONTROLLED
COPY