- Anne Rossborough holds NDT Level II certification in ultrasonic testing, which expires on January 31, 2021. She received this certification from Olsson Associates on January 7, 2016. - She has an associate's degree from Ridgewater College in ultrasonic testing and work experience of over 25 months in the field working for two employers. - Her most recent eye exam on January 7, 2016 demonstrated that she meets the vision requirements for NDT work both with and without eye correction.

1. Anne Rossborough
#003-5597
Qualification Summary
• NDT Level II – UT
• Eye Exam

2. CertificateofCompletion
hascompliedwiththerequirementsoftheOlssonAssociatesWrittenPractice
OA-NDT&ASNT’sRecommendedPracticeNo.SNT-TC-1Aforcertificationas
InthefollowingNondestructiveTestingMethods:
IssueDate
CertificateNo.
Method
11627VirginiaPlaza,Suite103,LaVista,NE68128
ExpirationDate
NDTLevelIII
AnneRossborough
NDTLevelII
AMR-5597
Ultrasonic1/7/20161/31/2021

3. Certification of Personnel Qualification
Employee Name: Employee ID #:
Testing Method: Certification Date:
Certification Level: Expiration Date:
Continuing Performance Evaluation(approx. mid-point of 5 yr duration) Date:
Formal Education Summary (Formal Education attained and claimed for qualification)
Education Location Date
Technical Training Summary (Documentation exists which verifies that the above individual meets or exceeds the qualification
requirements, in accordance with the written practice of this company.)
Course Location Date Lab Hours Hours
1.1.2013 80 80
80 80
Work Experience Summary (The following is a summary of the qualifying work experience claimed for this method by the above
Individual, and verified by this company.)
Employer Position Hire Date Hours Months
6.1.13 1,200 22
9.1.15 500 3
1700 25
Examination
General: 91% Specific: 72% Practical: 92% Composite: 85%
Recertification Practical:
Certification
Level: Verified By:
Date of Initial Certification: Certified By:
Statement:
I, the undersigned verify that all information contained on the Certification of Personnel Qualification form of the
above individual is true. The examination scores, dates, names and signatures of qualified examiners listed on
these forms were taken from the original or copies of the original documents.
1.7.16
Date
1.7.16
Date
SGS NDT Level II
NDT Level II UT Thickness
Ridgewater College
Ridgewater College Willmar, Minnesota 5.17.13
Ultrasonics
Lake of the Woods High School Baudette, MN 1986
Anne Rossborough
Ultrasonic Testing
Level II
CF Temp.003
1.7.16
1.31.21
Totals:
11627 Virginia Plaza, Suite 103, LaVista, NE 68128
Printed Name
TitleSignature - Company Representative
Signature - Authorized NDT Level III
Total:
II
1.7.16
Michael J. Sullivan
Michael J. Sullivan
Group Leader - NDT
Michael J. Sullivan
LMT

4. VISION EXAMINATIONS
Anne Rossborough AMR-5597 xxx-xx-5597
Applicant’s Name Certification No. Social Security No.
1. Near-Vision
Meets without
eye correction
Meets with
eye correction Does not meet
Jaeger Number 2 or equivalent at
a distance of not less than
12 inches
2. Color Perception Meets without
Eye correction
Meets with
eye correction
Does not meet
Red/green differentiation
Blue/yellow differentiation
I, certify that I, ____Michael J. Sullivan_______________, administered an eye exam
Printed Name of Eye Examiner
to ___Anne Rossborough_______, on______1.7.16 which demonstrated
Printed Name of Applicant Mo. Day Year
the vision capabilities indicated above.
* Required upon initial certification and annually thereafter.
______________________________________
Signature of Eye Examiner
x