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AP_OPTIFLUX 1000__en_CRN_100105__
It Y. 0 PTI FLUX 1000 ©KROHNE 08/2009 KR O H N E TECHNICAL STANDARDS & �N``pL sT�h 7,9 SAFETY AUTHORITY �° 14th Floor. Centre Tower T S S A 3300 Bloor Street West Toronto,Ontario s Canada M8X 2X4 y�try AUtN9 August 25, 2008 o�HOHNE ALI0m, KROHNE ALTOMETER Contact : COR SCHELLARS ��; _ SEP �}{� KERKEPLAAT 12 3313 LC DORDRECHT DORDRECHT, NETHERLANDS - S@StPRIf� »Oti Dear Sir/Madam: Re: Your Design No: OPTIFLUX 1000 CATALOGUE - EXPEDITED SERVICE - NATIONAL REGISTRATION Our Reference No: BPV-D-07-04149 The above design has been registered under CRN : OF12511.5. A stamped copy of your statutory declaration form is enclosed. The invoice for registration will be forwarded under separate cover. This Registration expires on August 25, 2018. Valid quality control system must be maintained for the fitting registration to remain valid until the expiry date. Yours truly Charley Dong, P. Eng. Mechanical Engineer, BPV Tel. No.: (416) 734-3436 Fax No.: (416) 231-6183 cdong@tssa.org To make people's lives better by enhancing public safety Visit our web site. www.tssa.org �y,6A sr441 Q TECHNICAL STANDARDS& Show facsimile of manufacturer's logo or trademark,as it will SAFETY AUTHORITY appear on the fitting,in the space below T S S A " 14th Floor,Centre Tower 3300 Bloor Street West INK 7 Toronto,Ontario ►au��° Canada M8X 2X4 STATUTORY DECLARATION Registration of Fittings I Cor Schellaars,Chief engineer (Name and Position,e.g.President,Plant Manager,Chief Engineer) of Krohne Altometer (Name of Manufacturer) Located at Kerkeplaat 12,Dordrecht,the Netherlands, (Plant Address) (Telephone No.) (Fax No.) do solemnly declare that the fittings listed hereunder,which are subject to the Technical Standards and SafetyAct, Boilers and Pressure Vessels Regulation,comply with all of the requirements of (Title ofrecognized North American Standard) which specifies the dimensions,materials of construction,pressureltemperature ratings,identification marking the fittings and service; aor are not covered by the Drovisions of a recognized North American standard and are therefore manufactured to comply with ASMEVilldiv.1/ASMEB31.3 assupported by the attached date which Identifies the dimensions,materialof construction, pressure/temperature ratings and the basis for such ratings,the marking of the fitting for identification and service. I further declare that the manufacture of these fittings is controlled by a quality system meeting the requirements of ISO 9001 which has been verified by the following authority, Lloyds Register The items covered by this declaration,for which I seek registration,are category meas.dev Cat F type fittings. In support of this application,the following information and/or test data are attached as follows: See page 2"Statutory declaration Registration of Fittings OPTIFLUX 1000" (drawings,calculations,test reports,etc.) Declared before me at Sliedrecht In the of the 12 th day of February Commissioner for Oaths: (Printed name) ''• �^ r �,MncNV G SI na q�j• �� (Srgnatur rer) FO F�FIC SE ONLY '1 ethnical Boilers and To the best of my knowledge and belief,the application meets the requirements of the Standards Technical Standards and SafetyAct,Boilers and Pressure Vessels Regulation,and and Safety Pressure Vessels CSA Standard B51 and is accepted for registration in Category F Authority Safety Program CRN: OF 12 t-11•s NDIE' SES ttiE Sr:tp p4c�i: :�� �� � REGIST�'RED Registered by: �t9�1� � -pe sco Dated: A t,CSr.2,S', 20 o ,, /a.,/ s� �Zr Signed:.C� '`'�7 T&�J .. NOTE: This registration expires on Aisr, 2,Y 2'!a 2-1 o PV 09553(06104) Show facsimile of manufacturer's logo or trademark,as it will appear on the BOILERS AND PRESSURE VESSELS fitting,in the space below T•S S A SAFETY DIVISION 3300 Bloor Street West 4th Floor,West Tower^ut Toronto,Ontario K R O H N E CANADA M8X 2X4 STATUTORY DECLARATION Registration of Fittings 1, Oingfene,Li Quality Manager (Name&Position,e.g.President,Plant Manager,Chief Engineer) of KROHNE Measurement Technology (Shanghai) Co Ltd (Name of Manufacturer) Located at Minshen Road 555,Songiiang Industrial Zone Shanghai China 201612•Tel:+86-21-67600742 Fax:+86 21 67600503 (Plant Address) (Telephone#) (Fax#) ❑ do solemnly declare that the fittings listed hereunder,which are subject to the Technical Standards and Safety Act, 2000,and Regulations for Boilers and Pressure Vessels comply with all of the requirements of (Title of recognized North American Standard) which specifies the dimensions,materials of construction,pressure/temperature ratings,identification marking the fittings and service; ■ or are not covered by the provisions of a recognized North American standard and are therefore manufactured to comply with ASME VIII diy.I/ASME B31.3 as supported by the attached data which identifies the dimensions,material of construction,pressure/temperature ratings and the basis for such ratings, the marking of the fitting for identification and service. I further declare that the manufacture of these fittings is controlled by a quality system meeting the requirements of DIN EN ISO 9001,2000 which has been verified by the following authority,TUV Industrie Service GmbH. The items covered by this declaration,for which I seek registration,are category meas.dev.Cat.F . In support of this application,the following information and/or test data are attached as follows: See page 2"Statutory Declaration Registration of fittings Ontiflux 1000" l Declared before me at Shanghai in the Counia of China the 19" day of M AD 2007• Commissioner for Oaths: +.1'tWls Win•..u•.p,� r,� Huang Lan (Printed name) (Signature) ( gnature of Declarer) ►,. 1 � �1ht i P .� '`•-�-Y,:_,.m,w R OFFICE USE ONLY Standards pressure Vessels and Safety Safety Program To the best of my knowledge and belief,the application meets the requirements of AuthorltY Technical Standards and Safety Act,2000,and Regulations for Boilers and Pressur Vessels and 1 and is accepted for registration in Category F , j3�1�1GD NO%- SBE TH E SC W-9 MF CRN: � I Z.S��I'.� v For fc1zN p rKE �2 i.1::�".................... Registered by: C.R.N....���...��•• Dated: /}wS..,2�, 08 kor S1gIICd: �•• •�...••• NOTE: This registration expires on k 20 �' ! i� qr4 1ir�Zst.aoJ. r.6lydot-••en ame: TSSA Sr 1 , Page 10 of 10 Rev. 2 i Statutory Declaration Registration of Fittings Optiflux 1000 Page 2 On behalf of KROHNE Altometer and KROHNE Measurement Technology(Shanghai)Co., Ltd.,we are applying for an CRN Design Registration for our magnetic inductive flow meters as described within. Product model names to be registered include: Optiflux 1000 F Optiflux 1010 C Optiflux 1300 C For above listed models names,we are applying for Wafer type of fitting for sizes 3/8", 1/2", 1", 1.5",21,3", 412, 6". Please note that all our product names listed above have exact same flow-tube therefore the same exact welding, design, etc.The reason for multiple Product names is that the flow-tube can be configured with different electronic signal converters mounted on top of the flow-tube. Therefore Optiflux 1000, 1010 or 1300 have the same flow-tube but different electronic signal converter mounted to the top of the flow-tube.Thus they have different product names and labels. By including all product label names in our CRN, the local inspector will not be confused when inspecting a meter and the corresponding CRN document.Each letter of these product names are defined:F=field,signal converter remotely connected by electrode/coil cable to flow-tube; C=Compact,signal converter attached directly to flow-tube. Attachments: 1.set documents Optiflux 1300 C 3/8"Wafer type. 2. set documents Optiflux 1300 C 1/2"Wafer type. 3. set documents Optiflux 1300 C 1"Wafer type. 4. set documents Optiflux 1300 C 1.5"Wafer type. 5. set documents Optiflux 1000 F 2"Wafer type. 6. set documents Optiflux 1000 F 3"Wafer type. 7. set documents Optiflux 1000 F 4"Wafer type. 8.set documents Optiflux 1000 F 6"Wafer type. End of page 2. THIS IS PART OF CRN OF12S II•S Technical Staadards&Safety AuthoO, i Boilers & f ressura Vessels Safety Division d THE cxN rxprXs Additional Clarification of The Submission 1) The 1000 series valves have only wafer type connections and no flange connections. 2) The 1000 series valve ratings are: 16 bar @ 20 degrees C to 100 degree C. 3) Optiflux 1000 series has no nozzle or coupling (This is to confirm Optifiux 1000 design does not include a nozzle). 4) The pipe material is "ASTM A 312 Grade TP316 (stainless steel pipes and tubes), 16Cr-12N1-2Mo pipe". See calculation number 06843, Date of 27- apr-07. 5) The reference drawings shows the ring is spot welded to each end of OPTIFLUX 1000 pipe's sizes DN40 to DN150, but the rings are not part of pressure boundary. They are only used during construction to support the liner material and not the pipe. / FFFV_ ~0 7 / Technical Standards& �`/AL s�11'ti0 9 Safety Authority � 4th Floor,West Tower T S S A 3300 Bloor Street West Toronto,ON M8X 2X4 114r. AU1 Tcl:(416)325-9227 TSSA NATIONAL REGISTRATION SERVICE APPLICATION Fax:(416)326-1662 1.0 APPLICANT INFORMATION: COMPANY NAME: KROHNE Altometer ADDRESS: Kerkeplaat 12, 3313 LC Dordrecht, Netherlands TELEPHONE: +31-78-6306383 FAX: +31-78-6306394 CONTACT NAME: Cor Rrhellaars M E-MAIL ADDRESS: C,Schellaarsakrohne-altotiieler.nl 2.0 MANUFACTURER INFORMATION: O COMPANY NAME: KROHNE Altometer ] PLANT LOCATION: Kerkeplaat 12, 3313 LC Dordrecht, Netherlands Op FITTINGS DESCRIPTION: Optiflux Flowmeters 10O0F•11010C•/1300C CONTACT NAME: Cor Schellaars I I! 3.0 DOCUMENTS PROVIDED: [X] STATUTORY DECLARATION FORM-To be included for Fitting Submissions ONLY X] PROOF OF QUALITY CONTROL CERTIFICATE-To be included for Fitting Submissions ONLY [X] DRAWINGS/CATALOGUE NUMBER(S): See index �}_ [X] SUPPORTING CALCULATIONS/PROOF TEST 1i- J� 4.0 SERVICE REQUIRED: 4.1 REGISTRATION FOR: [ ] PRESSURE VESSEL Z [X] SINGLE FITTINGS [ ] CATALOGUE/MULTIPLE FITTING DESIGN 4.2 REGISTRATION REQUIRED IN THE FOLLOWING JURISDICTIONS IN ADDITION TO ONTARIO: [X] BRITISH COLUMBIA [ X ] NOVA SCOTIA [X ] ALBERTA [X ] PRINCE EDWARD ISLAND [X] SASKATCHEWAN [X ] NEWFOUNDLAND AND LABRADOR [X] MANITOBA [X ] YUKON [X] QUEBEC [X] NORTHWEST TERRITORIES FQT- ) X] NEW BRUNSWICK [X] NUNAVUT � 11 4.3 FORMAT FOR RETURNED DOCUMENTS: [X] HARD COPY [ ] CD-ROM SIGNED DATE a T:IVOORSCHRIFTENICRNIformulicren\TSSA National Registration Seivicc Application Optiflux IOOO.doc c Statutory Declaration Registration of Fittings Optiflux 1000 Page 2 On behalf of KROHNE Altometer and KROHNE Measurement Technology(Shanghai) Co., Ltd.,we are applying for an CRN Design Registration for our magnetic inductive flow meters as described within. Product model names to be registered include: Optiflux 1000 F Optiflux 1010 C Optiflux 1300 C For above listed models names,we are applying for Wafer type of fitting for sizes 3/8", 1/2", 199, 1.591,2",359, 4", 6". Please note that all our product names listed above have exact same flow-tube therefore the same exact welding, design, etc. The reason for multiple Product names is that the flow-tube can be configured with different electronic signal converters mounted on top of the flow-tube. Therefore Optiflux 1000, 1010 or 1300 have the same flow-tube but different electronic signal converter mounted to the top of the flow-tube.Thus they have different product names and labels. By including all product label names in our CRN,the local inspector will not be confused when inspecting a meter and the corresponding CRN document.Each letter of these product names are defined: F=field,signal converter remotely connected by electrode/coil cable to flow-tube; C= Compact, signal converter attached directly to flow-tube. Attacliments: 1. set documents Optiflux 1300 C 3/8"Wafer type. 2. set documents Optiflux 1300 C 1/2"Wafer type. 3. set documents Optiflux 1300 C 1"Wafer type. 4. set documents Optiflux 1300 C 1.5"Wafer type. 5. set documents Optiflux 1000 F 2"Wafer type. 6. set documents Optiflux 1000 F 3"Wafer type. 7. set documents Optiflux 1000 F 4"Wafer type. 8. set documents Optiflux 1000 F 6"Wafer type. End of page 2. THIS IS PART OF CRN 01:- 123'11•S Technical Standards&Safety Authority Boilers& Pressure Vessels Safety Division NOTE : p -M1` Sao ps °t CR9. Q TEE c�e�l eKpcRrs du *j,2r 2, �ssA µsr^ TECHNICAL STANDARDS& Show facsimile of manufacturer's logo or trademark,as it will ����`�\*10 SAFETY AUTHORITY appear on the fitting,In the space below TT S S AA 14th Floor,Centre Tower 3300 Bloor Street West K R O�NLE]Toronto,OntarioCanada M8X 2X4 STATUTORY DECLARATION Registration of Fittings 1, Cor Schellaars,Chief engineer (Name and Position,e.g.President,Plant Manager,Chief Engineer) of Krohne Altometer (Name of Manufacturer) Located at Kerkeplaat 12,Dordrecht,the Netherlands (Plant Address) (Telephone No.) (Fax No.) do solemnly declare that the fittings listed hereunder,which are subject to the Technical Standards and Safety Act, Boilers and Pressure Vessels Regulation,comply with all of the requirements of (Title of recognized North American Standard) which specifies the dimensions,materials of construction,pressure/temperature ratings,Identification marking the fittings and service; aor are not covered by the provisions of a recognized North American standard and are therefore manufactured to comply with ASME VilI div.1/ASME B31.3 as supported by the attached data which identifies the dimensions,material of construction, pressure/temperature ratings and the basis for such ratings,the marking of the fitting for identification and service. I further declare that the manufacture of these fittings is controlled by a quality system meeting the requirements of ISO 9001 which has been veiled by the following authority, Lloyds Register The items covered by this declaration,for which I seek registration,are category meas.dev Cat F type fittings. In support of this application,the following information and/or test data are attached as follows: See page 2"Statutory declaration Registration of Fittings OPTIFLUX 1000" (drawings,calculations,test reports,etc) I Declared before me at Sliedrechl in the of the 12 th day of February Ana;• Commissioner for Oaths: 4• O� (Punted name) (S' naturel �� Si nature rer q'r VIa'nadianFO FIEE SE ONLY Standards Association To the best of my knowledge and belief,the application meets the requirements of the Rexdale [31vd. Toronto, ON (4 16)747-4000 Technical Standards and Safety Act,Boilers and Pressure Vessels Regulation,and CSA Standard B51 and is accepted for registration in Category F f CRN: C OF12511 ,5L REGISTERED _ C.R.N.:CSA Registered by: ............. I2�IJ, 1Z •�>�1�1�4��5 ........... Dated: �oy� ��� ��2 � Signod:... ....... .. ... NOTE: This registration expires on 74 U-,v ST Jam/ 2O1 V 2� rv09553(06/04) ' oT e '1+t'E �{-7fi�Cq_,1IEN FbP— `Tc,L/E SCE a� . Statutory Declaration Registration of Fittings Optiflux 1000 Page 2 On behalf of KROHNE Altometer and KROHNE Measurement Technology(Shanghai) Co., Ltd.,we are applying for an CRN Design Registration for our magnetic inductive flow meters as described within. Product model names to be registered include: Optiflux 1000 F Optiflux 1010 C Optiflux 1300 C For above listed models names,we are applying for Wafer type of fitting for sizes 3/8", 1/2", 1", 1.5",2", 3", 4,,,6 —4 Please note that all our product names listed above have exact same flow-tube therefore the same exact welding, design, etc.The reason for multiple Product names is that the flow-tube can be configured with different electronic signal converters mounted on top of the flow-tube. Therefore Optiflux 1000, 1010 or 1300 have the same flow-tube but different electronic signal converter mounted to the top of the flow-tube.Thus they have different product names and labels. By including all product label names in our CRN,the Iocal inspector will not be confused when inspecting a meter and the corresponding CRN document.Each letter of these product names are defined:F=field,signal converter remotely connected by electrode oil cable to flow-tube; C=Compact,signal converter attached directly to flow-tube. Attachments: 1. set documents Optiflux 1300 C 3/8"Wafer type. 2. set documents Optiflux 1300 C 1/2"Wafer type. 3. set documents Optiflux 1300 C 1"Wafer type. 4. set documents Optiflux 1300 C 1.5"Wafer type. 5.set documents Optiflux 1000 F 2"Wafer type. 6. set documents Optiflux 1000 F 3"Wafer type. 7.set documents Optiflux 1000 F 4"Wafer type. 8.set documents Optiflux 1000 F 6"Wafer type. • CABMAN STAN6ANDf ANfNC1AT16 1 End of page 2. THIS IS PART OF ATTADOMM CRN OF12S"il•S' cRNC O� I I .5 Technical Standards&Safety Authorih, Boilers & Pressure Vessels SIGNED Safety Division 176IUMIMS"kn,4Twone"Cw.1WWsM9W NDTF_ © Scoplz I cpg 146 CRN fixprXS oil Au�,2rs-e� Cx0 +p116 ar44,o 10 Show facsimile of manufacturer's logo or trademark,as it will appear on the N BOILERS AND PRESSURE VESSELS fitting,in the span below T'S S A SAFETY DIVISION �� 3300 Bloor Street West � AutNoa` 4th Floor,West Tower K R O H N Toronto,Ontario CANADA M8X2X4 STATUTORY DECLARATION Registration of Fittings I, Oingfene,Li Quality Manager (Name&Position,e.g.President,Plant Manager,Chief Engineer) of KROHNE Measurement Technology (Shanghai) Co. Ltd (Name of Manufacturer) Located at Minshen Road 555.Songiiang Industrial Zone, Shanghai China.201612•Tel:+86-21-67600742 Fax:+86-21- 67600503 (Plant Address) (Telephone#) (Fax#) ❑ do solemnly declare that the fittings listed hereunder,which are subject to the Technical Standards and Safety Act, 2000,and Regulations for Boilers and Pressure Vessels comply with all of the requirements of (Title of recognized North American Standard) which specifies the dimensions,materials of construction,pressure/temperature ratings,identification marking the fittings and service; ■ or are not covered by the provisions of a recognized North American standard and are therefore manufactured to comply with ASME VIII div.I/ASME B31.3 as supported by the attached data which identifies the dimensions,material of construction,pressure/temperature ratings and the basis for such ratings, the marking of the fitting for identification and service. I further declare that the manufacture of these fittings is controlled by a quality system meeting the requirements of DIN EN ISO 9001,2000 which has been verified by the following authority,TUV Industrie Service GmbH. The items covered by this declaration,for which I seek registration,are category meas.dev.Cat.F . In support of this application,the following information and/or test data are attached as follows: See page 2"Statutory Declaration Registration of fittings Optiflux 1000" Declared before me at Shanghai in the Country of China the 190' day of M AD 2007. Commissioner for Oaths: Huang Lan Song I a�g �f. (Printed name) j+ _C;*1- c` t (Signature) I ( gnature of Declarer) PI Ihl i r �' � ,P w,=r„ "^�. .r•.=v "FiOR OFFICE USE ONLY Canadian Standards Association 40 178 Rexdale,Blvd. To the best of my knowledge and belief,the application meets the requirements o the Toronto, ON (416)747-4000 Technical.Standards and Safety Act,2000,and Regulations for Boilers and Pressi re Vessels and CSA Standard B51 and is accepted for registration in Category F i REGISTERED CRN: C5A- 0 ����1!5� :.OFF-� 1/156. C.R.N.• Registered by: �Z-3f�RNES Dated: t bN e-rVl�� 2G0 a Si ned: ... .................. ... ................ NOTE: This registration expires on t)CI U S r r O&Ybaahg: TSSA tatutory Declaration Form,Aug 24,2001,Rev.01.doc NoT ; SEE 744E A7TAr4AE-NT` (Z -iE- Sco PE Page 10 of 10 Rev. 2 � t Statutory Declaration Registration of Fittings Optiflux 1000 Page 2 On behalf of KROHNE Altometer and KROHNE Measurement Technology(Shanghai)Co., Ltd., we are applying for an CRN Design Registration for our magnetic inductive flow meters as described within. Product model names to be registered include: Optiflux 1000 F Optiflux 1010 C Optiflux 1300 C For above listed models names,we are applying for Wafer type of fitting for sizes 3/8", 1/2", 1", 1.5",2",3", 4",6 Please note that all our product names listed above have exact same flow-tube therefore the same exact welding, design,etc.The reason for multiple Product names is that the flow-tube can be configured with different electronic signal converters mounted on top of the flow-tube. Therefore Optiflux 1000, 1010 or 1300 have the same flow-tube but different electronic signal converter mounted to the top of the flow-tube.Thus they have different product names and labels. By including all product label names in our CRN, the local inspector will not be confused when inspecting a meter and the corresponding CRN document.Each letter of these product names are defined:F=field,signal converter remotely connected by electrode/coil cable to flow-tube;C=Compact,signal converter attached directly to flow-tube. Attachments: 1. set documents Optiflux 1300 C 3/8"Wafer type. 2. set documents Optiflux 1300 C 1/2"Wafer type. 3. set documents Optiflux 1300 C 1"Wafer type. 4. set documents Optiflux 1300 C 1.5"Wafer type. 5. set documents Optiflux 1000 F 2"Wafer type. ASSAM 6. set documents Optiflux 1000 F 3"Wafer type. OAMA�IAN it AssOaIATONraN 7.set documents Optiflux 1000 F 4"Wafer type. 8.set documents Optiflux 1000 F 6"Wafer type. ATTACHMENT TO CR O1= i 5 End of page 2. THIS S IS PART OF SIGNED (Al , C R N D 12 S I I'S q!RwdaM eoulwad Toiomo oN cwwa M!W 1RJ a Technical Standards&Safety Authorit}, Boilers g Pressure Vessels Safety Division NOTE: Q sco�fi o�- cP,>J. (9) THE cRN rxprXs oi`l cxv I/Z7i TECHNICAL STANDARDS & s SAFETY AUTHORITY 14th Floor, Centre Tower 3300 Bloor Street West Toronto, Ontario Canada M8X 2X4 December 22, 2008 KROHNE ALTOMETER Contact :COR SCHELLARS KERKEPLAAT12 3313 LC DORDRECHT DORDRECHT NL Dear Sir/Madam: Re: CRN Number: OF12511.5 I am enclosing the original response from CSA INTERNATIONAL registered under the above mentioned CRN Number. Please do not pay any jurisdictions directly as all jurisdictional fees are handled by TSSA. Once your design has been successfully registered in all of the requested jurisdictions you may receive an invoice from TSSA for any outstanding jurisdictional fees. If you have any questions or concerns please contact me. Notes Yours truly, Anna Sebastiampillai Administrative Support Tel. No.: (416) 734-3423 Fax No.: (416) 231-6183 asebastiampillai@tssa.org "To make people's lives better by enhanching public safety" Visit our web site www.tssa.org 09-12- 08 09.54 FROM-ACI CENTRAL INC 9825553133 T-581 P022/028 F-775 aui.n r v, rvn Nil I tIVill TERRITORIES MANO�ACTU4ERS NAME P r1`0 A-Altometer MAN CTURERSAODRE59: Kerke laat 12, Dordrecht, the Nelherdands PLANTL TIONS: See anOVB CATkqpHy of FITT BE REGI3TERGD CIRCLE ONE JFGORY ONLY m F ra q A Pipe frltiril Inducing couplings,tees,elbows.y9. plugs,unions.Poe caps,c r rgducefs ` 0 Plmnpeg: ail flanges Proprietary standard supported C Valves: all Ilse vistveg by ASME VIII div.11 ASMF 0 Expaneten JOINS,flexlble connexions and hose aacamti4es. at;types B31.3 calculations anclor proof E Stralnoro, filters.Separators,and steam traps tt'StB. 0 Measuring devices,Including pressure gauges,level gauges sight glesees. Isvals,or pfessu`e-tronarnAerg G Cill capectty-rattrd press"relief drll acceotable ac primary over pnli ssure proledion On boilers,prmuro vessels,piping end Fusible plugs H Presauty retaining composer"that do not feu into one of the it categorlei N Nuclear component: r:bos 1 O Class 2 O Class 3 O, (Meeting AECS or ASME requiremenLv) S YV MA NAME,TRAOMARK LOGO AS IT M—LL—A—Mlihp ON THE PRO UCY rypeQF Cipt48TRl 1`9111060 C M-6= la wpoucur m oAV O ottrert C KROHNE i oaacraoFonrER _1ST OF SUPVORTING DOCUh,F, N ANp IDENTIFICAT(q OF THE A�:TWAttITEMS TO 6E REGISTERED Urawings Stress-calculations welding plans wPSNVGIP TechnlCal datimeet 0 CLARATION: I John van der uraaf t,,e—w si employed by KROHNE A Itometer and being the person having full authority and resportslbfliry for the qusiity of the end Product do solemnly decllare that th3 Infortnabon contelnad in this form it true and to the best of MY kn0*0idge fepresAnts the product`or which registration is sought Thlr d-imenaions,materials of Wriatruelion,presil temperature rabrigs,and identification markinggrap m accordance with the herein nernat standards. I further decam that the manufacture of these fitlinga ie.regulated tuyr Centirol Program which extends to each plant where fabrlostion occurs in whole or in part end has been verified by / xis befng suitable for that purpose antl I make this solemn declaratlon conscientiously beHi -.and knoNing that it Is oil same force a t as If maUe under oath Signature of Declarer: Q P3pc�/0 Declared before me at 5l t U �� ! � F O R T M This 12 th day of Frwuary AD 2007 * C. E A L CCMM1iS510ner of paths or Notary Public: (sign) rGiat yell to the h or Qr This opaca for Regulatory Authority use a S`it This registration ril be revalidated after ten (10; years from the ptance. CR N. 0F12511 . 5 SENT pF FIDfl: 015 a � Norma, �fI' 2 `t 1 All11ttings shall ix reglstefed In the name of the Manufacil �CRr /;� 2. FaceIegory cal hall be euppartW with two Statutory Oevaratia+ � ` —"""/-" } roans and ono copy of supporting docum"tat:on. 3. The declarallvn shag be made by the person having fun euUarny and Do,TF40 7ryJ�/ responetbil ry for the quality of life end product. �\ /TT"""" ' a m rn 4. Quality Control programs ill be reflubmrltBd br validation f at a exrmu interval or five(S)yea f) G rs. / A� ���r�5 g� 09-1Z-' 08 09:54 FROM-ACI CENTRAL INC 9025663133 T-581 P024/028 F-775 e U�{tFORAO STATUTORY QRCIARAnCh FORM Ft8 THE REGISTRATION OF FITTING DESIONS NEW BRUNSWICK NOVA SCOTIA PRINCE EDWARC ISLAN^ NEWrOUNDLAND AND LABRADOR NUNAVUT Y�U�K�ON NORTHWEST TEF'!RtTOWES MANUFACTURERS NAME: �,KOHN PJ"& T� � MANUFACTURERSAO0II ttN g / PUNT LOCATIONS: ahD CATEGORv OF FI^iNO3 TO Br RE(ISTERED CIRC E ONE CATJI )Rj_Qh.Ij A Pipe fittings,Including aou0tings 'eas.albows Ys plugs,unions. I raps•or reduesn 8 Ftangea: ou llartge6 / C valves: alllinevalves Prrpr, Wy 54 / 4f g Expansion iatnlA oRX"Gonn2C*ni,ana nose assarnDliPS; sir types f A Y(f 6 Strainers,fixers,separators,ens ataam traps � C DR4636uring deviow,00u0ing pressxuegauges. bvel gouges,sight grasses,levels, or {J / owaure trancmioers ©3/ 3 G Certified ca3packy+eed pwaure reimf devices accaotaob ar Primary over pressur!protection on boilers.prML re TSWO,piping sad fusible plugs rfr prvje *its. H Pressure retaining components that do not fad into one of the above oetegoriec JJ N NurJU7,corngonents. Class t p Clats a❑ Class 3 0. (Meeting CNSC or ASW nsou+ramentsl W MANUFACTURERS MA ARK OR L060 AS IT W LL APPEAR 6N TNe PR000C'T TM°E OF CoNs'rtucrioN Wltoao 0 W@LaEa Q wR011rnT 8 CAST 0 CITnot C KR OH WSCILBE OTINIER I LIST GFF SUP.P,ORTIll 4Q(` NTgT10N Af1D IDQNTtFiGATiOfy OF THE ACTUA, jjCZ j @E REGSTERE 'Vx �Plolt• lwy Qa�i� DECLARAT N. I h`1 Imis a)employed by I4T5 ano being the parson having full authority and responslbtNty fC e a my of the end product do Solemnly de tare the the inf Nmation contalned In this form is true and to the best of my knowledge retxaser le the product for whroh registration Is sought. The dintenalona, materials of construction,prrassure temperawre raUngf, end Identification markings are in aCcoroence with the herein named standards. !further declare that the man dacture of these fittings la r4qulated by a 01-1811ty Control Program whiCh extends m earn plant where fabricatlon beCurs in whole or in part and has been verified by as being suitable for that purpose and I make this solemn declaration conscientiously oarfewng it to be true,and knowing that it Is Of the E ame force and effect as if made under oath Signature of Declarer: Declamd before me at A4l: 3;E T H l S S P A C E F O R T H E This 1 +�daY of AO F�':1�C I A L 5 E A L Commissioner of Oaths or Notary Publlc:(Sign) ( x OtTctal seal tot rt0 t1 This spooe fo?kagul;Io?yAu810iity.u8e 711-16 registration must be revalidaled after ten Hb)yearS.ffoltf.the CRN; D F 12 511 . 5 Q,� �L OF y FID#: 2015 A � G O Notes: (Cr�ivQ� �n //s i '. Afi fit mV shall oa registered In the name of tits ManufaCturar ( I �[ `e Z, Each category shah be suDportaa with tvro 3tatumry Declaration � forms ano one col of stipoI dooumentatlon. DA . 3 The daclaatfort shad ye mt►de o7 Cie person Having fuil authority one respaniabiGfy for the gtrNity of the end prWuet. \ ,� d. Duality Co-':ul programs shall Olt r%viornmed for+audat oi, �/� .G at a rriaximurn interval of five(S)years E��S Fpl Ptings aev 1 9512CO3 05-12-' 38 89. ?8 FROM--,CT C NTRA7 TNC 9025663133 T-5'- P021i825 F-770 a UMIFQRM STATUTQRY DECLARATION FORM FOR THE REGIST�AT OF FfTTING DESIGNS NEW 6RUNS'NICK NOVA SCOTL4 PRINCE EDwARO lsLArJo NEWF`�LJNDLANO AND LASRAOOR NUNAVUT YUKON NORTHWEST TERRITORIES MANUFACTURERS NAME. ONNr ,^ltXl 416 ,, LS 6-, L .MANUFACTURERS AOORESS: �r' it n 575• �f t�rr PLANT LOCATIONS: u D CATEGORY OF FITTINGS TO RE REGISTERED. CIRCLE ONE CATEGORY DNl A Pipe fittings,including couplings,tees.elpow>, Y-j,plugs,unions pipe caps,or reducers s ValveFlanges, line P1v�rr � 5 .>c�tret'sryw/'� C Valves at1 me valves �' I D Exparnion joints.flzAtple connections,end nose ass -Wiab' all types by� � �� /y r1414b EE Strainers, niters s¢pareors.and steam traps o &Measurfng oe•icos.inching pressure gauges lavel gauges.sight glasses,levels.or pronsurs trwomAers 6 3/ i Ga�,OVIS 441 G Certified capacity-rated pmcroro relief dsvieas accaotabie as prihnry over pressure protection on boderc,pressure vessels,piping and fusible plugs H Pressure retaining components Utet do not fall into one of tre above categeriss N Nuclear components; Class 1 !1 Class 2 lJ Class C. (.V"Iing CNSC or ASME reouiremenW SHOW'AANUFA TUBER NAME T'RAD MARK OR G AS IT WELL APPEAR ON THE PRODUCT Tr,E ofcomsTMrucno" FogGeOO r1tLnisp 3 waovCnT 2 _ CaST C: OTnE-P C .7ELCRle2 OTHER' _LIST OF SUPPORTING DOCUMENTATION ANO II;ENTIFICATMN OF TH5 ACTUAL ITEMS TO BE REGISTERED: Draw) vr/QS/r�P 7ar„�rr�r�,��tslr� DECLARAT N: i ' t:eonpo >employed Dy � Qt(N� (H jS and being the person having full authority and responsibility(o t e q ity of the end product do solemnly der,are that the Worrnatian captained in this term Is true and to the best of my knomedge represents the product for which registration is sought. The dimensions materials of construction. pressure temperature ratings,and iCentifcoation markings are in accordance with the herein named standards.I funher deciare that the manufacture of these fittings is regulated by a Quality Control Program which extends to each plant where fabrication occurs in whole or in part and has been verified bil, all being suitable for that purpose and I maKe this solemn declaration conscientiously believing it to qe true. and //Knowing that it is of the same force and effect as if made under oa(h. Signature of Declarer: t�• W _ Ceclared before me of zlk— U.S.rE T M I S S PACE FOR T H E This day of J A� ��l " � F`(,C I A L S E A L Commissioner of Oaths or Notary Public. sign) n - ( x Of'dal seal tot rig o This space for Regulaiory Authority use NEWFOUNDLANC This registration must be revalidated after ten(10j yefars from.! a d fplepia7t111G LABRADOR De- anmcnt of OF12511 ,5 CRN. g Go.emment Services 2015 I! Reglste+eo 2S}1. 5�i Ftptt date 2,Z NOtAS. ` GOVERNMENT 1, All fiRinr�a anon be rog,tac+rctl;n(he namo of the!Act nufaCturE r. Engine en ng and Ins CGUr _zrvrces 2. Each calegory shall oc supported with two Statutory Dedarstian Reg:stereu Cy forms and One copy of supporting documentation t 3, The daClard:lnn snaM oe made 3y the person having full nutdOr,y ano 1 UNDER THE AUTHOR TY J=Tt,f_. respors[t•Iiity rot the quality of the and product PU6UC SAFETY ACT ',14C s. Quality control proararns snail be resubmitted for va„dat,on THE 60t_EP.PRE3SuRE vESSEL AND 3t s MaXIMum of rive(S)YEWS. COMPF( �q EaA 4,4T rOOZ 203 I 09-12-' 0u 09 28 FAON-ACI CENTRAL INC 90256631'3 T-577 P@22i025 F-770 Statutory Declaration Registration of Fittings Optiflux 1000 Page 2 On behalf of KROHNN-E Altorrletcr and KROIdNE Measurement Technology(Shanghai) Co., Ltd., we are applying for an CRN Design Registration for our magnetic inductive flow meters as described within. Product model narles to be reo stered include: Optiflux 1000 F Optifux 1010 C Optiflux 1300 C For above listed models names, we are applying for Wafer type of flitting for sdzcs 318", 12", 1", 1.5", 2", 3", 4", 6". —.- Please note that all our product names listed abo-C have exact same flow-tube therefore the same exact welding, design, etc. The reason for multiple Product names is that the flow-tube can be configured with different electronic signal converters mounted on top of the flow-tube. Therefore Optiflux 1000, 1010 or 1300 have the same flow-tube but different electronic signal converter mounted to the too of the flow-tube. Thus they have d.iffercat product names and labels. By including all product label names in our CRN, the local inspector will not be confused when inspecting a meter and the coucsponding CRN document. Each letter of these product names are defined:F=field, signal converter remotely connected by electrode/coil cable to flow-tube; C=Compact, signal converter attached directly to flow-tube. Attachments: l. set documents Optiflux 1300 C 3/8"Wafer type. 2. set documents Optiflux 1300 C 1/2"Wafer type. 3. set documents Optiflux 1300 C 1"Wafer type. 4. set documents Optiflux 1300 C 1 5"Wafer type. 5. set documents Optiflux 1000 F 2"Wafer type. 6 set documents Optiflux 1000 F 3"Wafer type. 7. set documents Opd lux 1000 F 4"Wafer type. 8. set documents Optiflux 1000 F 6"Wafer type, Q GOVERNMENT OF e NEWFOUNOLAND "01 AND LABRADOR WDerartmcr,�or End of page 2. Regisrcrc% �12 <<,_c _ GOV_,:6-!VcENT SERN N.;_vTRE Engn�, Nnng @r.0 iL�S Reg�stereo 5y UNDER THE AV-�nRi Y JF THE PUB'-ICS.�.��TY q(,T AND 711E BOILER. PRESSURE VESSEL AND COMPRESSED GAS REGJLR,71ONS `3 t 09-12 08 09:Z8 FROM-ACI CENTRAL ?NC 90250133133 T-577 P019;025 F-770 NJJNAVUT YUKON NORTHWEST TERRITOl MANUFACTURERS NAr"'E. Krohne-Altometer NnANuFACTURERS ADDRESS: Kerkeplaat 12. Dordrecht, the Netherlands PLANT LOCATIONS See atove CATEQQR OF FAT Ki59 To t3E AF_GISTERED. CIRCLE ONE CATEGORY ONI Y r T'F OF 7HF 5T2J?MOAE CQt48TTF1.1r31QN A Pipe fittings,including couplings,tees.elbows,YS,plugs,union*.pipe caps,or reducers Proprietary standard supported B Flanges: all flanges C valves: all line valves Dy ASME VIII div.1/ASME D Expansion joints.flexible connections, and nose assemblies: ail types 831.3 calCU1815ons and/or proof E Strainers,filters,bepwatora,and steam traps tests ©Measuring devices,Including pressure gauges,level gauges,sight glasses, levels,or prossur@ transmitters G CeRlfled rapacity-rated pressure relief devices acceptable as primary over pressure protection on boilers.pressure vessels.piping and fusible plugs H Pressure retaining components that do not ran into one of the above Categories N Nuclear components: Class 1 Q Class 2❑ Class 3 O, (Meeting AECa or ASME requirements) SHOW MANUFACTURERS NAM TRADEINAR OR LOGO AS IT WILL APPE R ON THE PRODUCT PE D G0+31 W1101J43f I FORGGD� wEIOED O WROUG NT t CAST ❑ OTKR :3 KR OH N E OEGCRI8E 0T„ER. Li�T OF SUPpQRTING DOCUMENTATION AND IDENTIFICATION OF THE ACTUAL ITEMS TO BE REGISTERED: Drawings Stress calculations Welding plans WPS/WQP Technical datasheet DECLARATION: I John Van der Graaf f— a.3;employed by KROHNE Altometer and being trip, person having full authority and responsibility for the quality of the end product do solemnly declare that the information contained in this form is true and to the best of my knowledge represents the product for which registration is sought. The dimensions materials of construction. pressure temperature ratings,and identification markin In accordance with the herein named standards. I further declare that the manufacture of these fittings is regulated r a�y Control Program which extends to each plant where fabrication occur:in who. or in part and has been verified by as being suitable for that purpose and I make this solemn declaration conscientiously believin Ind knowing that it is of the same force an as if made under oath. Signature of Declarer: Papa;oat Oeclared before me al S� t l i E F O R T H E This 12 th day of 963t0uary AD 2007 E A L Commissioner of Oaths or Notary Public_(sign) al seat to the righ Of G This space for Regulatory Authority uS to VERNMENT l This registration must be revalidated after ten (10)years fror th eQUNDLAND 0 F 1 25 11 .5 �� AND LABRAOOR CRN' DeWriment of ,3 vwn;nenr Services Fl Dtt: 2 01 S I Ln3tE_� Z Notes CJ'•'ERN^%1ctiTSERvI n`!?PE 1. All fillings small oe registered in the name of the Manufscturer. Enginetinry and I p vices 2. Each category snail be supporteo with two Statutory Decia1auon forms and one copy of supporong documentauon. Registered by 3 Tme dectaration shalt be made oy the person navrng full authority and UNDER THE AUTHORiT OF THE ,esponsibiary for the quohty of the end product. PUELrC SAFETY A'-' D a. Quality control programs shaft be rasubmined for validation THE BOILER. oRESSURE VESSEL ANEW at 3 maximum Interval of five(5)years CCwPRESSED CAS REG LATIQ 09-12-' 08 09 2S FROM-ACI CENTRAL INC 9025663/33 T-577 F020/025 F-770 Statutory Declaration Registration of Fittings Optiflux 1000 Page 2 On behalf of KROIdNE Altomctcr and KROHNE Measurement Technology(Shanghai) Co., Ltd., we are applying for an CRN Design Registration for our magnetic inductive flow meters as described within. Product model names to be registered include: Optiflux loco F Optiflux 1010 C Otitiflux 1300 C For above listed models names,we are applying for Wafer type of fitting for sizes 3/8", 1/2", 1", 1.5" 2" 3" 4" 6„ Please note that all our product names listed above nave exact same flow-tube therefore the same exact welding, design, etc. The reason for multiple Product nm aes is that the flow-tube can be confiagiued with different electronic signal converters mounted on top of the flow-tube. Therefore Optiflux 1000, 1010 or 1300 have the same flow-tube but different electronic signal converter mounted to the top of the flow-tube. Thus they have different product names and labels. By including all product label games in our CRN, the local inspector will not be con'fused when inspecting a meter and the corresponding CRN document.Each letter of these product names are defined; F=field, signal convertecr rernotely connected by elcctrodc'coil cable to flow-tube; C-Compact, signal cornverter attached directly to flow-tube. Attachments: 1. set documents Optiflux 1300 C 3/8"Wafer type. �1 GOVERWENT OF 2. set documents Optiflux 1300 C 1/2"Wafer type. NEV1FOUNDLAfVo 3. set documents Optiflux 1300 C 1" Wafer type_ AND LABRADOR 4. set documents Optiflux 1300 C 1.5"Wafer type. Derarment or set documents Optiflux 1000 F 2"Wafer type. >�': "^r services 6. set documents Optiflux 1000 F 3" Wafer type. Re9s'- 0 �2511 SD 7. set documents Optiflux 1000 F 4"Wafer type. I Da e_ r__1 ��__ t 3. set documents Optiflux 1000 F 6"Wafer type. ° GOv:F>:?.}".NAAUTHORI •.TRE EnginQ�r r.g , vces P.egisterea by End of page 2. UNDER;HE OF THE PUSL1C SAFETY ACT AND TtiE eOILER,PRESSURE VESSEL AND COMPRESSED GAS REGULATIONS Ntw tiRUNJWIGK NOVA SCOTIA PRINCE EDWARD ISLAND NEWFOUNDLAND AND LABRADOR NUNAVUT YUKON NORTHWEST TERRITORIES MANUFACTURERS NAME. Kroh ne-Altometer MANUFACTURERS ADDRESS: Kerkeplaat 12, Dordrecht, the Netherlands PLANT LOCATIONS See above CATEGORY OF FITTINGS TO BE REGISTERED. CIRCLE ONE CATEGORY ONLY TITLE OF THE STANDARD OF CONSTRUCTION A Pipe fittings, including couplings, tees,elbows.Ys. plugs, unions.pipe caps, or reducers i B Flanges all flanges Proprietary Standard supported C Valves. ail line valves by ASME Vlll div.1/ASME D Expansion joints, flexible connections,and hose assemblies all types B31.3 calculations and/or proof E Strainers filters.separators, and steam traps tests. OMeasuring devices, including pressure gauges.level gauges.sight glasses, levels, or pressure transmitters G Certified capacity-rated pressure relief devices acceptable as primary over pressure protection on boilers,pressure vessels,piping and fusible plugs H Pressure retaining components that do not fall into one of the above categories N Nuclear components: Class 1 0 Class 2 0 Class 3 O. (Meeting AECB or ASME requirementsf I SHOW MANUFACTURERS NAME,TRADEMARK,OR LOGO AS IT WILL APPEAR ON THE PRODUCT TYPE of coNSTRUCTION FORGED C WELDED 2 WROUGHT 2 CAST C OTHER 7 DESCRIBE OTHER I KROHNE LIST OF SUPPORTING DOCUMENTATION AND IDENTIFICATION OF THE ACTUAL ITEMS TO BE REGISTERED: Drawings Stress-calculations Welding clans WPS/WQP Technical datasheet DECLARATION: I John van der Graaf ;see,CEO 31 employed by KROHNE Altometer and being the person having full authority and responsibility for the quality of the end product do solemnly declare that the information contained in this form is true and to the best of my knowledge represents the product for which registration is sought. The dimensions, materials of construction, pressure temperature ratings,and identification markin re in accordance with the herein named standards. I further declare that the // manufacture of these fittings is regulated atity Control Program which extends to each plant where fabrication occurs in whole or in part and has been verified by _� as being suitable for that purpose and I make this solemn declaration conscientiously believing tjfae tr and knowing that it is of the same farce an_Uffext as if made under oath. P paNG;o Signature of Declarer: Declared before me at U I F O R T H E 12 th Febru ar y 2007 1 This day of" AD E A L Commissioner of Oaths ✓mil �n ;_.b,° ` "c or Notary Public: (sign) - —�� — ;� �, (A ¢ CW seal to the right This space for Regulatory Authority use t 1e This registration must be revalidated after ten (10)years frorie lT 0 F 12 51 1 . CRN BruAzi.m. � OEPT OF PUBLIC SAFETY FID#- 2015 BOILER & PRESSURE VESSEL ACT I ?,EOISTRA71ON ONLY j Notes ,1 i All fittings shall be registered in the name of the Manufacturer CRN; � 2. Each category shall be supported with two Statutory Deciaration LLL��� forms and one copy of supporting documentation 3 The declaration shall be made by the person having full authority and eXr? A4N ER: responsibility for the quality of the end product _ - a Quality control programs shall be resubmitted for validation 'oi at a maximum interval of five (5)yearst;''P�v' il? 8I-hs lJ y`'fs ;J. 1 ='•T7Ii�sa C-*1EN T S UNIFORM STATUTORY DECLARATION FORM FOR THE REGISTRATION OF FITTING DESIGNS NEW BRUNSWICK NOVA SCOTIA PRINCE EDWARD ISLAND NEWFOUNDLAND AND L ABRADOR NUNAVUT YUKON NORTHWEST TERRITORIES MANUFACTURERS NAME: 1-X0HAG Nle2Su'ement rtzA,1,&91 CS ) Co. Ltd IV V MANUFACTURERS ADDRESS: t!;'� itLvt o 535. oNA 1 'a�,a /�? sue^%�. ono 1 ..? / iz PLANT LOCATIONS: CATEGORY OF FITTINGS TO BE REGISTERED. CIRCLE ONE CATEGORY ONLY I Ti cF-r SraNgnr±D of gks;ay��•oN I i I A Pipe fittings,including couplings,tees,elbows.Ys,plugs.unions,pipe caps,or reducers / ! B Flanges: all Flanges C Valves: all line valves D Expansion joints,flexible connections,and hose assemblies: all types i A I, y,11,VAI-Z I E Strainers,filters,separators,and steam traps I)measuring devices.including pressure gauges,level gauges,signt glasses,levels.or 1 / pressure transmitters Q 31.3 CG� ;oy�S R,xu/ G Certified capacity-rated pressure relief devices acceptable as primary over pressure protection Dn boilers,pressure vessels,piping and fusible plugs vY Pr J �QS�S H Pressure retaining components that do not fall into one of the above categories N Nuclear components: Class' G Class 2 0 Class 3 C, (Meeting CNSC or ASME requirements) I SHOW MANUFACTURERS NAME,TRADEMARK,OR LOGO AS IT WILL APPEAR ON THE PRODUCT rY-E OF CONSTRLCTICri FORGED= WELDED 3 'WROUGHT 3 CAST C OTHER C i KR CIH N7E i DESCRIBE OTHER I I LIST OF SUPPORTING DOCUMENTATION AND IDENTIFICATION OF THE ACTUAL ITEMS TO BE REGISTERED: I 1 I 1�'Gtu'�y�5 I ,,r,Ps/wr P DECLARAT :N I i'n (5eanoie3)employed by ��ZOCt1/yr r�7-5 and being the person having full authority and responsibility fo t e q ality of the and product do solemnly dde lave that the information contained in this form is true and to the best of my knowledge represents the product for which registration is sought. The dimensions, materials of constriction, pressure temperature ratings,and identification markings are in accordance with the herein named standards. I further declare that the manufacture of these fittings is regulated by a Quality Control Program which extends to each plant where fabrication occurs in whole or in part and has been verified by as being suitable for that purpose and i make this solemn declaration conscientiously believing it to be true, and knowing that it is of the same force and effect as if made under oath. Signature of Declarer: c2,, 4 Declared before me at C USE THIS SPACE FOR T H E This Jq t4 day of A0 — - _ O F F I C l A L S E Commissioner of Oaths or Notary Public: (sign) (A.ix O h n fficial seal to tght) qew.. �?.,-�,Iayeau This space for Regulatory Authority use This registration must be revalidated after ten (10)years from the data of aELFeVqQg POBLI!C SAFETY BOILER & of rc-SS iRt=_ VESSELACT CRN: O F 12 51 1 . '�Zr,7 - i L�NLY Flo#: 2015 is FPi ,.1 /� Notes: d- /I��j :. All fittings shall be registered in:he came of the LlanufaC•urer E{AliyNF 3 ft/�11 2. Each category•snail oe supported with wo Statutory Declaration forms and one copy of supporting yocumer.tatior.. .,. 3. Tie declaration snail oe made oy tre person having;.wl autNtirty arc �riir-F -B47,�,En :rr.�PS-C T OR responsibility for the quality of the end 3rcduc:. s Duality control programs snarl oe resucmit:ect for vaoca-,;v DATE: at a maximum interval cf five(5)yeas Se Z. - .-=:t.�s Rev �3.2C'3 ❑ �L J PVs -ET'FI' ❑C.OMPONENT3 ey 1ZY ZUUb lb: Z7 jbL-4Z4- ,L i7 I)LL 1-UbLII- IV., 10 by-1[ wa 0y;13 k-NUM-AUI ULNI'HAL INC 9025663133 T-57E F027%033 F-71772 •v,..�.v r v rwn rV V+C I M W Ca 1 I Cp K I I V rV W MANUFACTURERS NAW: Krohn e-Altometer MANUFACT-UREMS ADDRESS: Kerke last 12, Dordrecht, the Netherlands PLANT LOCATIONS: See above CAtEGQRT OF PITTING$TQ RIE fMgl `GIRCI E ONE CATEC30RV pNLY > ��e�r of•pN$ Aix 7r�y A Pipe fittings, including couplings,tees.elbows.Vs plugs,unions,pipe caps,or reduces a Piangae: en flanges Proprietary standard supported C vervres: an line valves by ASME VIII div 1/ASME D Expansion jo0ft.flexible COFMOetlpnc,and hose assemblies_ all types 631.3 calculations and/or proof E S"i"M,titters,separators,and steam traps tests. (E)w3suring devices,Including pressure gougas.4WO1 gauges,sight glasses, leveta,Or presauro tranarnitt&M 0 Certified capacity-rated pressure relief devices orr+ntabha as primary over pressure protection on boilers.pressure vessels,piping aril fu&iblo p4r. H Pressure retaining componanla that do not fall into one of the above categorlRx N Nuclear companenta: Clam.1 ❑ Gass 2 C Class 3❑. (Meeflng AECB or ASME rmquiremarts) SNOW ANIJFACTllR NA B,5CEMARK,OR LOGO AS IT"&[.J� R ON TM PRODUCT TYpF OF rx)ms' ,. 'c FORCED WELOM R NMIGM 2 CACT O OT*R Z) ARUH- N owgcwE oYHCR, JjST QF 3UPPQRJJ Ci_DOCIJtMENTAT1pN ANO IOF�IFICAT�t'J OF THE ACTUAL rrFINB Tn I3 8jgL3TERED; Drawings Stress-calculations Welding plan WPS/WOp Technical datasheet DECLARATION: I Jq n van der Graaf two mma at employed by KROHNE Altorneter And being the person having fuA authority and responsibility for the quality of th®end product do solemnly declare that the information contained in this term is tn,e grid to the best of my knowledge represents the product for which registration is sought. The dimermionn.materials of constructlw%pressure temperature ratings,end ide-riffcation mark in ee In accordance with the herein named standards.I further declere that the manufacture of thasA Fittings is regulated 13y Control Program which extends to each plant where fstb►icMion occurs in whole or In part and hag been verified by 9R being suitable for that purpose and I make this solemn declaration conscientiously betlevl and knayvlrig that A is of the same force an as if made under orAh. Signature of Decfalrw, Q Pap'�i0 t 1 Declared before me at U I F O R T H E This 12 rh day off F4bfuery qp 200 G E A l Commissioner of Oaths or Notary Public: (sign) f 4Vr•�,r .,��� (MpRejal seal to t ri h �` eU TW&space for Regulatory Authority use to Sl1e This reglstration must be revalidated after ten(10)years from the rice. cRN. OF12511 .5 NOTAS Cc7 nA S f FID#: 20I5 � Notes' 1. All fl-,drgs shah be reginterad in the name or the MpnufaCtur2r, 2 Each category shalt ea supported with two 31atutory Deciaratlon LL I forms and one copy otsupporting documerttition. Qw _Cl.s.�-� I.S7.ea...._-_._- 3 The declaration anall be made by Ma parson having full outhor,ty and responsibility for the quality of the grid product. A 0uelity cantml programs she?be reauomitted for valldation " at 0 maxlmurn me val of Rve(S years. by.•'1Lr Lto10ts lb: z:) V0Z-4L4-J4a= LGl_ t-UDLlI+ D"rC.r T 09-12-'08 09:33 FROM-ACI CENTRAL INC 9025663133 T-5730 F029/033 F-772 VNlFO TAT TO Q tION F WE REGI T TION 0 1 T iG S NEW BRUNSWICK NOVA SCOTIA PRIMCE EOWARD ISLAND NEWFOUND1AND AND LAERADCR NUNAvUT YUKON NORTHWEST TERRITORIES MANUFACTURERS NAME: k'90' pasuremvit MANUFACTURERS AODRQSt3: PLANT LOCATIONS: CPTMryX OF FITTINGS TO 8E R QISTEREO�C RCLE ONE CATEGORYONLY I T a�-6F"g AN MA .-glrS�Sl3IRyiK eN I A Prpe fdtings,incJudinq WuDfinan.bass.elbows,Vs.plugs,unions•pipe oada or reducere 8 ftrigee: ad flanges,'„�f,'"",/'Jury C valves: an line valves 0 EXpw4lan Jolnta,fk�bile connections.and hose assemolies: all types b r1 e p crl,�C W"6 j/y!/N't E Strainers,fitters,sapa(MOM,WA abeamrap traps ©Maasudng dovtm,Including pressure gauges,"I gauges,sight glasses,levels.or of"gum troncrntftore G Certified cepai;,"ted pressure relief devisors Acaoptt+bie os prirmary aver p"nnum protaclion on boilers,pressure vessels.piping and fusible plugs H Arassuro ratelntng components that do not fail Into one of the above categories N Nuclear oentponerta: Class t ❑ Class 2 O Class 3 ❑, Meelfng CNSC or AWE requirements) SHC ANFATUER5 NAMETROEMAKOR 04AIT MLL OPPAi ON THEP C RC*X MAGb00 W61.0ra rX WRoucnT 2 CAST 0 OTNOR C S �tLai-'7�� pEy0R79E OTHER �IsT QF aL!PPO TI�NG OQGuMENTATION AND ro6NTIrICATIOM_OF THE ACiUAt.IYF�Igs_rp_aE�GIS�.EB�pa i I it:ye,�CGGykscv�S 1•I/q,���.la�s ,tips/wov , DECI.ARA fd: I � ova �.; rswrtote3)amployll by �n �-, %� and tr©Ing tho person herring full aubnority sr4 respon�f ee q tlty of the end product do solemnly de larc that the Wi0i'MAtion contained in this form is true and to the nest of my kwMedge represents the product for which regfstrafion la sought. The dimensions,materials of construction,pressure tamporature r2Wg6,and identification merltinga aM in aceardance with the herein named standards.I further declare that the manufacture of thege fittings is regulated by a Quality Control Program which extends to each plant where Faoreatior occurs,n whole or in pert and has been verified by aB being suitable fW that purpose and I make this solemn declarAtlon conecientiousty belie/w'i C it to be I►ue,and knowing that a Is of the same 1btr,.e and effect as If mgdrt under oath. S+gnalure of Declarer: (x l OeGered before me at S_>s 1' MIS SPACE FOR THE This day Of AD °' ; -:I, '' b 5yF`�s C I A l SEA L Commissioner of Oathe or Notary Public: (sign) �A , clal Seal to lh right) 1 This space for Ragultitorry uthartty :p•R 'R This registration must be revalidated after ter(tOf yo tf a a t CRN: 0 F 12 511 .5 FIN: 2015 v Daln-Wit' 3.F.N -O_F.1-� �.11_•. g--•--•----- N0106: ` 1. All fittings shall be regtatered in the ram¢a th0 Manufacturer. �� d g C.r 1 6 e--------- 2. Each Category 0611100 9uWnad vAh WStatutory Oaclarati0n J W 9'-'-•••_ ---• farms aril one Copy of euppprlkng documcnutlok 3. The decleretIOA anal)De made oy Me person having full authotlry and jig^?Cy J- _ ,"porsbtlity for rM quality of rha end product d. Quallty ConCrol prOgrame 0ap BA reAuOmi ted For vel,dat+On at a maximum tntervai of five(5)years. T C r t Fillings Row. '0612CO3 01 8 ` NEW BRUNSWICK NOVA SCOTIA PRINCE EDWARD ISLAND NEWFOUNDLAND AND LA13RADOR NUNAVUT YUKON NORTHWEST TERRITORIES MANUFACTURERS NAME: KfOhne-AltOmeter MANUFACTURERS ADDRESS: Kerkeplaat 12, Dordrecht, the Netherlands PLANT LOCATIONS: See above CATEGORY OF FITTINGS TO BE REGISTERED. CIRCLE ONE CATEGORY ONLY TITLE OF THE STANDARD OF CONSTRUCTION A Pipe fittings, including couplings,tees.elbows. Ys. plugs, unions, pipe caps, or reducers Proprietary standard supported B Flanges: all Flanges C Valves: all line valves by ASME VIII div.1/ASME D Expansion joints. Flexible connections,and hose assemblies: all types B31.3 Calculations and/or proof E Strainers, filters,separators,and steam traps tests. QMeasuring devices,including pressure gauges,level gauges,sight glasses, levels, or pressure transmitters G Certified capacity-rated pressure relief devices acceptable as primary over pressure protection on boilers, pressure vessels,piping and fusible plugs H Pressure retaining components that do not fall into one of the above categories N Nuclear ccmponents: Class 1 C Class 2 G Class 3 ❑, (Meeting AECB or ASME requirements) SHOW MANUFACTURERS NAME TRADEMARK OR LOGO AS IT WILL APPE R ON THE PRODUCT I TYPE OF CONSTRUCTION FORGED G WELDED 41 WROUGHT 2 CAST D OTHER `1 JKROHNE DESCRIBE OTHER. LIST OF SUPPORTING DOCUMENTATION AND IDENTIFICATION OF THE ACTUAL ITEMS TO BE REGISTERED: Drawings Stress-calculations Welding plans W PS=Q P Technical datasheet DECLARATION: I John van der Graaf (see-oie3)employed by KROHNE Altometer and being the person having full authority and responsibility for the quality of the end product do solemnly declare that the information contained in this form is true and to the best of my knowledge represents the product for which registration is sought. The dimensions, materials of construction, pressure temperature ratings, and identification markincLWe in accordance with the herein named standards. I further declare that the manufacture of these fittings is regulated ality Control Program which extends to each plant where fabrication occurs in whole or in part and has been verified by ' as being suitable for that purpose and I make this solemn declaration conscientiously believin It e t and knowing that it is of the same force an t as if made under oath. Signature of Declarer: Q PaPa-O� Declared before me at S�de t I F O R T H This 12 th day of Reb'r'uary AD 2007 G E A L Jt, =may''•:L =' Commissioner of Oaths ✓� f �. or Notary Public: (sign) L 00 (A O cial seal to the right Q; This space for Regulatory Authority use t@ 5�1� This registration must be revalidated after ten (10)years from the f a ceptance. CRN: OF12511 . 5 FID Notes. 1 All fittings shall be registered In the name of the Manufacturerk'—ice 2 Each category shall be supported with two Statutory Declaration ,• forms and one copy of supporting documentation f � 3 The declaration shall be made by the person having full authority and —` ;-' —�-----� responsibility for the quality of the end product- r?w; 'y_ 4 Quality contrnl programs shall be resubmitted for validation ---__at a maximum interval of five (5)years. _.. L a UNIFORM STATUTORY DECLARATION FORM FOR THE REGISTRATION OF FITTING DESIGNS NEW BRUNSWICK NOVA SCOTIA PRINCE EDWARD ISLAND NEWFOUNDLAND AND LABRADOR NUNAVUT YUKON NORTHWEST TERRITORIES MANUFACTURERS NAME: kROHivF 114X5 zremewt T•e Al) 6 ) Co. Zrd MANUFACTURERS ADDRESS MeH �en Qcr'555, Sang i,'a,s a 104s�441z or PLANT LOCATIONS: 5k abp CATEGORY OF FITTINGS TO BE REGISTERED. CIRCLE ONE CATEGORY ONLY TITL=CF TH,F, TaypARt)oQNssau�T pN 1 A Pipe fittings,including couplings,tees,elbows,Ys,plugs.unions,pipe caps,or reducers l B Flanges: all flanges I rY�,j stanci�Aro�5 � C Valves: all line valves Pao dl D Expansion joints,flexible connections,and hose assemblies: all types i b `��� y //�M� I E Strainers,filters,separators,and steam traps I /1✓+nG Measuring devices,including pressure gauges,level gauges,sight glasses,levels,or pressure transmitters (3 3/.3 Czkca,bns / G Certified capacity-rated pressure relief devices acceptable as primary over pressure protection on boilers,pressure vessels,piping and fusible plugs H Pressure retaining components that do not fall into one of the above categories N Nuclear components: Class t C Class 2❑ Class 3 C, (Meeting CNSC or ASME requirements) I I SHOW MANUFACTURERS NAIVE TRADEMARK OR LOGO AS IT WILL APPEAR ON THE PRODUCT TYPE OF CONSTRL CTICN FORGED 7 WELDED 3 WROUGHT B i + CAST C OTHER i C KR OH N l DESCRIBE OTHER I I LIST OF SUPPORTING DOCUMENTATION AND IDENTIFICATION OF THE ACTUAL ITEMS TO BE REGISTERED: Draw, 5 vVX1Waa TPc����datas•� � DECLARAT N: i I'/t (see note 3)employed by k; msikltln and being the person having full authority and responsibility fo t e cl ality of the end product do solemnly de fare that the information contained in this form is true and to the best of my knowledge represents the product for which registration is sought. The dimensions,materials of construction, pressure temperature ratings,and identification markings are in accordance with the herein named standards. I further declare that the manufacture of these fittings is regulated by a Quality Control Program which extends to each plant where fabrication occurs In whole or in part and has been verified by as being suitable for that purpose and I make this solemn declaration conscientiously believing it to be true, and knowing that it is of the same force and effect as if made under oath. Signature of Declarer: Z-r Declared before me at l U..S.E T H I S S P A C E F C) R H E This�day of AD off O F F I, C I A L S E A L Commissioner of Oaths or Notary Public: (sign) (A ix Official seal to th right) This space for Regulatory Authority use This registration must be revalidated after ten'-(I D)years from�lttIC tIlmn CRN: 0 F 12 51 1 . 5 FID#: Dun a -,.'.,.,.. - ,'.� .^;.h,;x� •��:�=•i�a 3'�I3�' Notes: rl 1 11 J 1. All fittings shall be registered in the name of the Manufacturer. . . . 2. Each category shall oe supported with two Statutory Declaration t , forms and one copy of supporting documentation. 7 3. The declaration shall be made by the person naving full authority anc G responsibility for the quality of the end oroduct. -'j----- 4 Quality control programs snail De resubmitted'or vaODaCOn RNS-117Y.SVII IO N;Q Re".at a maxcmum interval of five(5)years ,, gy;y ty.�;v tgN ev 2CO3 Oct-01-2008 04.24pm From-FIRE MARSHAL +8679755315 T-0'9 p 001/001 F-302 MANUFACTURERS NAME Kronne-Alto meter MANUFACTuaERSADDRESS: Korico laot 12, Oordreoht, the NothorlDndc PLANY LOCATIONS. See above CATEGQRY OF FITTINGS TO 4L ttl-VIN I EFtfb• GIRCt E,pNE CATEGORY ONLr tTLw nw�;'7�Lt0 �OF CQNvTR'y4T14N A Pipe fittings, Including coupAngs,lees,elbows. Yc,plugs,union;,glpQ,dpii, qr rsdVDel; ';ttary atendetrtl 3uppertod 0 Flanges all flanges C valves: all tine valves by ASME Vill div.1/ASME 0 Expansion joints,flexible canneclions, and hose asstlrnDlies. all types 531.3 calculations andlor proof E Strarnera, filters,separators,and steam Iraps tests. FO Measuring devices,including pressure gauges,level gauges. sight glaeaas level&, or pressure transmitters 6 Oc,i;GcJ...o ty-'.1aJ y.t_aawo.atlat Jc.,ua Ou.oyloLlC oa yilnlr,y uvc. y,aaaura y ulovU�, >oLlers,prosburA vmSWA,pipbtg dndfubiUla plugs lf1Pl 4-1—t 1-11 114V YI'4 YtU'��1YYYG Y9lGYYit4a Cl— 1 M l•.laaa f. ❑ Moon 1 t5. lMcolt'•y J,ns... A,7MI_...4-.-.......W gHOW MA UFACTURER$NAME,TRAOEMAR OR LOGO AS ff=LL7AFiP--h&DN THE PROD C PE of cn v.Tauc +� FoRGED 0 �tERd 0 wnaucrr ra CAST 1 to HN DESCRIED OTNEA: LIST aF SUPPORTING DOCUMENTATION ANO IDENTIFICATION OF THE ACTUAL ITEMS TO BE EGtST6Ri p: Drawings Stress-calculatlons VVvIding plans WPS/WQP DECLARATION- I John van der Graaf I.serww-jl employed by KROHNE Altometer and being the person having full authority and responsibility for the quality of the and product do solemnly asclare tnat line Imermatlon wntaattnj Ill u,ia r.nn,to true and co tho bocl of my knowledge represents the product for which registration Is sought. The dimension, materials of construction, pressure temperature ratings,and Identification markin a In accordance with the herein named standards. I further declare that the ran.foctar•c of lhcoo fittine. is rogulatodd j tl2Uty rnnlrmi PmorAm which extends to each olarrt where fabrication occurs in whole or in part and has been verified by /�', as being suitable for that purpose and I make this solemn declaration consclentiousty believVrt o nd Knoyillny a gat iL Is of tr6 anmc force an f or.if made undar oath. Q,?apai, Signature of Declarer: Declared before me at 5 t U I 6 F 0 R T H E This 12 th day Qf ary AD 2007 E A L Commissioner of Oaths or Notary Public; (slan} (A clal seal to the r h � alb p er- T+,a ayo..c fv. rieaulotary Author;ty uco O all _� This registration must be revalldaled after ten (10) 0F12511 . 5 NU? �',i°LJT CRN; 6cilers and Flo# � Pressure vessel, Act 1llutlavut t. AN ntttngc chow oo rogictored in the name of the 2 Each category small be supported with two Statutory Declaration / �l forms and ono copy of supporting documentation. CRNC� Q r nag 3 The declaration small"made tly the person havrng full autnonty and pate J QQ responsibility for tho quafity of the end product. E'\ 4. Quality control orogrems shall be resubmitted far vsraation Signed Pr at 3 maw;, "A""verval of No (G)years. r Ctt1'3T IrlsoeVor Oct-01-2008 04:1Sum Fruw 55:-FIRE MARSHAL +B8?g1 '5 T-01a P 002/011 F-301 ' e 1-1141FORM STATUT❑RLPFgLARATION FORM FoFt THE REG(ST^nATION OF FITTI[iG_I7ESLGNS NEW BRUNSWICK NOVA SCOTIA PRINCE EDWARO ISLAND NEWFOuNDLAND AND LABRADOR NUNAVUT YUKON NORTHWEST TERRITORIES MANUFACTURERS NAME: k Or1Nt Vino C a Co. MANUFACTURERS ADDRESS. M, 555. ,'a /n pia PLANT LOCATIONS: , CATEGORY OF FITTINis TO ag REGISTERED. GiRCLE ONE,CATEGORY ON4�Y '` " -1L -r`•QL-4elLW A Pipe fittings.including coualirngs,tees,feOW5.Ys,0,23.unions.pipe Caps, or reducers `I p !`angeg! eM flangoo p r, C Volvo,t: IN lino vmvcc r G p„�,,,„,t.,,.�„i...-. rt..h............__.....,.�i._----�....t_i:�. _n r,a++ �l R.Jn'jG twin •�1►'.i����s otrainera.Plers,separators, and steam traps (� Measuring devices,in"Ing prassurs gauges.IEVei gauges,sight glasses.IevIIS, or preasura tron9n91110ro I e 91 G cenined CapacllyNOtcJ t+ 6surz reFicf devicas aecoptablo ac oeirnoiiry over prorcurn protection nn boilers,pressure veaaels, piping and furrow plugs !P/ PYa°f f5 H Pressure retaining curnponenta that do not tall into one of the above categories J N NWClder uunryu,rcrdo. Claac 1 ❑ 111W 1j❑ 01111111111 3 0. (fteel CNEC or.rlW6*gUIramim SHmAt MANU C URE17S NAM TRADEMARK OP O IT W1LL APP ON THE DOuGT TYPe of ccns'rauc-ton FORLEo O WELOED Sr WROUCIN7 1) ;AST Q gnreR 0 OESCMRE OTHER KRGHNE t IS�T OF SUPPORTING DOCUMpW ATION AND IDENTIGICA ON OF THE ACTUAL IT GISTERED= vt/ps/wt9P Ter.�,�a1� tasf DEC N: and being the person having full authority and I r�oc+/� . _cretlnUlB])employed bynN� responsibility to gdWity of the and product do solemnly de6are that Tine t ,buu, rw,tai a+! r.olio forte+in 11u0 and to the bo=c of my knowledge repreecnta the preduat for which registration Is Sought- Tlr rlirrw.nWona, rnotortola of conOtrvgtion,proscure tamperature ratings.and Identification markingG are In accordance with the nerein namea standards- I hather dedere MI the �rrt�ftufpF�N�c of[lino. .is a mgulated by o Quallty Control Arogr;im wnir-h PYti nrlh In mrn plant Yllilt3re Wimign ou4rs In Whole ;n part ar,d h-• 10-v rrfnrd by. t!b buluq, s.16L i6 tu. tl.At AJrp03d end I Htolto this colomn declaration conscientiously believing it to be true,and Knowing that it i,ut the samln terda en0 CTrc8t JO If InuUO u"Jo. .+etn. Signature of Declarer: tt �1 . 11� TMIS SPACE FOR HE Deelorod eafere Me it I ^+ � !7,rr•I'g �t This ,Qt� day of AD 7 _0•A F`YI�G I A L S E A L f-- ,. Gommisvorw of uatna or Notary Public: (sign) -^`` —71 (A Official sea�th g t) - - ---- _ Thlo spaoo For R6guIY1Orp This registration must oe revalldateo after ten QIOf yl x U,e datc oif It pminc.• Q S 1 2 5 1 . S Boilers and CRN: `acu�` preSSUC2 +1C'SSC AC, 2015 I���'1av�t Fs �;, V pry I NOtaa: 1a5 � I. AN fittings shall De reglsterea in me name of fie Mdrwfa1-LW 2 Each category shalll De supposed with two Statutory Declaration forms ano One copy Or supporting docuTentatlon ` mate 3. The Oec`aration snau be marls oy the parson naving full sutnority and t reaponsioIllty ft., the quaNty o!the lino proauct. Signs C�r 4_ QueFty control programs shall be resuDmittea for v8110ation i Cnief inSJeDtOr at o me■�mum mten ai of five(S! years. i Secs.1-G-Ftv�gsftev ^_3rLOG3 09-12—'08 09 50 FROM—ACI CENTRAL INC 9026663135 (-5�10 ria�t�loc� r—+ry ..,,,...._. vnv�. nrure r nvvtti t t cram t uses EACTURERS NAME: Kroh ne-Altomete r MANUFACTURER6 A00RE9 : Karkepiaat 12, Dordrecht, the Netherlandt3 PLAN OT�C.AT : See above C -Oft Fi-"HWGA TO BE REQISTERILO. A Pipe I'Minge,including tAupAngs,toes,efbowa,Ya, ptugs,unions.pipe cape. or reduc=5 Propriotary standard supporteo (1 Flanga&: as Qanpea C Valves: all line vain by ASME VIII dtv.1/ASME 0 Expansion joints,fhriblo conneaono,Ord heis iccsm 0%. all types 11331_3 CSICUlatlon9 9nd/or proof Strainers, Nwrv.separators,and swam traps test9 L�Messurino devbes,including pressure oeuges,level gaugers,eight g+xses {ovelL,or pr eaoure'tr7neTn i lien a Cmirod oapoolty-rorad pressure tWlaf devices scoaptabie es primary over prusure protacfbn on MMon,pressure veesele.pioN aced fusible pkV* H Prenum mta6ng component;that do not fall into one of the above cute fwa N Nuclear cemponenta: CiWse 1 ❑ Class Z 0 Ghee 3 O, (Meetlnp AEC8 or AaW requuemerta) FORWD Q VaLeac a vAtov(WT vsscetes otet[R KREIHNF]- L131 OP INN 0 CUMENTAT�O-Mplpl CATiON Or fi-if ACTUAL IT. TERBD: Drawings Stme-caIcutotlong Wrlding plans WPS/WQP Technical dataaneet DCCLARATION: I John van der Graaf employed by KROHNE Altametsrr and belrtp the person having full authority and ampone(bilty for the quality,of the end product do solunnir declare that the information contained In tints form la true and to the hest of my knowisago roprasenta the product for which fegletratfon le eougttt. The dlrrtmnlona,materiels of construction,pressure temperature raUnp,and IdentiflcallIon marktn In accordancti Whi the WOO named standards.I further declare that tho menukwAwo of these fillings is regulated Control Program winkch e"nda to each plant where fewicatlOn occurs in whole or in port and has been vwhled ere being auEleble for that purpose and I make this solemn dedaratton consclentfausly ballrav{ no It I6 thal It IG of the saute force a as if made under oath. Signature of Declaror: ,e Pfl f� Deciered Defers me at 9 t U < I �� F O R T H E This 12 th day of ary AQ_ 2007 G E A L Commissloner of OeMa or Notary Puiollc:(sign)_A6 �' ctai anal to the .rigat Pi This sovA for Repulamgy Aut tus This registration must be revalidated alter ten (10) re from it ` �• OF 12 51 1 .5 G RN: ftzt ntOrits PESTERED FIRM: 2015 UNIDER THE AUTHORITY Or- THE BOILER AND PRESSURE Notes: JE SEL AC 1. AM nuingc SnaN be reptetered to It1e name o1 the Manufacturer. 2. Each eatedery shall be eupoortod with two Statu"Ceaiaralion CyR.N Forma end one copy of supporting documorkation. rGCJ 3. Trig declaration GNI be mate Dy trio person having twit eutteority ano SI GNEQlt rc3pon3ibllity for me Quatigr of the and omduct. DAT 4. ouaAty control programs anev bq reaumiaw for v2mauon al a rrarlmurn interval of rive(5)years. 09-12—'08 09.50 F30M-42 CENTRAL INC 9025663133 T-580 F024/028 F-774 e UNIFORM STATUTORY DECLARATION FORM FOR THE.R2011_TRA!aN OF FITTING Dfa91�1� NEW BRUNSWICK NOVA SCORIA PRINCE EDWARD ISLAND NPWFOUNOlANO ANC r_ABRAOOR NUMAVUT YUKON NORTt V%te5T TF-MTORF-S MAWFAGTURERS NAME' F&dy T / L MANUFACTURERS ADDRESS: 5 S PLANT LOCATIONS: LY:�OPPub37N+oetSA- RO A Plpe Altlrtpe,fndudtng coup✓m9l,1006,efnows•Ya,Chip,unions,pipe oaps.or reducers e Ftangee: ap Mangos pro?r,*.rj C Valves: op lino valves b axpanllon Joints,All 1.connocdans,and Moss asaemolles: o!I types bN �gl�c w1l 4Y,t/zmC it &miners:,FAlin,separators,ono anam fr2p6 ®Nhssurtnp d,ll Imaiw og prusura gauges,hvel Gauges,s{ght plaz3as, nvem or proasuns tranamitter3 e 3�' 3 ca( L 0 Certifiod capnort"ted preen um relief devicm&czeptable ea pomary over pnesure p(oWIioi on I OY r � bolle s,pressure vassals.pigmy and fusible plu89 H prwaure meal"carnporIbM thal do nW HII Vrto ors ottha abeua calegonaa N Nuclaat eompommU: Claea 1 ❑ Class 2❑ Gass 3 O. (Meeting CNSC or ASME mqulnmanu) a U ' cbfl9 ab 0 WE1060 �H wAOVatitT 9 GaJT () 011t4R C osfiQPA5 OrnFPA I LIST OP BLIOP-50$ntJ,131150r.UrJENTATION MD IOENYIFICAI ION OF 7HE ACTUAL ITfiPRitl rQIS1 Elgf Nz�)v Svrt�(fCA�� •►t/e�� plAps VVPS/ P DtiCLARAT N: ���� ( ' I*.��el Omployad by kPnH4Ll-LL"LT5 —and being the person having Full authority and napansibiGty fo 0 e q ity of ltu snd product do 30l--MNy de are sisal the in(onnaltoll conlalnecf in this form 15 true and to the beg(Of my knowiGdge re"Mmilo the product(Of which mg(5irat(on Ib bought The dimanriantr,maiariala of conatrucfion,pressure temperature rabngs,and Ider+tif►oatlon mWWge we In et:r:Ordelnoe with the nwan named ot>AdWda.I funnelf declare that the rnenuf9clure of threw fktingB is regulated by 2 Quatky ConUol Program which ertmnda to each plant where fgbncslion occurs in whole or r part and haw been verified by as being sukable for chat purpose and I make thiG solemn Wtafatlon consclenGouaty bekving It to be free,and Knowing that it is of the same force end effect a3 if made under oath. 51pnature of Declarer. DarJsred before me at H IS S P A C E FOR THE AD I A L S E A _ Thla day of ; Comnusclonw of Oathc or Notary Pubkc'(61F) ;:'•;-' ( OfM1clsl a"to (' This spare for Ragu4Eo, gtrk,Y-,uw . TMi regiStration must bo rwalJCatad attcrte 0)Years,ftom th iQ eptenee. 0 F 12 511 , 5 �iOf l�wrtst l " CRN: Ternlo►>Q's FIDii 2015 R1�GISTERED UNDER THE AUTHORITY O� THE I}Qi;-ER AND PRESSURE Notes: { EL ACT. t Au tlnlnGe enau bo reglsuretl in Ina ramw of the ivlanufocturor I Z each category Owl Do auoported*0 IwO Statutory Dedersdor, i forms and one copy of suPponl^p oocumenratlon. G•R N_' 3. The datllererion snap as mad+ny too parson moving full autnr:rny and SI GNEt mspongoehity(or the quality of the and product. PATE �,je a Quallty -nvo{Pragrima anal)t?a rtiubmkted for velitlatio� 064003 41 a meum Interval of Me(5)year&. peel. fjiuingc Rtty.t sim TECHNICAL STANDARDS & .,+���'L Sr,N�-1 SAFETY AUTHORITY N 14th Floor,Centre Tower T S S A 3300 Bloor Street West �� Toronto,Ontario Canada M8X 2X4 ����Tv�u���a` October 6, 2008 KROHNE ALTOMETER Contact :COR SCHELLARS C,`r 2�08 KERKEPLAAT12 3313 LC DORDRECHT DORDRECHT, - 3eSte)'1'1d Vo01'; NETHERLANDS - Dear Sir/Madam: Re: CRN Number: OF12511.5 I am enclosing the original response from BRITISH COLUMBIA SAFETY AUTHORITY registered under the above mentioned CRN Number. Please do not pay any jurisdictions directly as all jurisdictional fees are handled by TSSA. Once your design has been successfully registered in all of the requested jurisdictions you may receive an invoice from TSSA for any outstanding jurisdictional fees. If you have any questions or concerns please contact me. Notes Yours truly, Anna Sebastiampillai Administrative Support Tel. No.: (416) 734-3423 Fax No.: (416) 231-6183 asebastiampillai@tssa.org "To make people's lives better by enhanching public safety" Visit our web site www.tssa.org 88 6th Street,Suite 400 � � � � � � New Westminster,BC V3L 5B3 Sa ety AUTHORITY Phone:(604)660.6286 Toll Free: 1-866-566-SAFE Fax: (604)660-6215 www.satetyauthority.ca Date: September 18, 2008 TECHNICAL STANDARDS & SAFETY AUTHORITY Account#: 35231 14TH FLOOR CENTRE TOWER-3300 BLOOR STREE Journal #: 45483 TORONTO ON M8X 2X4 Our File #: 3867104 Attn: ANNA SEBASTIAMPILLAI Re: Application for Design Registration The design, as detailed in your, TSSA Log # BPV-D-08-04379, for a Fitting is accepted for registration as follows: Registered To: KROHNE ALTOMETER CRN: OF12511.51 Drawing #:VARIOUS DRAWINGS Conditions Of Registration: 1- This registration is for OPTIFLUX 1000 series electromagnetic flow sensors as listed on page 2 of the Statutory Declaration. Amount GST Total Fee for reviewing your design: Total: Contact me if you have any questions. ALIREZA BONAKDAR (604) 660-6239 Alireza.Boncikdar@ safetyauthority.ca Design Engineer rc1 (PROD)30400-20 GST 0:87391 2802 RT0001