01129608-01148-0112-9608 DD1423-2 WELD REPAIR CERTIFICATION C DRL DI-NDTI-80809 REV 2-27-2020.doc

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CONTRACT DATA REQUIREMENTS LIST

(2 Data Items) Form Approved

OMB No. 0704-0188

The public reporting burden for this collection of information is estimated to average 220 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing the burden, to the Department of Defense, Executive Services Directorate (0704-0188). Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number. Please do not return your form to the above organization. Send completed form to the Government Issuing Contracting Officer for the Contract/PR No. listed in Block E.

A. CONTRACT LINE ITEM NO.

0002AH

B. EXHIBIT

H

C. CATEGORY

TDP ______ TM ________ OTHER___NDTI/MISC_________

D. SYSTEM/ITEM
E. CONTRACT/PR NO.
F. CONTRACTOR

1. DATA ITEM NO.

H001

2. TITLE OF DATA ITEM

TEST/INSPECTION REPORT

3. SUBTITLE

WELD REPAIR CERTIFICATION

4. AUTHORITY (Data Acquisition Document No.)

DI-NDTI-80809B

5. CONTRACT REFERENCE

PER CONTRACT

6. REQUIRING OFFICE

PURCHASING ACTIVITY

7. DD 250 REQ

DD

9. DIST STATEMENT REQUIRED

D

D

10. FREQUENCY

ASREQ

12. DATE OF FIRST SUBMISSION

SEE BLOCK 16

14.

DISTRIBUTION

a. ADDRESSEE
b. COPIES

8. APP CODE

N/A

D
11. AS OF DATE

N/A

13. DATE OF SUBSEQUENT SUBMISSION

n/a

Draft
Final
Reg
Repro

16. REMARKS

Block 9: Distribution Statement D. Distribution authorized to DoD and DoD contractors only. Administration and operations only, effective 4/22/2020. Other U.S. requests shall be referred to COMNAVSEASYSCOM.

Block 10 – Submit documentation per DI-NDTI-80809B stating weld repairs performed.

Block 12 – Certification/Data Report documentation shall be attached in the Wide Area Workflow (WAWF) e-Business Suite. Acceptance/Rejection of Certification/Data Report documentation will be accomplished with the corresponding material and will not be accomplished prior to shipment of material.

N4523A
0
1
0
15. TOTAL
0
1
0

1. DATA ITEM NO.

H002

2. TITLE OF DATA ITEM

CERTIFICATE OF COMPLIANCE

3. SUBTITLE

WELD REPAIR CERTIFICATE OF COMPLIANCE

4. AUTHORITY (Data Acquisition Document No.)

DI-MISC-81356A

5. CONTRACT REFERENCE

PER CONTRACT

6. REQUIRING OFFICE

PURCHASING ACTIVITY

7. DD 250 REQ

DD

9. DIST STATEMENT REQUIRED

10. FREQUENCY

ASREQ

12. DATE OF FIRST SUBMISSION

SEE BLOCK 16

14.

DISTRIBUTION

a. ADDRESSEE
b. COPIES

8. APP CODE

N/A

D
11. AS OF DATE

N/A

13. DATE OF SUBSEQUENT SUBMISSION

N/A

Draft
Final
Reg
Repro

16. REMARKS

Block 9: Distribution Statement D. Distribution authorized to DoD and DoD contractors only. Administration and operations only, effective 4/22/2020. Other U.S. requests shall be referred to COMNAVSEASYSCOM.

Block 10 - Submit Weld Repair Certificate of Compliance when No Weld Repairs were required. Stating the fact that No Weld Repairs were required.

Block 12 – Certification/Data Report documentation shall be attached in the Wide Area Workflow (WAWF) e-Business Suite. Acceptance/Rejection of Certification/Data Report documentation will be accomplished with the corresponding material and will not be accomplished prior to shipment of material.

Document no.: 0112-9608

N4523A
0
1
0
15. TOTAL
0
1
0

G. PREPARED BY

/S/ Mann, Kevin

H. DATE

4/22/2020

I. APPROVED BY

/S/Gilger, Frank R.

J. DATE

4/22/2020

PRICE GROUP

ESTIMATED TOTAL PRICE

PRICE GROUP

ESTIMATED TOTAL PRICE

N/A

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