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Boiler & Pressure Vessel Safety Forms
You may need to download FREE Adobe Acrobat Reader to view the following files.

Form Number
Form Name
Description
Adobe Acrobat Reader Symbol BPV -5 - 17KB

(form must be printed
on green paper)
Boiler or Pressure Vessel Data Report - First Internal Inspection
Inspectors complete this form to report the results of all initial inspections.
Adobe Acrobat Reader Symbol BPV - 6 - 19KB
Boiler - Fired Pressure Vessel - Report of Inspection
Inspectors complete this form to report the results of all renewal inspections.

CVR1 - 36KB

Adobe Acrobat Reader Symbol Interactive PDF

R1 Form Report of Welded Repair Alteration

Repair companies holding "R" Stamp complete and Contract Fee Inspectors sign to describe repairs made. For alterations, ASME Code Stamp holders complete and National Board Commissioned Inspectors sign to describe alterations/reratings.

NB - 66

Clicking on the link will direct you to the National Board order form

Form R-1 Report of Welded Repair
Repair companies holding "R" Stamp complete and National Board Commissioned Inspectors sign to describe repairs made.

NB - 229

Clicking on the link will direct you to the National Board order form

Form R-2 Report of Alteration
Repair companies holding "R" Stamp complete and National Board Commissioned Inspectors sign to describe alterations/reratings.

3 27 74 - 34KB

Adobe Acrobat Reader Symbol Interactive PDF

Application for BPV Inspector's Examination
Any candidate to be an Inspector must complete this form listing education/experience before taking an examination required for a Virginia Certificate of Competency.
Adobe Acrobat Reader Symbol BPV -3 - 10KB
Application for Reciprocal Certificate of Competency and ID Work Card
Inspection company must complete this form for Inspectors transferring to Virginia or for renewal of Virginia Work Identification Cards.

NB - 4

Clicking on the link will direct you to the National Board order form

Notice New Business of Discontinuance
Inspection companies complete each time companies owning or using boilers/pressure vessels are added or dropped.
Adobe Acrobat Reader Symbol NB - 181 - 183KB
Incident Report Form
Complete this form to report boiler or pressure vessel incident.
Customer Feedback Form - 28KB
Adobe Acrobat Reader Symbol
Interactive PDF
Complete this form in order to improve the quality of our service.


Note: All Interactive PDF files listed above are provided for your convenience by enabling you to type your input and print it. However, your work cannot be saved.


Disclaimer: The Virginia Department of Labor and Industry's (DOLI) Web site includes hyperlinks to other sites on the World Wide Web that are neither controlled nor sponsored by DOLI. We have provided these links for your convenience and to to give you easy access to other organizations whose expertise may be related to the mission of this agency. Composition of these links is not an endorsement by DOLI or the Commonwealth of Virginia of the sites' sponsors or any commercial products.

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Last Updated: Wednesday, August 10, 2005 10:22 AM


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