Annual Vision Examination Record
Vision Examination Portal · Record No. AV-2026-0148
Approved
Valid through Sep 09, 2027
Inspector
Elias Navarro
Employee number
GLM-22874
Company
Gulfstream Line MRO
Certification standard
NAS 410 — Jaeger No. 1 at 12 in, at least one eye
Role level
NDT Level III — UT, MT, PT, VT
Examination date
September 09, 2026
Examination site
Gulfstream Line MRO — Quality office
Near vision — Jaeger
| Eye | Jaeger line | Correction | Distance | Result |
|---|---|---|---|---|
| Right (OD) | J-1 | Glasses | 12 in | Meets J-1 |
| Left (OS) | J-1 | Glasses | 12 in | Meets J-1 |
Color vision — Ishihara
Plates presented
24
Read correctly
24
Outcome
Pass
Test set
Ishihara 24-plate
Level III determination
Decision
Approved — meets vision requirements for NDT Level III
Level III Examiner
Hedda Boonstra
Decision date
September 09, 2026
Next examination due
September 09, 2027
Signatures
Inspector
Elias Navarro — signed Sep 09, 2026, 10:02 AM
Examiner
Dana Whitfield — signed Sep 09, 2026, 10:04 AM
Level III Examiner
Hedda Boonstra — signed Sep 09, 2026, 4:41 PM
Employer authorization
On file — uploaded Sep 09, 2026
Examination requirements
| Near Vision Options(Select One): |
|
|---|---|
| Color Perception: | Personnel shall be capable of adequately distinguishing and differentiating colors used in the process involved. |
| I/A/W SNT-TC-1A, NAS -410, EN4179 and AWS D17.1.1 | |
| *In at least one eye, natural or corrected. Simulated vision test and distance is not permitted. | |
Sample record for prototype review only. Not a valid examination record. Software provided by De Jesus Platform Works, LLC.