Boiler CRN Application Supplement - Reciprocal Form 1438

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British Columbia Safety Authority Engineering & Research, Operations Design Registration Suite 200, 505 Sixth Street New Westminster, BC V3L 0E1 Phone: (778) 396-2027 Fax: (778) 396-2064 www.safetyauthority.ca
 
Note: The information on this form is collected to administer the provisions of the BC Safety Standards Act and section 26 of the Freedom of Information and Protection of Privacy Act. If you have any questions about the collection, use, or disclosure of this information, contact the Records, Information and Privacy Analyst for the BC Safety Authority at 1-866-566-7233.
BOILER CRN APPLICATION SUPPLEMENT - RECIPROCAL
This supplement form is to be completed and signed for all applications for a reciprocal registration. Drawing #:___________________________ CRN #: ______________________________ BOILER CLASS (check one)
High Pressure Boiler Hot Water Boiler Low Pressure Boiler Thermal Fluid
Revision: _________
Title: ___________________________
Date of Initial Registration: _____________________________
BOILER TYPE (check one)
Cast Aluminum Core Boiler Cast Iron Sectional Coil Tube Condensing Boiler Electric Fired Heater Horiz. Return Tube F. Box Horizontal Return Tube Locomotive Miniature Boiler Port. Boiler (Trac. Boiler) Pulse Boiler Recovery Boiler Scotch Dryback Scotch Wetback Thermal Liquid Traction Boiler Unfired Steam Gen Vertical Firetube Vertical Tubeless Vertical Watertube Watertube
DESIGN CONDITIONS AND CONFIGURATION (complete and check applicable units)
MAWP: MAWT: PSIG deg C kPa deg F Cast Iron Bar
Primary material of construction: Overall Vessel Length Maximum Boiler Output Minimum Heating Surface Area Minimum Safety Relief Valve Capacity
Steel feet lbs/hr m2 lbs/hr meters Mbtu/hr Mbtu/hr
kg/hr kg/hr
kW kW
Note: vessels with an overall length greater than 20ft (6.1 meters) must have detailed seismic and loading calculations submitted (see boiler and pressure vessel registration guide)
CODE OR STANDARD OF DESIGN (check one)
ASME Section I ASME Section IV ASME Section VIII, division 1 ASME Section VIII, division 2 ASME Section VIII, division 3 ASME PVHO-1 ASME B31.1 ASME B31.3 ASME B31.5 CSA B51 CSA B52 Other (specify)______________________________
RECIPROCAL COMPLIANCE DECLARATION
I declare that the submitted design in this application conforms to the design that has been previously registered by another Province and that documentation of previous registration is provided.
Name ______________________ Signature ___________________________ Date ________________________ 
FRM‐1438‐00 (2013‐02‐06) 
 
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