1.03_DD Form 1423 A0004_Test Certifications.pdf

S/N 0102-LF-010-5600

CONTRACT DATA REQUIREMENTS LIST

(1 Data Item)

Form Approved OMB No. 0704-0188

A. CONTRACT LINE ITEM NO. B. EXHIBIT C. CATEGORY

TDP

D. SYSTEM/ITEM

SHAFT,SUBMARINE

E. CONTRACT/PR NO. F. CONTRACTOR

1. DATA ITEM NO.

A0004

2. TITLE OF DATA ITEM

CERTIFICATION/DATA REPORT

3. SUBTITLE

TEST CERTIFICATIONS

4. AUTHORITY (Data Acqisition Document No.)

DI-MISC-80678 (DD)

5. CONTRACT REFERENCE

TDP: PARA 3

6. REQUIRING OFFICE

PURCHASING ACTIVITY

7. DD 250 REQ

DD

9. DIST STATEMENT

REQUIRED

D

10. FREQUENCY

ONE/R

12. DATE OF FIRST SUBMISSION ASREQ

DATE: N/A

Number of Days: 0

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

8. APP CODE

N/A

11. AS OF DATE

DATE: N/A

Number of Days: 0

13. DATE OF SUBSEQUENT SUBMISSION

ASREQ

DATE: N/A

Number of Days: 0

Draft Final

Reg Repro

16. REMARKS

Block 4 - Paragraphs 10.2.2, 10.2.3, 10.2.4, and 10.3 of DI-MISC-80678 do not apply.

Block 12 - Certification data shall be submitted to Portsmouth Naval Shipyard for review and acceptance prior to each shipment of material. Certification documentation shall be submitted via WAWF (Wide Area Work Flow).

Enter in WAWF as follows:

"Ship to" N50286 "Inspect by" N39040 "Accept by" N39040 and eMail notification field: PORT_PTNH_WAWF_Notification@navy.mil

No material is to be shipped prior to the receipt of Acceptance.

N39040 0 1 0

15. Total 0 1 0

G. PREPARED BY

8322V

H. DATE

2020-09-23

I. APPROVED BY

Ryan Orzell

J. DATE

2020-09-23

DD Form 1423-1, JUN 90 Page 4 of 14 Page(s)