（参见ASME 锅炉及压力容器规范第IX卷，QW-301）

焊工姓名：                      工作卡号No.                     钢印号：                 

焊工焊接试件时遵照的WPS No.                                                      

试件母材牌号：                               厚度                                

填充金属标准：                                        实际值         评定范围  

所用的焊接方法：                                                            GTAW           GTAW   

自动化等级（手工、半自动、机动、自动）                                       手工             手工   

衬垫（金属、焊缝金属、双面焊、焊剂等）                                        /                 /     

母材P-No.或S-No.Y与 P-No.或S-No.                                            /                 /     

母材厚度-OFW                                                                10mm           Unlimitel  

填充金属或焊材标准                                                         AWS A5.9                 

填充金属 F-No.                                                                 6                    

填充金属种类 [实芯/空心/药芯-GTA/PAW ]                                         实芯             实芯   

熔化性嵌条（GTAW或PAW）                                                       /                /     

每种焊接方法的焊缝熔敷厚度                                                     10mm         Unlimitel 

焊接位置（1G，5G等）                                                           1G             F,     

焊接方向（上坡焊/下坡焊）                                                      /                /     

背面保护气（GTAW、PAW或GMAW）或燃料气（OFW）                                  /                /     

过渡形式（GTAW）                                                            熔滴过渡         熔滴过渡  

焊接电流类型和极性（GTAW）                                                    DC              DC  

自动/机动焊变数　                                                              /                /     

直接控制/遥视控制                                                              /                /     

电压自动控制 （GTAW）                                                          /                /     

接头自动跟踪                                                                   /                /     

导向弯曲试验结果

   弯曲试验类型：   QW-463.2 （側弯）/ □ QW-463.2(a) （横向背弯和面弯）/ □ QW-463.2(c) （纵向背弯和面弯）                                                   

外观检验结果 （QW-302.4）                                                            

渗透检验结果                          

 PT报告号：                                                                               

角焊缝-断裂试验（QW-182）                  /                缺陷的长度和百分数           /      in

熔合宏观检查（QW-184）             /           角焊缝焊脚尺寸       /     in   /    凸度/凹度     /      in

焊接试验记录人                                 

兹证明本报告记载正确，且试验是根据ASME规范第IX卷的要求进行试件的准备、焊接和试验的。

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