RECERTIFICATION EXAMINATION REQUEST FORMThis form is required for recertification applications only. Applicants must include a completed “Recertification Examination Request Form” in addition to a completed “Renewal and Recertification Application Form” in order to receive a recertification examination admittance and registration form. Clients are not permitted to attempt recertification exams without a valid, method-specific, recertification examination admittance and registration form. Incomplete documentation may lead to longer processing times.

PROTECTED (When Complete)

Please Note: Certified Personnel that are eligible for recertification will be required to complete at least two practical examination specimens to satisfy the requirements for recertification. Level 3 applicants are required to complete a written examination or structured credit system in addition to a practical examination. Applicants can choose to complete the examination at an Authorized Examination Centre (AEC) or may request special accommodation/allowances (may include on-site locations to allow registering of on-job-site locations as special examination centres) to be reviewed by the Natural Resources Canada (NRCan) National Non-Destructive Testing Certification Body (NDTCB).

Applicant ExperienceApplicants should use the chart below to indicate any relevant experience with the listed specimen types and techniques for the method and level in which they are due for recertification. This information, along with other assessment factors, may be used by the NDTCB to determine the specimens used in the recertification examination. Applicants are required to choose at least one specimen type (if applicable) and one technique for the level and method in which they are seeking recertification. Level 3 applicants will use the level 2 section of their method in the table below. Please enter any additional information regarding relevant experience in the space provided below the table.

Method Specimen Type (Check at least one where applicable) Technique (Check at least one)

UT1Welds Formed Products

(Castings/Forgings)N/A Contact N/A N/A

UT2 Welds Formed Products(Castings/Forgings)

N/A Contact Immersion N/A

MT2 N/A N/A N/A Bench Yoke N/A

PT2 N/A N/A N/A Visible Fluorescent N/A

ET1 N/A N/A N/A Tube Inspection

Crack Depth in Plate

Non-Conductive Coating Test

ET2 N/A N/A N/A Tube Inspection

Multi-layer/Fastener Assembly

Surface Scan

RT1 Welds Formed Products(Castings/Forgings)

N/A X-Ray N/A N/A

RT2 Welds Formed Products(Castings/Forgings)

Composites (A/S sector only)

Gamma X-Ray N/A

Additional Information:

NRCan National NDT Certification Body (NDTCB)8.2.1-005 Recertification Examination Request Form

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Preferred Language of Examination:

Date of Birth:

Name:Surname (Last Name)

Mr. Ms.Mrs. English Français

Telephone: Email:

Given Names

Reg. # YYYY Method(s) and Level(s):MM DD

/

PROTECTED (When Complete)

Recertification Examination

Please choose one of the following:

Standard Recertification Examination Practical or Written

I would like to request to attempt my recertification examination at the Authorized Examination Centre (AEC):

Name of Authorized Examination CentreI understand that I will be responsible for booking my own examination and will contact NRCan NDTCB at least two (2) weeks before my examination date if the AEC of my choice changes.

Special Accommodation/AllowancesPlease note: Special accommodation/allowances are subject to extra processing time, fees and require explicit approval from the NRCan NDTCB. Each request will be reviewed on a case by case basis and does not guarantee acceptance, nor does it set a precedent for additional requests. It is recommended that the request be submitted as early as possible as logistical or other delays may occur. The NRCan NDTCB is not responsible for any direct or indirect costs, expenses or delays that may arise; candidates are advised not to make any scheduling or travel arrangements for recertification examinations until they have received confirmation of an accepted request.

I would like to request to attempt my recertification examination at a Temporary Recertification Examination Centre (TREC). I attest that there is no conflict of interest between myself, the examination centre or the invigilator (independent 3rd party invigilation). I understand that I will be responsible for booking my own examination and will contact the NRCan NDTCB if the examination centre of my choice changes. The NRCan NDTCB is not responsible for any processing delays that may arise and someone from the NRCan NDTCB may contact me for more information in regards to this request.

I would like to request that a formally structured performance demonstration or task qualification be reviewed by the NRCan NDTCB for acceptance. I understand that the NRCan NDTCB will be contacting myself and/or my employer for more information.

Privacy Policy: The NRCan NDTCB is committed to protecting your privacy whether you are an existing client or a new applicant. All personal information created, held, or collected by the Government of Canada is protected under the federal Privacy Act. Our office will ensure that collected personal information and any communications between the NDTCB and their clients or applicants are considered confidential, protected, and are for the exclusive use of the intended recipient to fulfill certification program requirements. Personal information is collected as stated in NRCan’s Info Source (PAA 3.1.2 – Materials and Certification for Safety and Security - Bank Number: NRCan PPU 015), and the certified personnel’s name, city and province of residence and certification status are made publicly available in support of section 9.3 of the CAN/CGSB-48.9712-2014 national standard as a mechanism of effective certification status verification.

Please Note: Payment of fees does not complete or guarantee the renewal or recertification process. Renewal of certification and recertification examination admittance and registration forms are issued only after completion, verification, and NRCan NDTCB approval of application. It is the applicant’s responsibility to provide the NDTCB with payment information for each application submitted. To protect payment information, we ask that all forms containing credit card information (Mastercard, Visa, AMEX) be submitted via Fax or Mail only. Do not send credit card information by e-mail. If you have any questions, please call 1-866-858-0473 or our Recertification Hotline 905-645-0835. Renewal and recertification applications are subject to current NRCan NDTCB policies and procedures. As renewal and recertification applications are processed in arrival sequence, processing times may vary depending on the volume of applications received and are not guaranteed. Incomplete documentation or complexity of routine verifications and checks may also lead to longer processing times. The NRCan NDTCB makes all reasonable efforts to ensure candidate applications, examination requests and certification submissions are completed as per service standard targets. Despite these efforts, the occurrence of errors, omissions and delays cannot be completely ruled out and the NRCan NDTCB is not responsible for any direct and indirect costs, expenses or delays which may arise.

I attest that the statements made by me in this request are true and complete:

Applicant’s Signature: Date //YYYY MM DD

NRCan National NDT Certification Body (NDTCB)8.2.1-005 Recertification Examination Request Form

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