lF10-'060822 ~UNAVUT NT t.OCATION6: (J LL PiPl! ~ o 'f)·'ro•.", !hI TL IS tl!911,"Ibow,. v». plugs. unions. pipe C3p~. or rClduc~TJ; fittings. Includirtg coupli~s, FI"ngBs; AND LA8RADOR NO~THWEST TERRITORIES Dl" FITTING CATI:C;;ORY NEWj:OUNDLAND f:l~INCS EDWARD ISLAND 03 25 P003/026 F-0r50 i-543 3025663133 INC NOVASCOTlA YUKON New BRUNSWICK PAGE DEL PUBLIC SAFETV 902-424-3239 FROM-ALI CEJllTRAL 11.'1412005 12:12 1111 f1!1"rlO' all line v<llves IhIIVA1'l; 911lype~ SIr~lners. fillers. separalors, :md ~teom Irll'S . .F Me1llluring devices. inclucllnQpressure l)auges. level g3uges.,~i!ilhl gIM~~3, levels. or e E~p<)l'lgtor"ljOll'ltt. lIEl~I\)(e COl'lnBetlons. anll hMI! '~MmbliM; IlTessura"lrllTlSmll'lors G Certffied capacity·rated p~llBurB rel/ef devices acceplable ~~ "rim",1'11ever pre~"tJre protactlon on boil~~, pressure vesqell>, piping and fu~fbl~ plu"ll H Pf9ssure ret9i"mQ COI'I'IIlO"!ll'ltlllhat dO nOI (alf into one of lh~ ~"ov" Ollh:gorl!!1'l N Nuclear ",mponeo\!!.: CIM~ 1 0 Clan 20 W MA e UFACTURERS Class30, (Meeling AECe orAGMS rolllilromcnts) I'lK OR LOGO AS 1''' WH.l. A 'P r"''''r-.ll'' DUCT ;i. N r 're 'oN FORG60 ~el.OF.p 0 WAOU~HTJt. CA:lT i*:.. Q,TIIIlR 0 P~Uf S I r.")rJ C(Jtt1f!tuJr!i.lJ·t5 DES~RIa'E 0'" F.R: Pc... I.IS1 pf 13.\.1. ff fel.5 J r: It:fl.pt TIDe ME!N AIION I CIJ m huJetlr:::5 l),'..l - C~N .,.... 50 Pt. if KJ,..{8 uE. 113~ OF THE ACTUAL ITEMS ro BE REGISTER EO; C 4 rt4-c oC I'J~/, 1':,' /JA,hS· 1(1:;.0/ :.?Y''':,,~..-l- ~()iJrJ:5l,JN D5CIJl,RAT10N: AND I qoc;• I UJOV ~ I'''.MI. ~I~mployod by ~SlrnJ 1Jd().v~d being lne person having full aulhority ~nd l1uall1y of tne end product do solemnly declare that lhe inforfMlion contained In tht:l form II! true I"Jnd10 the best of reSllon\:il:lilily for Ii'll!! my Knowledge reprl!l&l!lMtS 1M product for wnlch registration 1$sought The dimensions. materials of construction, pressure lemperalure ratings. and Identlflcation markln~s are in ~QeorClQnc~with the h~r'!in named standards. I further declare Ihatlhe m~nuf!letur~ of these fitllngs Is regltted by iil Quality Conlrol Program which extends1tl each ptsnt where fabrlcetiOrl occurs in whO!!> or in part and hal; 109M vgrlfl~d by ~ ~~Jlll,j as being suitable for that purpose and I make tnis solemn dectaration canscisntiously believing it to bs lrulil. and knowing thtlt It io of the same forco lind effect as If made under oalh. ? t{.:.cJ-l..- Signature of Declarer: ~ OI!!ClIDfCd This bel'ore me al ..J ?Jf4.- day ~~bA-t. n- "1-:m-~ Commissioner of Oaths or Notary Public: (sign) AD 2J!;r::;b ~!~ .':1~--~-~(AlIlI( OHlcf,1 ~!!~I te the rl~ht) T!\i; SO:lCll for Regulatory b,ull'lor:ly ur.C! This regiSlratlon mll!:l be revalidOltlld aftl;!r len (10) yl;';lra from lhe~"p~";l1f.~~:Jt9I~~ eRN: <,~ ---,,,-=--=-=c...=..;=-.:...:- __ ~ ? " ~~ -:;.C :-OO\~SCi)T1A v FIDI#: _-=-.;~~ 2172 <, _ ~C) Notes. 1. All roUlng5shell be registered In lhe nllme of [1\8 M3llulaeturer. 2. F."r:h e:lfagf.lTV ~1'I:l1IbO ~UPflCItM with lINe SIAtutOryDClOIIHlltIO" torrns and one copy of su~po"inll documenllliioll. Do. teJ~'i.·_·IA/·D..Io.-..• C.R.N.. O~J~~~·,~~··········'········ D 1'1 9 _.c;A:\.~J.oau.A- -' -' .-. 3. TM doclQr<)llon sMIl be mide by ll1e person having lull authority 'In': 1lI~"onr.itlility lOf llle qUl\Iil¥ of thO allIS produel. 4. QUBllly control prog~ms shall bEl resuomiltP.<l fOr validalion 01 II I'II'Il!u:lmum Int"IVIII of fllte (5) years. .. P-~.~·. Sign2~_.~ \ c; ...J.. ...... *; t: I •••••• '- v.""" H E