Alabama Public Service Commission Gas Pipeline Safety Plastic Fusion Qualification Form Revision 11-5-17 Please Complete all the Personal, Class and Company Information Below Personal Information Class Information Date Name Signature Class Location Company Information Home Telephone Name Address Telephone City Address State Zip City Date of Birth You Must Provide The Last 4 Digits of Your Social Security Number State XXX-XX- SSN Everything Below This Line To Be Completed by Instructor Butt Fusion Pipe Material Procedure MDPE* HDPE** 2708 4710 Passed Passed Passed Polyethylene UNV PPI TR-33 ( and TR-13 ) Medium and High Density Resins Compatible with Generic Butt Fusion Joining Procedure for Polyethylene Gas Pipe and PPI MS-2 and ATSM D2513 and Manufacturers General Guidelines for Butt, Saddle, and Socket Fusion of Unlike Polyethylene Approval (must meet requirements of 192.59) and Fittings (MDPE to HDPE fusion will follow exact procedure specifications, unless another APPROVED procedure is provided) Other: Other: Polyamide UNV-PA PPI TR-45 Other: Compatible Resins PPI MS-4 and ATSM Butt Fusion Joining Procedures for Field Joining of Polyamide 11 Passed Passed Passed F2945 and Manufacturers Approval (must meet requirements of 192.59) Saddle Fusion Pipe Material Procedure MDPE* HDPE** 2708 4710 Passed Passed Polyethylene UNV PPI TR-41 Medium and High Density Resins Compatible with Generic Saddle Fusion Joining Procedure for Polyethylene Gas Piping PPI MS-2 and ATSM D2513 and Manufacturers Approval (must meet requirements of 192.59) Other: Socket Fusion Pipe Coupling Procedure MDPE* HDPE** Manufacturer Manufacturer 2708 4710 Passed Passed Driscoplex Performance Driscoplex Poly Pipe Poly Pipe Uponor UNV ASTM F2620 Other: Central Standard Practice for Heat Fusion Joining of Polyethylene Pipe and Fittings Electrofusion Pipe Material Fitting/ Coupling Processor Friatec- Passed Passed Passed Polyethylene Central Friatec Fusamatic Medium and High Density Resins Compatible with Central- PPI MS-2 and ATSM D2513 and Manufacturers Trifusion- Approval (must meet requirements of 192.59) OTHER: OTHER- Polyamide Passed Passed Innogaz MTD Compatible Resins Under PPI MS-4 and ATSM Trifusion F2945 and Manufacturers Approval (must meet requirements of 192.59)
Alabama Public Service Commission Gas Pipeline Safety Plastic Fusion Qualification Form Revision 11-5-17 Please Complete all the Personal, Class and Company Information Below Personal Information Class Information Name Date Signature Class Location Home Telephone Company Information Address Name City Telephone State Zip Address Date of Birth City You Must Provide The Last 4 Digits of Your Social Security Number State SSN XXX-XX- Everything Below This Line To Be Completed by Instructor Butt Fusion Pipe Material Procedure MDPE* 2708 HDPE** 4710 Polyethylene Medium and High Density Resins Compatible with PPI MS-2 and ATSM D2513 and Manufacturers Approval (must meet requirements of 192.59) UNV PPI TR-33 ( and TR-13 ) Generic Butt Fusion Joining Procedure for Polyethylene Gas Pipe and General Guidelines for Butt, Saddle, and Socket Fusion of Unlike Polyethylene and Fittings (MDPE to HDPE fusion will follow exact procedure specifications, unless another APPROVED procedure is provided) Passed Passed Passed Other: Other: Polyamide Compatible Resins PPI MS-4 and ATSM F2945 and Manufacturers Approval (must meet requirements of 192.59) UNV-PA PPI TR-45 Butt Fusion Joining Procedures for Field Joining of Polyamide 11 Other: Passed Passed Passed Saddle Fusion Pipe Material Procedure MDPE* 2708 HDPE** 4710 Polyethylene Medium and High Density Resins Compatible with PPI MS-2 and ATSM D2513 and Manufacturers Approval (must meet requirements of 192.59) UNV PPI TR-41 Generic Saddle Fusion Joining Procedure for Polyethylene Gas Piping Passed Passed Other: Socket Fusion Pipe Manufacturer Coupling Manufacturer Procedure MDPE* 2708 HDPE** 4710 Driscoplex Performance Driscoplex Poly Pipe Passed Passed Poly Pipe Uponor UNV ASTM F2620 Standard Practice for Heat Fusion Joining of Polyethylene Pipe and Fittings Other: Central Electrofusion Pipe Material Fitting/ Coupling Processor Polyethylene Medium and High Density Resins Compatible with PPI MS-2 and ATSM D2513 and Manufacturers Approval (must meet requirements of 192.59) Central Passed Friatec Passed Fusamatic Passed Friatec- Central- Trifusion- Polyamide Compatible Resins Under PPI MS-4 and ATSM F2945 and Manufacturers Approval (must meet requirements of 192.59) Innogaz Passed MTD Trifusion Passed OTHER: OTHER-
New%20Plastic%20Fusion%20Qualification%20Form%20Online%2011-5-17.docx