FORM U-1A MANUFACTURERS DATA REPORT FOR PRESSURE VESSELS

(Alternative Form for Single Chamber, Completely Shop or Field Fabricated Vessels Only)
As Required by the Provisions of the ASME Boiler and Pressure Vessel Code Rules, Section VIII, Division 1

1. Manufactured and certified by:

(Name and address of Manufacturer)
2. Manufactured for:
(Name and address of Purchaser)
3. Location of installation
(Name and address)
4. Type:
(Horizontal or vertical tank) (Manufacturers serial number) (Drawing number) (National Board number) (Year Built)
5. The chemical and physical properties of all parts meet the requirements of material specification of the ASME BOILER AND PRESSURE VESSEL
CODE. The design, construction, and workmanship conform to the ASME rules, Section VIII, Division 1
Year
to
[addenda(date)] (Code Case numbers) [Special Service per UG-120(d)]

6. Shell:
(Material spec. number, grade) (Nominal thickness) (Corr. Allow.) (inner diameter) (length overall)

7. Seams:
({Long. (welded, dbl., sngl., ({Girth. (welded, dbl., sngl.,
{R.T. (spot or full)} (Eff., %) H.T. temp. (Time, hr) [R.T. (spot or full)] (Eff., %) (No. of courses)
lap,butt)} lap,butt)}

8. Heads: (a) (b)

(Material spec. number grade or type) (Material spec. number grade or type)
Location (Top, Thickness Radius Elliptical Conical Hemispherical Flat Side to Pressure
Bottom, Ends) Min. Corr. Crown Knuckle Ratio Apex Angle Radius Diameter Convex Concave
(a)
(b)
If removable, bolts used (describe other fastening)
(Material spec. number grade, size, number)

9. MAWP at max temp.

(Internal) (External) (Internal) (External)

Min. design metal temp. at Hydro. , pneu., or comb. test pressure

Proof test:

10. Nozzles, inspection, and safety valve openings:

Purpose Diameter Material Nozzle Thickness Reinforcement Attachment details Location

Number Type
(Inlet, Outlet, Drain) or Size Nozzle Flange Nom. Corr. Material Nozzle Flange (insp. Opening)




11. Supports: Skirt Lugs Legs Others Attached
(Yes or No) (Number) (Number) (Describe) (Where and how)
12. Manufacturers Partial Data Reports properly identified and signed by Commissioned Inspectors have been furnished for the following
items of the report:
(List the name of part, item number, Manufacturers name and identifying stamp)

CERTIFICATE OF SHOP/FIELD COMPLIANCE
We certify that the statements made in this report are correct and that all details of design, material, construction and workmanship of this vessel
conform to the ASME BOILER AND PRESSURE VESSEL CODE, Section VIII, Division 1. U Certificate of Authorization Number
expires
Date Co. Name Signed
(Manufacturer) (Representative)
CERTIFICATE OF SHOP/FIELD INSPECTION
Vessel constructed by at
I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and/or the State or Province of
and employed by
have inspected the component described in this Manufacturers Data Report on ,and state that,
to the best of my knowledge and belief, the Manufacturer has constructed this pressure vessel in accordance with ASME BOILER AND PRESSURE
VESSEL CODE, Section VIII, Division 1. By signing this certificate neither the Inspector nor his/her employer makes any warranty, expressed or
implied, concerning the pressure vessel described in this Manufacturers Data Report. Furthermore, neither the Inspector nor his/her employer shall be liable in
any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspection.
Date Signed Commissions
(Authorized Inspector) [National Board (incl. endorsements) State, Province and number]