III Technicalt Safety AuthoritYI of Saskatchewan

2202 2nd AvenueRegina, SK

S4R 1K3Canada

(306) 787-1443info@tsask.cawvwv.tsask.ca

REGISTRATION OF FITT¡NG DESIGN

19-Oct-15

Wika lnstruments Ltd

3103 Parsons RoadEdmonton, ABT6N 1C8

ATTENTION : Adam Coderre File Number: 9920 [ 0 F]

With reference to your submission respecting the registrat¡on of the item below, forlegal use in the province, please note we have surveyed and registered this design inaccordance with The Boiler and Pressure Vessel Act.

MANUFACTURER Wika lnstruments Ltd

CATALOG OR DRAWING : ATS-18310 Sheets 1-9 Rev' 0

ITEM: Thermowell

We wish to point out that every fitting must be constructed strictly in accordance withthe registered design.Fitting registrations are required to be resubmitted for validation after ten (10) years

from the registration date in accordance with CSA 851, Clause 4.2.1. The date ofexpiry for this registration is July 27,2025.

Sincerely,

Athan Syrgiann s, Engineer-in-Training

Codes and Standards Compliance

REMARKS: CRN registered under reciprocal agreement.

CRN: OH15947.23

ffiffiffi TechnicalI Safety AuthorityI of Saskatche\ /än

PH:FAX:

22022nd Ave.Regina, SK S4R 1K3

(306)798-71 1 2 Toll Free: (866)530-8599(306)787-9273 Toll Free: (866)760-9255

Email: boilerpermits(ôtsask.caWebsite: www.tsask.ca

TSK-1008

I Robert Woo, P.Eng

(company(must be in a position

title, e.g. vice presof author¡ty in the man mffiil

ln this space, show facsimile ofmanufacturer's logo or trademark as it willappear on the fitting.

or rAl

orrATSl

T6N 1C8

ineering Manager

produced)

Of: WIKA Instruments Ltd

Iocated at:

(name of manufacturer)

3 Lt) J PATSOnS KOaO Edmonton, Al-berta, Canada(Plant Address - ApVStreet) (City,Prov) (Postal Code)

do solemnly declare that the fittings listed hereinunder, which are subject to the Saskatchewan Boiler and Pressure

Vessel Safety Act (check one)

O Comply with the requirements of ___ _ which specifies the dimensions,(t¡tle of recognized North American Standard)

Materials of construction, pressure I temperature ratings and identification marking of the fittings' or

@ Are not covered by the provisions of a recognized North American standard and are therefore manufactured

to comply with ASME B3L.l- & 831.3 201-2 as supported bY the attached

data which identifies the dimensions, materials of construction, pressure / temperature ratings and the basis

for such ratings, and the marking of the fittings for identification.

I further declare that the manufacturer of these fittings is controlled by a quality control program which has been

verified by the following authority, I9o,_9!91j20q9- q 4EFè- as being suitable for the manufacturer

of these flttings to the stated standard. The fittings covered by this declaration, for which I seek registration, are

thermowells

ln support of this application, the following information, calculations and / or test data are attached

Drawings ATS-I-83L0 Sht 1-9

Sample design calculaLions

Alberta CRN oHl-5947.2

l. Declaration lnformation

MY COMMISSION EXPIRESOCT. ô,

of Commissioner of

Edmonton

AÞÞÔINTtrtr T Ãa^

f/^ day ofthis

of Albertaln the Provj-nce

.Lz-(print name)

DECLARED before me at

ACOMMISSIONER FOR OATHS INAND,1.*L-- 2 015

ll. Declaration

(Date Reg istered - MM D D YYYY)

(For the Administrator / Chief lnspector)

Safety Act andand Pressurerequirements of the

(Expiry Date - MM DD YYYY)

Unitn

z

To the best of my knowledgeCSA 851, Clause 4.2, and is

(Registration Number)

qq7ÐREGISTERED

¿fi.tq,?þt5

Office

Flle

Date

lll. Office Use Only

TSK-1OOBRev,09/2012

Page 1 of 1

lnspection and Technical Services Manitoba500 - 401 York AvenueWinnipeg Manitoba R3C 0P8

T (204) 94s-3373F (204) 948-2309www.fi recom m.gov. m b.ca/cod es_stea m_pressu re, htm I

November 10,2015

WIKA Instruments Ltd.3103 Parsons Rd.Edmonton, ABT6N 1C8

Attn : Adam Coderre

RBGISTRATION OF VALVES AND FITTINGS

Manufacturer: WIKA Instruments Ltd

The design(s) for the following Valves/Fittings has been received by us and has been examined and acceptedfor registration in the Province of Manitoba as follows.

DRAWING / CATALOGUB CRN FILEWLG LEVEL GAUGES

ATS-I8310 SHT I THRU 90H15947.24 35787

An invoice covering survey and registration fees is enclosed.

NOTE: CRN registered under reciprocal agreement & is conditional bøsed on compliance with the notes setby the original issuing Jurisdiction: ABSA. This registration expires July 27, 2025.

This registration is valid until the indicated expiry date only if the Manufacturer maintains a valid qualitymanagement system approved by an acceptable third-par! agenay untilthat date. Should the approval of thequality management system lapse before the expiry date indicated above, this registration shall become void.

The registration of this design does not relieve the manufacturer, the owner or his agent of the responsibilityfor the design or construction of a fitting in accordance with the applicable Acts, Codes and Standards.Inspection and Technical Services assumes no responsibility by registering designs, examining plans and/orinspecting equipment or facility.

Yours

Ryan ky, C.E.ï.Design SurveyorOffice of the Fire Commissionerlnspection and Technical Services Manitoba500 - 401 York AvenueWinnipeg, Manitoba, R3C OPBPhone: 244-945-3373Email: ryan.orlesky@qov. mb.ca

MANITOBA fi'DEPARTMINT OF LABOURAND IMMIGRATION500 - 401 York Avenue

Winnipeg, Manitoba R3C 0P8 STATUTORY DECLARATIONREGISTRATION OF FITTINGS

(¡) Design Qualification

Robert Woo, P.Eng(See Note 2)

Engineering Manager(Position e.g.: president, plant tnanager, chief eng.)

WIKA Inst.ruments Ltdof

located

(Name of company)

at 3103 Parsons Road Edmonton, Alberta T6N ]-CB

(Plant Address)

do solern¡ly declare that the fittings listed hereunder, which are subject to the Boilers & Pressure Vessels Act,

or cornply with all the requirements of the ANSVASME codes as to their dimensions.

are not covered by t6e provisions of tl-re ANSVASME codes, atrd are therefore constructed to cornply with

ASME 831. 3 & B3i .1- - 20L2 codeorstandard, and are designed to the best current

engineeriug practice, as shown by the supporting test data.

(b) Quality Control of Manufacture

I further declare the manufacture ofthese fittings is controlled by a quality control prograrn which complies with the requirements of

ISO 9001:200 and has been verified by the following authority or authorized agencY ABSAI

The fìttings covelecl by this declaration, for which I seek registration, are Thermowell-s

I¡ support ofthe application, the f'ollowing information, calculations and/or test data are attached:

-9, sample des ign calcu Iations, Alberta CRN 0H15947'2Drawings ATS-I-8310 Sht 1

Declared before tue at Edmonton

A ioner for oaths)

in the

EzoÉëOtr,ttvllSStONER FOR OATHS tN AÌ{D

FOR THE PROVINCE OF ALBERTAMY COMMISSION EXPIBES OCT. 6, 2017

of Alberta

ofday

nSignature

lFor Official Use Onlv)' "lJ " lit accordance with the Boilers and Pressut'e Vessels ActThe application is accepted f'or registration in Category

and CSA Standald 85l.

This registration must be revalidated after ten (10) years from the date ofacceptance'

/<

Number c,¡¡'t Øtl Iç147.74 For the ChieflnsPector

Date: ?otç¿I

Notes:(l) This fornt shail be completed and signed by the president or highest officiat in th.e manufactttring plant where the fitting is produced

(z) Two contpleted copies of Starutory Declarationform ,oìgrinu irirn t*å "opies

of Catalogs, drawings or Bulletins illustrating above

./ìttings shall be subntitted." Q¡ Åt t finings are required to be registered in the nante of the Manufacturer'

TSSAÉ

14th Flmr, Cenke Tower

3300 Bloor Street West

Toronto, Ontario

Canada M8X 2X4

Tel.: 41 6.734.3300

Fax 416.231.1ô26

Toll Free: 'l.877 .682.8772

www.tssa.ofg

October 30, 2015

ADAM CODERREWIKA INSTRUMENTS LTD3103 PARSONS RD NWEDMONTON AB T6N 1C8CA

Service Request Type: BPV-Fitting RegistrationService Request No.: 1724762Your Reference No.:Registered to: WIKA INSTRUMENTS LTD

DeaTADAM CODERRE,

Technical Standards and Safety Authority (TSSA) is pleased to inform you that your submission has beenreviewed and registered as follows:

CRN No.: 0H15947.25Main Design No.: ATS-18310 SHEETS ,|-9 REV 0Expiry Date: 27^lul-2025

Please be advised that a valid quality control system must be maintained for the fitting registration toremain valid until the expiry date.

A stamped copy of the approved registration and invoice for engineering services will be mailed to youshortly. Should you have any questions or require further assistance, however, please contact aCustomer Service Advisor at 1.877.682.TSSA (8772) or e-mailcustomerservices@tssa.org. We willbehappy to assist you. When contacting TSSA regarding this file, please refer to the Service Requestnumber provided above.

Yours truly,r)

-t/ 4

-/et atac- 1 -r1-Zivko Gacevic P. Eng.Mechanical Engineer, BPVTel.: 416-734-3429Fax: 416-231-6183Email: zoacevic@tssa,orq

Putting Public Safety FirstPage 1

TSSAf

TECHNICAL STANDARDS &SAFETY AUTHORITY14th Floor, Centre Tower3300 Bloor Street Westïoronto, OntarioCanada M8X 2X4

Show facsimile of manufacturer's logo or trademark, as it willappear on the f¡tting, in the space below

or rA¡ or I ATS I

WIK'I

REGISTERED

c.n.N., ..Q. tlJ.{.?..!.2ÅL. -.,.,.

signe d: ../?l.g#:..r...2. *.... o..

te,/.{....,.........O" (.[]ate:

PressureVesselsSafoty P¡oEFam

.',1¡-inrJ¡rds::nd Saíetyl.ruthorlty

STATUTORY DE TIONRegistration of Fittings

l, Robert Woo, Engineering Manager

(Name and Pos¡tion, e.g. Pres¡denf Plant Manager, Chief Eng¡neer)

o1 Wika lnstruments Ltd.

(Name of Manufacturer)

Located at 3103 Parsons Road, Edmonton, Alberta, Canada 780-463-7035 780-462-0017

(Plant Address) (Telephone No.) (Fax No.)

do solemnly declare that the flttings listed hereunder, which are subject to the Technical Standards and SafeúyAc( Boilers

and Pressure Vessels Regulation, comply with all of the requirements of

(T¡tle of recogn¡zed Notlh Amerícan Standard)

which specifies the dimensions, materials of construction, pressureltemperature ratings, identification making the fittings and seryice;

ø or are not covered bv the provisions of a recognized North American standard and are therefore manufactured to comply withASME 831.3 &B31.1-2Q12 as supported by the attached data which identifìes the dimensions, material of construction,

pressure/temperature ratings and the basis for such ratings, the marking of the fitting for identifìcation and service

I further declare that the manufacture of these fìttings is controlled by a quality system meeting the requirements s¡ ISO 9001:2008

whidr has been verifed by the following authority, ABSA

The items covered by this declaration, forwhich I seek registration, are category H type fittings. ln support of

this application, the following information and/or test data are attached as follot¡s:

Sample design calculations, Drawing ATS-18310 Sheets 1-9, Alberta CRN 0H15947.2

(drawings, calculat¡ons, test repofts, etc.)

Declared before me at Edmonton in the Province of Alberta

the lf* dav of *¿1"^ l"' AD 20 15

Commissioner for Oaths ADAM CODERREA COMMISSIONER FOR OATHS IN AND

ALBERTAocT.6,2017 /4586

(Signature)

FOR OFFICE USE ONLY

To the best of my knowledge and beliel the application meets the requirements of the

Technical Sþ,ndards and Safety Act, Boilers and and

CSA Standard B5 and IS accepted for registration

CRN

Registered by z vtco 6a

Dated:

NOTE: This

Oo 30

istration ex res on

o

,,/f C

7 oPV 09553 (u/12)

MANUFACTURERS NAME: WIKA lnstruments Ltd.

MANUFACTURERS ADDRESS. 3103 Parsons Road, Edmonton AB, T6N 1CB

PLANT LOCATIONS: 3103 Parsons Road, Edmonton AB, T6N 1C8

CATEGORY OF FITTINGS TO BE REGISTERED, GIRCLE ONE CATEGORY ONLY

A Pipe f¡ttings, including coupl¡ngs, tees, elbows, Ys, plugs, unions, pipe caps, or reducersB Flanges: all flangesC Valves: all line valvesD Expansion joints, flexible connections, and hose assemblies: all typesE Strainers, filters, separators, and steam trapsF Measuring devices, including pressure gauges, level gauges, sight glasses, levels, or

pressure transmittersG Certified capacity-rated pressure relief devices acceptable as primary over pressure protection on

0N

bo¡lers, pressure vessels, piping and fusible plugsPressure retaining components that do not fall into one of the above categories

Nuclearcomponents: Class 1 tr Class 2 tr Class 3 D, (Meeting CNSC oTASME requirements)

ASME 831.1 - 2012ASME 831 .3 - 2012

FORGED O WELDEO tr WROUGHI OCAST tr OTHER EOÉSCRIBE OlHÉR:'A'or'ATS'or lffiñ'll

LIST OF SUPPORTING DOGUMENTATION AND IDENTIFICATION OF TÞIE ACTUAL ITEMS TO BE REGISTERED:- Certificate of Authorization for our Quality Control Program- Our ISO 9001:2008 Certificate of Registration- Statement of Project Scope- Sample Design Calculations- Draw¡ngs (ATS-18310 Sheets 1-9)- Copy of Alberta CRN 0H15947.2

NEW BRUNSWICKNUNAVUT

NOVA SCOTIAYUKON

NEWFOUNDLAND AND |jBRADOR

WIKA lnstruments Ltd and being the person having full authority andresponsibility for the quality of the end product do solemnly declare that the information contained in this form is true and to the best ofmyknowledgerepresentstheproductforwhichregistrationissought. Thedimensions,materialsofconstruction,pressuretemperature ratings, and identification markings are in accordance wilh the herein named standards. I further declare that themanufacture of these fittings is regulated by a Quality Control Program which extends to each plant where fabrication occurs in wholeor in part and has been verified by ABSA as being suitable for that purpose and I make this solemndeclaration conscient¡ously beli to be true, and knowing that it is of the same force and etfect as if made under oath

DECLARATION:¡ Robert Woo. P.Eno. ,sEe nore 3) employed

PRINCE EDWARD ISLANDNORTHWEST TERRITORIES

CODERREFOH OÊúltgtNlANÞ S P ii ,l r:

¡s zc't FOR THE PROVINCE OF ALB€B+TAF-TlYC0Mñ{i-SStoN EXP|RES OCT. 6, 201

Signature of Declarer:

Declared before me at

ïhis ll'^ day of

Commissioner of Oathsor Notary Public: (sign) á /--_ APPOINTEE # 0741586

';,4,1

l- i't

ti. t.1 I

7

This space for Regulatory Author¡ty use Dg? f OÊ; PUBLIC Sl\FE'fyThis registration must be revalidated after ten (10) years from thelEh.dRç¡€PþÉgSURE VESSEL ACT

Notes:'l . All fìttings shall be registered in the name of the Manufacturer.2. Each category shall be supported with two Statutory Declarationforms and one copy of supporting documentation.3. The declaration shall be made by the person having full authority and

responsibility for the quality of the end product.4. Quality control programs shall be resubmitted for validation

at a max¡mum interval of five (5) years,

1â+

lN$'PECTOR

5 /âotsibqb l.lTlttinss ÞVJ 06/2003

Icil{

for

n

N ONLY

üAtlñIR

FtD#: 2Bh

CRN 0H15947.2

n Firl'lt(oS i-J t.i]ll,,ir"'ri;,i.::..r.S

19024288770 Labour & Advanced Education 09:33:06a.m. 09-29-2015

uNlFoRM STAruTORY DECLAFATION FORM FORTHE REGISTRATTON OF FlÎnNG pESlcNS

6 t23

NEW BRUNSWICKNUNAVUT

NOVA SCOTIAYUKON

ø

PRINCE EDWARD ISLANONORI}IWEST TERRITO RIES

OECLARATION:

Slgnalure ol Declarer:

Oeclaled before me at

Thlg /5-t\ day ol

Commlssloner of 0alhsor Nolary Publlc: (slgn) â,/.-

NEWFOUNDI¡NO AND I.ABRAOOR

CODERREFOR0AT}|S|ilüANB S P

^ c L: Fr'i,.'

¡p ¿o,r FORTHEPROVINCEOFAL{EFfi& I Cì I Å t_ :j r: ,., ,

-ñ{YïõMMISS|oN Ð$IRES OCT:8, 201?APPOINTEE # 0741586

WII(A ln¡lrumanla Lld.

MANUFACTURERS ADORESS: 3103 Par8on0 Road, EdmonlonAB,T6N 1Cg

PLANT LOCAÍIONS: 3103 PcrBonE Rosd, Edmonton AB, T6N 1C8

A Plpo flttlngt, lncludlng coupllngr, teer, clbowr, Ys, plugr, unlons, plpe crpr, or reduc¡r¡B Flanger: rll llangesC V¡lvo¡: ¡llllne valve¡0 Expanolon lolntr, llc¡lbl€ connecllone, qnd fiora asromblles: all lyperE Slf¡lnon, f,lten, leparalon, and sleam trapsF Mearurlng devlocc, lncludlng pro!!urð gauEar, levol gauger, rlght glaraar, laveh. or

prorsurc lrrnsmltlorsG as prlmrry ovct pfessufa protectlon 0n

tha above oatcgorlor

CNSC oTASMÊNuclearcomponcnls: Olalr1tr Cla¡l 2tr Cl¡sr3tr,

ASMEB31,r.2012ASME 831,3 - 2012

,A'orArs,or liuiffill FO¡0t00 wetoEo 0 v!¡ñoucHr oc^tf o oDtER ooÉtcRGt onei:

. Co¡tlflcate of Authorlzatlon lor our Qusllty Conlml Program- Oul ISO 9001:2008 Carllllc¡te of Reglstr¡tlon. st¡tgmsnt ol Pml€ct scopo. Sample 0eslgn Calculallons. Orawlngt (ATS-1 8310 Sheato ,|.9)

. Copy ot Alborto CRN 0H15947,2

Noto¡lL Allfilunge ehrll be reglsterod ln ths n¡ma of lho Menulecturår.2. Each catogory ohall bc supportad wlth two Statutory Declarallonfolm¡ and ono copy of supporllng document¡tlon.3, Ths decl¡ftllon ¡hall be mada by lhE p€¡Bon hâvlÁg full authodty aÁd

rasponslblllty tor thc quallty ot lhe Bnd product.

4. Quallty control programe sholl bo rqoubmllted fo¡ valldatlon

at ¡ m¡xlmum lnterv¡l of flve (5) ye¡ls,

28¿L

Soct. 1.0 . Flltlngs Rov. t 061200¡

accEptancE.

C,RN, ,aB1'rô

D,t*g,

Spnø

Pert

GL"

HI

ê¡.r.o

Iof¡_

0H15947.2

Thls space to. Rôgulatory Aulhorlty use

Thlr reglstratlon must be revalldated af,er ten (10)

CRN:

FrOlt:

09-25-15;11:294M; ;902-368-5526 i 3/ 14

NEW BRUNSWICKNUNAVUT

NOVA SCOTIAYUKON

FRINCE EDWAÂD ISTANONORTHWEST TERRITORIES

CODERRE

NEWFOUNOUANÞ ANÞ LAB',^D.R

S P ^

ù G Frì

Slgnaluro of 0eclerer:

Ooclarcd bofora rne et

Thls /f '\- day ol ç//..^tr-Commfesioner ol Oothsor Nolary Pubilc (slgn) /o/*-

AOC. l,ll.,:jr:Àt

Wll(A lnstrumsnb Lld,NAMGI

PersonB03 Rood, €dmonton TONAB. CBP!qNf 3 03 Poreone EdmônlonRoâd, T6NAs, c8

_ErpEn!lon_Jolnt5, flsxlblo connoctlona, ond hoao ¡srsmblle8iLI!o¡tnFf , 0cporrrorr, an¡ cicain-irqpîy::yltnp dovto.o¡, lnctudtns prôrEuro gauieo, tevot srugca,prcstuto l¡!nsrnltt6¡rCortlfled c¡peclty.tôted prôs!un roltel dcvlcas EcccÞtEblc arlglltlfr.ltf. voss6t;, prptng ond t rulãprrãi-'-''' ""Ftsrsur. ßlalnlno componanl¡ihat do not foif ln-to one ol the

A Plpo fltllnOr, fnctudlng coup[ngr,E ,-tEngori all llonoe¡C V¡lvo¡: cll llne v¡lves

tôca, s¡þsw¡, yÉ, plugÂ, unlont, plp6 çsp¡, or roducar:

0oll tYpe¡E

Fgla!r6i,olght lavcl of¡l

G0v0rnrlmary PÍêoôuaô 0nprotoctlon

abovo calcOodsg0N NuclBot componontsí Cla¡s tr Clas¡ o2 3Cl¡r¡ cNsc 0r ASME

ASME 831 ,1 . 201 2ASME 831,3 . 2012

h,or,ATS,orlWÃil toRqEoo wetoÈocÂsl 0 on{eRõE8cßt0ú ôll{!i:

(] WRouoHI O

Pro0rÉrn

Thls tÊsco lor Reguletory Authorlty usôThls regl trutlon mus be revafldatod altor tsn (1 0) y€etg from lhe dats gf accoptanco,

, ACCEPTEDPROWNCE O[.PRTNCE EDWARD ISI,AND

DNVIRoNMENT I-{B oUR ¿IU¡iö "

CRN:

Ft0il:

0HL5g47 ,2

)Alr

Nol€r:

:. ll]ljtllS.r shsil be rogt¡rerod tn tho namo ortho M¡nufEcturo¡,Í:.-!1i19¡j9S0,y ßhefl be ruppôrted wtth two St¡tutory Ooctarârtonrormr ânc 0ôc copy 0l supporllng documeñtellôñ,3, Tho dôclarEtlon oholl be moaa by lho peroon h¡vlng full suthorlfy åôdresoonllblllty for lho quallly of the ond produc{,a, QuEllty contrcl p rooremÐ choll Èô fEsubmlttod for vâttdåtlonel â maxlmum lntervsl ol flve (5) yoaro,

c,R-N.

D,ITE:

ôt+ tq gq .ot 1

NEWBRUNSWCKNUNAVUT

NOVA SCOTIAYUKON

DECLARATION:

Slgnature of Declarer:

OeclarEd before ms Et

Thts / r- /\ day of +,/".^.9^.Commlssionsr of Oatheor Nolary Pubtlc: (slgn) É'/\-

PRINCE EDWARD ISLANONORTI.ÍWËST TERRITORIE S

NEWFOUNOLAND AND TABRAÛOR

CODERRES F

^,1 [: f:r''

AI] ül¡l :"t','.r

Thls reglstrailon must be revalldated

cRN: 0H15 947 .z

Thla opoca for R lgulalory Authorlty uroafrer len (10) yaars from the date of acceptance. ¿:¿

t{ewfbuíxnuo¿Lal.rrarhx

FlDll: ) F,lt

-

Servi N

Regktered ZoD{t€

Eng¡neoring cs

UIID€R THE IHEPUEUC AND

IHE 8CILER, PRISSURE I.,IS51iLANO

c¡tg$bl$lß c F fi rffi t¡.ç'ç¡6,, o o,

NolssL All littlngs shsil bo reglstcrod ln thq nâme ol the Msnufactursr.2. Each calegory eheil be supported wlrh two Siáfuiól boelarat¡onforms lnd on6 copy of supporllng document¡ilon,3, The dcclarallon ¡hall bo m¡ds by tho poroon havlng full authorlty androspon¡lbll¡ly lor lha quallty of tha end product,4. Quallty contfol pfogrãms shsll bo forubmlttod for vslldatlonsl a maxlmum lntorval ol fivo (S) yearc.

NAMEI W l(A lnEtrumEnts Lld,

ADDRESS: 0331 Panon¡ Road Edmonton ï6AB, N c8PI-ANI LOCATIONS: 1033 Ps¡gons Road, Edmonton IT6N c8AB,

coupllnge, toel, olbowe, Ys, plugo, unlons, plpe cap.¡ of leducere

ExpanolonJolnts, flexlblg connocllonl, and hosa assembller; all types.sjlllnrl., ttlcrs, roparatoru, and sreain iiil;-- --'-"'"

#:::iíIflr1ii",i,t#crudlng prrssure sauies, taver gauses, stsht slasses, tovêta, or

AB

co

F

Pþe llttlngr, lncludfngFlongåg: all flangosValvss: all llne valvos

proloctlon on

rcqukamanls)

prlmary over proreure

obove cetegorlee

octlng CNSC o¡ASME

u

0N

ASME 831,1 .2012ASMÉ 831,3.2012

'AorhTS'rrWl FOROED tr WELOEqcÁ,8T O oIHERDeSCFtSE OTHeRI

c¡ wf,oucHT E

- Cerllflcole of Aulhorl¿¡ilon lor. Our ISO 0001:A0OB Cerllflcate. Slslom€nl of proJect Scooe- Sample 0eslgn CalculaUons

our Quallty Conlrol programof Regl¡lrstlon

. Drawlngs (AlS.1 S3l0 Sh€ots t.g)

. Copy ol Atberla CRN 0H15947,1

MANUFACTURERS NAME: Wll<A hstrumsnls Ltd.

ñ¡1ANUFACTURERS ADDRËSS: 4103 parsons Road, Edrnonton 48,T6N tC8

3103 Par6on6 Rosd, Edmonton AB, T6N 1CgPLANT LOCATIONS

ABcDe

F

G

Plpo flttinge, lncluding couptlngs, tsos, olbows, yB, plugg, unfons, plpê caps, or reducorsFlangos: all flangesValvss: all llne valvssExpanslon lolnts, floxfble c0nnôctions, and hoso assernbllesl oll typosSttalnars, llltors, sepa¡'ators, and staam trapsMoasurlng devlcos, lncludlng prossure gaugos, levol gauges, slght glassss, lovols, crplessuro ttansmlttorsCortifiod c¡pac¡ty.ratsd pressurs rellef dsvlcos acceptable as prlmary ovßr pr0ssurs proloc¡cn onboilsrE, prossute vossels, plping and fusibls plugsPressulo ¡otaln¡ng componsnls that do not fall lnto on6 of lh6 ûbovg catogori8sNuclesrcompononts: Class 1 tr Class2E Class3

0N CNSC or ASlvlE requlremenle)E, (lv'lssting

ASME 831.1 - 2012ASME 831,3 - 2012

,A'or^rs,orwtTffi FORGEO tr WÊLOêO O WROUGhT EcAsr o oTllËn ooESCRTSE OIHEn:

- Cortlficats of Authorizatlon for our Quallty Conlrol Program- Our ISO 9001:2008 Certílìcato of Rsglstratlon- Statemont of Project Scopo. Samplo Deslgn Calculatlons. Drawlngs (ATS-18310 Sheots 1-0)- Copy of Alberta CRN 0H15947.?

UNIFORM SJATUTORY DECLABATJON FORM FOR THE REGISTRATION OF FITTING DESIGNS

NUNAVUTNEWFOUNDLAND AND I.ABRADOR

DEC!ARATION¡ .lobortYloo. P,Eno, - (roonoro

responsibillty for the quallty of the end prodmy knowledge represents the product for whlch roglstration ls sough t, The dlmenslons, matorials of constructlon, pressuretemperature ralings, and identilicatlon marklnge are ln accord ancs wilh lho horeln named standards. I further dectare that themanufacture of these littings ls plant where fabrlcaiion occurs ln wholeor ln part and has been vorllied that purposo and I make this solenlndsclaration conscientiously effoct as if made under oath

Signature of 0sclarer:

Declarod before me atCODERRE

FoH OATllglNrANù s rr ^

r: Lj r- riThis- /f/( day of {"L,^ {r.

NEW BRUNSWICK

Commissionor of Oathsor Notary Public; (sign)

NOVA SCOTIAYUKON

PRINCE EDWARD ISI.ANONORTHWÉST TERRITORIES

r¡ employed by $/lKA lrrstrumont¡ Ltd. and bêing theuct do solemnly declare lhat the lnformatlon containsd ln lhl

person having futl authority ands form is true and to tho besl of

ap ¿c,r FORTHE PROVINCË OF AL{ÇFirA¡ | i. I 11 |

-ñ'{YT0ñffi,TtSStoN EXP|RES ocr, 6; 2017 -

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rrom rhe date gJefiBtgtãlî6.

Prgf ,,.rrt. Vt,isels Act

REGt;l i::l1Et)

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fì É:(: tí)lSigned

CRN

Date

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Thls registratlon must bo revãlldatod

Notss:1, All fittings shall bo reglslered ln tha namo of tho fulanufacturer,2. Each category shall be supportod wllh tv¿o Statutory Doclaratlonforms and ono copy of supporting documsntation.3. The dsclaralion shall bs mada by the porson havlng full authofltyrorponsiblllty for lhs quallty of ths End product,4, Qual¡ty control programs shall bo r8submittod for va¡ldallonal a maxlmum lntervol of flvo (5) yoãrs.

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0H15947.2

This sp¡cs for

CRN:

FID/I:

c6i 200J

09-27-15;21',28 jFrom To:ACl Centra I ;86787301 17

UNIFoRM srAIgfpRY DECLAEIATIoN FoRlr¡l FoRTHE REGISISATION OF FlTrlNG DES¡qNs

NEìA/ BRUNSWICK NOVA SCOTIA PRINCE ÉOWARO IS|.ANO NE,WFOUNOUqNO ANO IÁBRADOR

NUNAWT YUKON NORTHWEST TERRITORIGS

OÉ,CLARATIONRobsrtWoo, P,Éno. laco ¡oto c¡ cmployod uy wra tnstrrmsntg snd bolng the person havlng fuÍl aulhority anó

tospônsiblltty for the quallty of the end product do solemnly declare that lho fnformatlon cont¿lned ln thle fom lÊ true and to tho best offor whlch reglgtrâtlon ls aought, The dlmonslons, ¡nsterlalo oÍ con6lrucllon, pre0Eule

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marklngs sre ln Eccordancg wllh tho hareln nsmed 6tåndards. I lurlher doclaro lhat lho

mEnufacturâ of thssê t¡ttlng s ls rogulated by a QuaÍlly Conttol Progro m whlch oxtends to each plant whoro fabrlcatlon occuri ln whols

or ln parl and has been verlflod byL as bolng eultable for that purposø and I make thls eolemn

of lho samo force and etfecl BE tf mado undor oath,

CODERRE

doclatalion consolentlously be!l lo be true, ðnd knowfng thât lt ls

my knowlodgo reproeente tho producttamperature lâtlnge, ând ldentlllcstlon

Slgnotuco of Doclarer'.

ooclared before mo ot

rnls-ÓoavCommlsslonor of Oathor Notary Publlc (slgn)

Fon gATHSllt¡tANÊ s P ^

t: Li F r'¡ ,.ì

l(il¡1L i:irr,it7

MANUFACTuRÊRS NAME: Wll(A lnstrumonts Lld,

MANUFACTURERS ADoRESS| 91oA par3oncRoåd, Edrnonlôn AB'ToN 1C8

PIANT 3103 PBrsong Edmonton AB, T6N 1C8

a Plpô rlttlôoâ, lôcludlng coupllngc, t€os' olbow$, Ys, plugû' unlono, glpe caP6, 0l roducôrs

B Flongeår rlf llengeec velvosi ôfl llno valvosO ExpenalonlolntÊ, floxlblo connoctlong, ond hoso ertombllos: oll lypocÉ strolnorr, fltc¡¡, oepw¡toro, Bnd 6toâm tr¡PgF MBAsudno dovlcos, lncludlnE preesum geuges, lovol gaugeg, olght glass0e, l€vols, 0r

ASME 831.1 - 2012ASMÉ 831,3 . 2012

plc99ufc Irsnsmltt€rsG Côrllllod cûpâclty.lôtod pr9esuf0 rallof dovlces oecepteble q8 prlmsry ovo pfos3ul0 protoctlon 0n

bollero, Pr€9Eul9 vessolâ, plplng and fuolblo plugû

rotûlnln0 componontr that do nol fall lnto 0ne of the obovo ostsgortss

Núcloor Class 1 E Olass 2 E Cl¡gs 3 Q, (Meellng CNSC oTASME róqultomonls)

'A or'AT5'of W-rfñlFORAEOO WELOEO O WNOUCHÍ OcAgf o ofxoR o0e0cnr6e 0üERl

¡- côrüllcr¡lo of Aulhorlzatlon for our Quallty Control Progrôfi. Our ISO 0001:200s Cottllcoto of Reglstrqtlon. Stetôrnont ol Prolect Scope- Somplo Doolgn CÊlculotlons. Drawhso (ATS-1 s310 Shoste 1.0). Copy of Alborta CRN 0H15047,2

Rov, 'l 0â12003

lhe detêÀr

REGISTERED

s,oN

Thls reglsVatlon must be revalldated âftgr tên (10)

Nolos:l, All flltlngs shsll bô roglstôlod ln lhe namo of tho MBnufeclulor'

2, Éôch cilogory ohall be supponod wlth two statutory Doclarltlonfotmt ond ono copy of suppodlno docurnont¡tlon.3, Tho dôclît¡tlon shsll b0 mado by lhe p6t8oñ havlñg full culh0rlty Ûnd

responrlblllty for tho quallly ol tho ond produol,

4. Qu¡llry control proglqm3 sh¡ll be rssubmlttod lorvalldÊtloí

Et a moxlmum lnlorval ol llvo (å) years,

) Al¿

0H15947.?

ThlÊ epcce lot Ro0uletory Authorlly

CRNI

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\EW ERUNSI,VICKNUNAVUT

UNf FoRtl/l_.El.A

NC"'r\ sooll,rYUlr.,)N

MANUÍ:ACTUREIISNi.1,¡E: !V:r{Alnstr,rrrir:ntsLtd

MANUFACTURH RS AllrDRi{ìS: 3103 [:'aíBuns load, Ed¡nonton AB, TßN 1C8PLANT LOCATIONS: 3103 Pafsorrs load, Edmonton AB, TtlN 1CB

PRlNCti êDTVARD ISLANDNoRTllì¡/EsT l'E.RRITORtE S

*+{}AM CODEHRE

NEWFOUNDTAND AND LABRAOOR

- Certlf cal0 ol A.t.ttho.i:ãìtir:rì lt- cri (1. ellty Cor,r.¡l p¡gg¡¿¡.- Our ISO g1)Ct:z.jnt i'r:rrlltlc;rtl r,Rr:ilístiaLrn, St;ttetner¡i cl F,fîi rî: ,j.iotìo- Setn¡lle 0')slgn CAlCr, l;rli('nfl- Dri,vir,gs {l,l$-1831,) Slturl:: .i rì)- Cct! of A:br}rta CRF;0t-'.15î47.?.

'A'or ATS' :r

ÞEC LARA,f IC) rr¡ ;

I Robôrt Wüc, P EnQ.

resp0n$ibility fcr lhs c

my k;ìo',vlçJ,)99 iÍ Dftr ìtemperaturtr ralin?s,,manUfaclure of thos,r,or ln pad ançl has. l¡e:doclantìon ctn¡ci:rnr

Slgnalure r.l l)ecia¡'e,

Declarod Þr¡fore me ¡ t

This ¡t

ffir:ffi"üJ

R FoE gAT,þlSlñrAhJÈ S tj  ,t [: !: r',(,:ry

Conrmissicror r¡f ()elhor Notary i:ubll, . lEl,rr)

CFÌti: t;l l. :;'; i. ; , ;

Tlull'. ') À ¿,

Ncles:1, All lìttlngs ¡hail bc regist.;r¡d i¡.r lh:¡ :raûs,:l thÐ Mani:f¡clr¡rer,2, Éech c¿,tegotj" .tl;. ll !.¡ st.;i,p':rl0ll r,/;th t¡¿t; 3'tatutíry Þr:,claralio,rlorms and oñÐ .:otr)' L f srl)Fr}ti¡r ¡ documer¡l¡J[¡( n.3. tho cc :le'¿'Ìo', sl all [:o nrac : by the persor; havlng futi authorlty anCrolporrslbilily lùr inF uâl ly :t lhfl erid procluct,4. QuÊllt:, contt('l !:fiigra.ls .,¡ha'l bi, rër,ubmltt( d for vå'ldåticnat n nìå:(iiìÌun1 lnlrtviiÌ ot ivn (S) yt:lrs,

'"1 .;v-.*&rþx*_- AD -¿Jg-Iq!ll,t f)ROVINCE OF

,j ./ ,¡ ¡ / -lilYe0Mñ{mtoN

ËxPtRES

.,.,L,.i,.-_. /¿d-_ - APPOINTEE # 0741

ALB$fil'AF I (i I rr t..

ocT.6,2017586

Trls opace fcr R,:gulatorl r\ulhorlty usoTlr.;,-cg::¡ir¡rtìontr,.6tbor¡v¿ilidateduftcrlen(lC,)yearsfromtherJate

e¿.Tå-Gofu-iFl:ITNffioA Plp':lttints, irlclucll.'E ccut)l:,ì9i, teos, elbows ys, plugs, unlonr, plpo caps, or reduce* IB F.langos: all fang'::i frrv verr' v' ¡euuÙÞ¡¡

C V3lvos: ¡ill llne val',,r.s

! Expons:or-Jol.tt$, lle:ribls c.-ì:.nerdi.Jtr"3, anij ho,e assarnblioal all typesÊ Elralnsts, fìlter9, sr¡¡¡¿¡¡¡¡¡t, a;:,j s.-.ain trapsF Mlasurlnl Ceylca$, i1al..Jiìf, ÊÍ3s: -'s g¿ri?0:t level g.iug¡ae, rlghl 0låiâes, lgvðls orprBssuro tr¿Ismltt€!i.,G C:trtlfled :8Þâclty-ra cd l)fr,s iu,.e rrtl,.jf clilrlc.rr. accðplåblå as pnmary ovðf plesguto prôlecl¡on onfì bîile's, pfessUr€ vo,rseh, ,,|)kr,j arl ft0tLrle r Ugs(U Pressuro relarnrng c,rnrccr¿irrs ìhat do nct fii: iñto ono of rhe abovð qrlegorres

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ASME 831.1 .2012AStvlE 831.3-2012

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