Copy for Revision - AB-512A Owner-User PEIM Program Scope and Responsibilities (D0000193-7)
Owner-User Pressure Equipment Integrity Management System
Scope and Responsibilities
AB-512a 2017-12
AQP- (For new companies this number will be assigned by ABSA upon certification)
The certificate holder is responsible for keeping ABSA up to date by sending this Form within 30 days of any change in the personnel and ownership of facilities operating under the above AQP number
To inform ABSA of changes to the program, mail this form to: ABSA, Quality Systems Certification, #9410 – 20 Avenue, Edmonton, AB T6N 0A4
New / Renewal / Revision – Company Name Change ; Facilities Change ; Ownership ChangeManagement Rep. Change ; Chief Inspector Change ; Inspection Company Change
Note: An AB-29 form must also be submitted when a revised Certificate of Authorization Permit will be required, such as when there is a company name change or an ownership change.
Company Name: / Phone: / ( )Corporate Address: / Fax: / ( )
Email:
Name and Title of Management Representative responsible for the Integrity Management System
Name: / Title:
Telephone No.: / ( ) / ext. / Fax No.: / ( )
Cell No.: / ( ) / E-Mail:
Name and Title of Person designated as Chief Inspector
Name: / Facilities: All or E-Mail:Telephone No.: / ( ) / ext. / Fax No.: / ( ) / Cell No.: / ( )
ABSA In-Service Inspector Certificate No.: / Expiry Date:
Certified Integrity Assessment Organization:
(please complete if contracted) AQP-9 / Facilities: All or
List all companies, subsidiaries, facilities or areas that are owned or operated under the
Scope of AQP- (For new companies this number will be assigned by ABSA upon certification) (Attach supplementary list if needed)
Company Name / List of Facilities /
Owned
/Operated
Identify types of facilities that are covered under the Pressure Equipment Integrity Management System
Type of facility (Petrochemical, Refinery, Pulp Mills, Utilities Oil & Gas, other)Type of Work: Performed by (indicate ABSA Quality System registration number if covered under a separate certificate)
In-House / Contracted
Engineering Functions
Process DesignMechanical Design
Technical Engineering Services (materials, corrosion, etc.)
Construction, Repair and Alteration of Pressure Piping Systems (piping, valves, fittings) (In accordance with AB-518 Requirements):
- Welded piping, valves, fittings
- Mechanically Assembled piping, valves, fittings
Pressure Welder Testing and Pressure Welder PQ Card Issuance
Construction of Boilers and/or Pressure Vessels
Boiler and/or Pressure Vessel Repairs and Alterations - Performance of WorkPressure Relief Valve Servicing
Replacement in Kind of Mechanically Assembled Pressure Piping Components Yes No(In accordance with the AB-523 Guideline)
Alternative Test Methods for Pressure Piping Procedure (In accordance with AB-519 Requirements) Yes No
Boiler Certification
/Note: Owner-user inspectors who certify boilers must hold an Alberta in-service Boiler & Pressure Vessel Inspector Certificate of Competency
/ Owner-User / ABSAFormal ABSA accepted RBI program used? Yes No
Note: The program must have been audited by ABSA and accepted to meet the requirements of AB-505
A Documented Risk Analysis Process complying with AB-506 Appendix B is implemented? Yes No
Inspection intervals for Upstream (E&P Pressure Vessels per API-510) may be assigned based upon AB-506 Appendix B and API 510 Section 9 requirements.
Scope of boiler, pressure vessel, fired-heater pressure coil, indirect fired heater coil, thermal fluid heater and boiler external piping repairs that are inspected and certified by the owner-user (per AB-513).
List the types of repairs that are to be inspected and certified by the owner-user and reference the applicable manual section or referred procedures where these are described. Indicate “None” if all repairs are to be certified by ABSA. (Attach supplementary list if needed)
Name of Management Representative or Designate :
Please Print
Signature: / Date :
Signature of Management Rep. or Designate
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