th

505- 6 Street, Suite 200

New Westminster
British Columbia V3L 0E1

Phone: (604) 660-6286

Toll Free: 1-866-566-SAFE
Fax: (604) 660-6215
www.safetyauthority.ca

The information on this form is collected to administer the provisions of the BC Safety Standards Act.
If you have questions about the collection, use or disclosure of this information, contact the Records,
Information, and Privacy Analyst for the BC Safety Authority at telephone toll free 1-866-5 66-7233.

CONSTRUCTION DATA REPORT FOR PIPING SYSTEMS

NPS 3 or Less
In accordance with the requirements of the Safety Regulation and CSA B51 Clause 4.8.1 & 4.16.2

Shop Construction

1.

Field Construction

Final Data Report

Constructed By:

Partial Data Report

Job #:
Name of Licensed Contractor/Primary Contractor or Subcontractor

Address

BCSA/Provincial Licensed Contractor No:

2.

Expiry Date:

Constructed For:
Name of Primary Contractor if different from above

Address

BCSA/Provincial Licensed Contractor #:

Expiry Date:

Required when the Primary Contractor undertakes some/all of the quality functions, eg. Material Supply, NDE, PWHT, Tie-in, Fabrication, Hydro Test, Final Assembly, etc.

3.

Owner and location of installation:

Name and Address

BCSA/Provincial Licensed Contractor #:

Expiry Date:

Required when Owner undertakes some/all of the quality functions, eg. Material Supply, NDE, PWHT, Tie-in, Fabrication, Hydro Test, Final Assembly, etc.

4.

WPS #(s) Used:

5.

ASME Code for Pressure Piping: B31.1

Nonboiler External Piping
Boiler External Piping
B31.3
- Fluid Service Category:
Normal
D
M
High Pressure
B31.5
B31.9
Other _______________________________________________________

Owners WPS #(s) (If Used):

P & I D or Isometric Drawing Numbers

Revision Number

Line List Document Numbers

Revision Number

FRM-1328-00 (2011-03-11)

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Complete this table when Line List is not available.

Fluid
(air,stm.
etc.)

Line
Numbers

Design
Press
(psi)

Design
Temp
o
( F)

Test
Press
(psi)

Test
Medium

Pipe Spec
&
Grade

CA
(in)

Pipe NPS
&
Schedule

Flange
Spec &
Rating

PWHT/
Preheat
Temp
o
( F)

RT
%

Other
NDE

Remarks: Provide additional comments including noting any code work that was not performed by the licensed contractor(s)
supplying this document as a Partial Data Report but which must be completed by another licensed contractor who assumes
overall responsibility for conformance with the applicable sections of the ASME Code for Pressure Piping and British Columbia
Safety Standards Act and Regulations, and who assures that all required code work is completed prior to putting the piping system
into service.

_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________

Endorse Certificate A or B
A.

CERTIFICATE OF COMPLIANCE

B. CERTIFICATE OF COMPLIANCE

Signed by the Subcontractor when supplying this certificate as a

Signed by the Primary Contractor when supplying this certificate as a

Partial Data Report

Final Data Report

We certify that the statements in this data report are correct and
that all details of material, construction, and workmanship of the
pressure piping part described in this data report conform to the
applicable sections of the ASME Code for Pressure Piping and
British Columbia Safety Standards Act and Regulations..

We certify that the statements in this data report are correct and that the
piping described in this data report was constructed in accordance with
the applicable sections of ASME Code for Pressure Piping and British
Columbia Safety Standards Act and Regulations.

Date

Date:

Primary Contractor
Subcontractor
Print Authorized Representatives Name

Print Authorized Representatives Name

Signature

Signature

This certificate is not valid unless it forms part of

a Final Data Report signed by Primary Contractor

CERTIFICATE OF INSPECTION
I, the undersigned, employed by
have inspected the piping described in this data report and state that, to
the best of my knowledge and belief, the Contractor has constructed the piping in accordance with the applicable sections of the ASME Code for
Pressure Piping and British Columbia Safety Standards Act and Regulations. By signing this certificate, neither the inspector nor his or her
employer makes any warranty, expressed or implied, concerning the piping described herein. Furthermore, neither the inspector nor his or her
employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this
inspection.

Date:
Name:

Signature:
Owners or Users Inspector

FRM-1328-00 (2011-03-11)

Owners or Users Inspector

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