Fitting CRN Application Supplement - Reciprocal Form 1439

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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.
 
FITTING CRN APPLICATION SUPPLEMENT - RECIPROCAL
This supplement form is to be completed and signed for all applications for a fitting reciprocal registration. Drawing #:___________________________ CRN #: _____________________________ Revision: _________ Title: ___________________________
Date of Initial Registration: _____________________________
FITTING CATEGORY (check one)
A- Pipe Fittings B – Flanges C – Valves D – Expansion Joints / Flexible Connections / Hose Assemblies E – Strainers / Filters / Separators / Steam Traps F – Measuring Devices G – Pressure Relief Devices H – Other
Note: Certain A, B, C and G category fittings are exempt from registration – see Directive D-B6 070402 3 DESIGN CONDITIONS AND CONFIGURATION (complete and check applicable units)
MAWP: MAWT: MDMT: External Pressure Single Fitting PSIG deg C deg C PSIG Yes kPa deg F deg F kPa No Bar
Bar
Expiry Date: _________________
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‐1439‐00 (2013‐02‐06)   
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