1. Request Conditions If the following conditions can’t be met, please don’t submit this form, as your request won’t be considered: The recertification date of the standard or apparatus must be between March 1, 2020, and September 1, 2020. All required seals on the standard or apparatus must be intact. There must have been no apparent damage to the standard or apparatus since its last calibration. The standard or apparatus must not have been modified (e.g. painting, refurbishing). Instructions This form applies to standards and apparatus that are evaluated on a case-by-case basis, and not those that have been permitted to be used past their recertification date without prior permission. Complete this form to request that Measurement Canada's Engineering and Laboratory Services Directorate allow standards or apparatus to be used past their recertification date. Ensure that the conditions listed at the bottom of this form are met before submitting it. If you encounter any difficulties filing out the form, please send an email to MC's Engineering and Laboratory Services Directorate at ic.mcacsl-mclsae.ic@canada.ca. Complete all fields applicable to the standard or apparatus; otherwise, the request will not be considered. Don't send standards or apparatus to Measurement Canada. Organization information Organization type Weights and measures (accredited, S-A-01) Electricity and gas (accredited, S-A-01) Delegated authority (C-D-01) Registered Measurement Canada Government of Canada (other than MC) Other (please specify) Organization name (required) Accreditation, registration or delegated authority number (required) Street address (required) City (required) Province/state (required) Postal/ZIP code (required) Country (required) Contact name (required) Contact email address (required) Phone number (required) Extension Standard, apparatus or gas mixture information Standard, apparatus or gas mixture information Reference meter prover High accuracy thermometer Direct-read thermometer (except for Cooper brand thermometers, which are not permitted to be used past their recertification date) Open neck prover Bell prover Flow meter Manufactured natural gas mixture Gas flow meter or measuring apparatus Standard other than RD type standard, or RD type standard that is more than seven years old Manufacturer (if known) Model number (if applicable) Standard/serial number (required) Required supporting documents Required supporting documents Photos of the standard or apparatus that display all faces (with seals and/or calibration sticker if applicable) A copy of current calibration certificate Check meter results (only applicable to flow meters and flow measuring apparatus) Recent yearly inspection or correlation meter results (only applicable to bell provers) Attach file Upload Upload requirementsOne file only.200 MB limit.Allowed types: gif, jpg, jpeg, png, bmp, eps, tif, pict, psd, txt, rtf, html, odf, pdf, doc, docx, ppt, pptx, xls, xlsx, xml, avi, mov, mp3, ogg, wav, bz2, dmg, gz, jar, rar, sit, svg, tar, zip. Certification I certify that, to the best of my knowledge, the information provided in this form and in all supporting documents is accurate and complete, and that the conditions stated above have been met. I understand that I am not to send standards or apparatus to Measurement Canada. (required) Submit