1048V100-00153-AA - VISUAL INSPECTION CDRL DI-NDTI-80809 REV 06-27-2017.pdf

CONTRACT DATA REQUIREMENTS LIST

(1 Data Item)

Form Approved

OMB No. 0704-0188

Public reporting burden for this collection of information is estimated to average 110 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 Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports (0704-0188), 1215 Jefferson Davis Highway, Suite 1204, Arlington VA 22202-4302.

Please DO NOT RETURN your form to either of these address. Send completed form to the Government issuing Contracting Officer for the Contract/PR No. Listed in Block E.

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

TBD A

TDP ___________ TM _______________ OTHER NDTI

D. SYSTEM/ITEM

FY-2021 HIC PURCHASE

E. CONTRACT/PR NO.

TBD

F. CONTRACTOR

TBD

1. DATA ITEM NO.

A004

2. TITLE OF DATA ITEM

TEST/INSPECTION REPORT

3. SUBTITLE

VISUAL INSPECTION (OVERALL)

4. AUTHORITY (Data Acquisition Document No.)

DI-NDTI-80809B

5. CONTRACT REFERENCE

SOW PARAGRAPH 4.2

6. REQUIRING OFFICE

PSNS & IMF C/2305.3

7. DD 250 REQ

DD

9. DIST STATEMENT

REQUIRED

D*

10. FREQUENCY

OTIME

12. DATE OF FIRST

SUBMISSION

ASREQ*

14. DISTRIBUTION

b. COPIES

8. APP CODE

N/A

11. AS OF DATE

N/A

13. DATE OF SUBSEQUENT

SUBMISSION

A. ADDRESSEE

Final

SEE BLOCK 16*

Draft Reg Repr o

16. REMARKS

Block 9: Distribution Statement D. Distribution authorized to DoD and DoD contractors only. Administration and operations only, effective 7/14/2021. Other U.S. requests shall be referred to COMNAVSEASYSCOM.

Block 12: Personnel Qualifications and Test Procedures, when ordered on separate contract line item, shall be submitted and approved before testing unless otherwise specified in contract.

Block 12 – Certification/Data Report documentation shall be submitted via Wide Area Workflow (WAWF) e-Business Suite: Invoice, Receipt, Acceptance, and Property Transfer (iRAPT). iRAPT email notification shall be sent to:

PSNS.WAWFQACertifications.FCM@navy.mil upon submission.

Block 13- Certification/Data Report documentation shall also be submitted with the shipment of the material to the delivery address supplied:

CERTIFICATE OF COMPLIANCE DOCUMENTATION SHALL ALSO BE SUBMITTED

WITH THE SHIPMENT OF THE MATERIAL TO THE DELIVERY ADDRESS SUPPLIED:

RECEIVING OFFICER BLDG 514, ATTN: CODE C/2305

PUGET SOUND NAVAL SHIPYARD & INTERMEDIATE MAINTENACE FACILITY

1400 FARRAGUT AVE, BREMERTON, WA 98314-5001

PSNS & IMF

C/2305*

0 1 0

PSNS & IMF* 0 1 0

TOTAL 0 2 0

G. PREPARED BY H. DATE I. APPROVED BY J. DATE

/s/ Peter J. Morgan, C/980 S.2

7/14/2021 /s/ Richard J. Balter C/980 S.2

7/14/2021

DD Form 1423-1, FEB 2001 Previous edition may be used. Page 1 of 2 Pages

Document No: 1048-V100 / JO# 69M44-HICMN-S01 / Item# 800

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

DATA ITEM DESCRIPTION

Title: Test/Inspection Report

Number: DI-NDTI-80809B Approval date: 970124

AMSC Number: N/A Limitation: N/A

DTIC Applicable: N/A GIDEP Applicable: N/A

Office of Primary Responsibility: F/AFMC-DOP

Applicable Forms: N/A

Distribution Statement A: Approved for public release. Distribution is unlimited.

Description/Purpose: The test/inspection report is used to document test/inspection results, findings, and analyses that will enable the Government or Contracting Agency to evaluate compliance with system requirements, performance objectives, specifications, and test/inspection plans.

Application/interrelationship: This Data Item Description (DID) contains the format and content preparation instructions for the data product generated by the specific and discrete task requirement as delineated in the contract.

This DID is applicable to engineering (developmental), preliminary qualification, qualification, and acceptance testing.

This DID supersedes DI-NDTI-80809A and DI-MISC-80653.

Requirements:

1 Format. Contractor format is acceptable. Organize the information required by paragraph 2 and its subparagraphs in a manner that facilitates presentation and understanding.

2 Content. The test/inspection report shall contain the following information, as applicable.

2.1 The following information shall appear on the outside front cover and title page:

a. Report date

b. Report number (contractor or Government)

c. Contractor’s name, address, and commercial and Government code

d. Contract number and contract line item number or sequence number (if applicable)

e. Type of test/inspection (for example, first article acceptance test, quality performance inspection, developmental test, qualification test, environmental test)

f. Identification of item tested/inspected

g. Date or period of test/inspection

h. Name and address of requiring Government activity

i. Security classification, downgrading and declassifying information, if applicable

2.2 Table of Contents. The table of contents shall identify the following:

a. The title and starting page of each major section, paragraph, and appendix of report

b. The page, identifying number, and title of each illustration (for example; figure, table, photograph, chart, drawing, etc.)

2.3 Introduction. The introduction shall include the following information:

2.3.1 Test/inspection objective(s). The specific test/inspection objective(s) as specified in the contract tasking document.

2.3.2 Item(s) tested/inspected. Complete identification of the item(s) tested/inspected including the following:

a. Nomenclature

b. National stock number

c. Model number, part number, and serial number

d. Type of item (for example; prototype, production item, laboratory model)

e. Serial or lot number

f. Applicable engineering changes

g. Production item specification, if applicable

h. Date of manufacture

2.3.3 Test/inspection requirements. Complete identification of the test/inspection requirements correlated to contractual requirements including the following:

a. Required test/inspection parameters

b. Performance requirements, acceptance or compliance limits, and environmental criteria

2.4 Summary. Complete test/inspection report summary including the following:

a. A brief discussion of the significant test/inspection results, observations, conclusions, and recommendations covered in greater detail elsewhere in the report

b. Proposed corrective actions and schedules for failures or problems encountered

c. Identification of deviations, departures, or limitations encountered, referenced to the contract requirements

d. Tables, graphs, illustrations, or charts as appropriate to simplify the summary data

2.5 Referenced documents. Complete identification of all documents referenced in the test/inspection report including the following, as applicable:

a. Prior test/inspection reports on the same item

b. Test/inspection plans and procedure documents

c. Prior certifications of compliance

d. Contractor’s file designation where test/inspection records are maintained

e. Input parameters used

Note: The applicable issue of the documents cited therein, including their approval dates and dates of any applicable amendments, notices, and revisions, shall be as specified in the contract.

2.6 Body of report. The body of the test/inspection report shall be as follows:

2.6.1 Test equipment identification. Complete identification of each item of test equipment used in the test/inspection including the following:

a. Nomenclature

b. Model number

c. Serial number

d. Manufacture

e. Calibration status

f. Accuracy data

g. Comments, if applicable

2.6.2 Test/inspection facility installation and set-up. Complete description of the physical set-up used in conducting the test/inspection to include the following:

a. Location or orientation of the item

b. Location, orientation, or settings of test equipment and instrumentation

c. Location, orientation, or settings of sensors and probes

d. Location or orientation of interconnections, cables, and hoop-ups

e. Electrical power, pneumatic, fluidic, and hydraulic requirements

Drawings, illustrations, and photographs may be used for clarification

2.6.3 Test/inspection procedures. Complete description of the procedures used in conducting the test/inspection to include the following:

a. Item selection and inspection that verified suitability for test/inspection

b. Summarized sequence of testing/inspection steps, including a description of how the item was operated during the test/inspection, and any control condition imposed

2.6.4 Test/inspection results and analysis. A copy of all test/inspection results and analysis to include the following:

2.6.4.1 Recorded data. The actual recorded data (for example, log book entries, oscillographs, instrument readings, plotter graphs). If the recorded data is extensive, it shall be provided in an appendix.

2.6.4.2 Test/inspection results. Identification of all test/inspection results to include the following:

a. Matrices comparing results achieved against test/inspection objectives or requirements

b. A discussion of these matrices as to their significance, and how they compare to any prior test/inspection

c. Calculation examples

d. Discussion of any anomalies, deviations, discrepancies, or failures including their impact, causes, and proposed corrective actions. The discussion shall address discrepancies between design requirements and the tested/inspected configuration.

2.6.5 Conclusions. Test/inspection conclusions distinguished between objective and subjective to include the following:

a. The effectiveness of the test/inspection procedures in measuring item performance

b. The success or failure of the item to meet required test/inspection objectives

c. The need for repeat, additional, or alternative tests/inspections

d. The need for item redesign or further development

e. The need for improved test/inspection procedures, techniques, or facilities

f. The adequacy and completeness of the test/inspection requirements

2.6.6 Recommendations. Recommendations appropriate to the test/inspection results and conclusions including the following:

a. Acceptability of the item tested/inspected (pass or fail)

b. Additional testing/inspection required

c. Redesign required

d. Problem resolution

e. Test/inspection procedure or facility improvements

f. Disposition of items tested/inspected

g. Documentation changes required

h. Testing/inspection improvements

2.7 Authentication. The following certifications shall be included, as applicable:

2.7.1 Authentication of test/inspection results. A statement that the test/inspection was performed in accordance with applicable test/inspection plans and procedures, and that the results are true and accurate. The authentication shall include the signature of the contractor personnel that performed the test(s)/inspection(s), a contractor representative authorized to make such certification, and any Government witnesses.

2.7.2 Authentication of prior validation. A statement identifying those requirements not tested/inspected or measured that were previously validated. Include identification of the data and method employed for such validation (for example, prior to test/inspection, analytical verification, equivalent item, etc.). The authentication shall include the signature of a contractor representative authorized to make such authentication and any

Government witness.

2.7.3 Authentication of acceptability. A statement that the item tested/inspected either passed or failed item acceptability requirements. This authentication shall include the signature of a contractor representative authorized to make such authentication and any

Government witness.

2.8 Appendices. Appendices shall be used to append detailed test/inspection data, drawings, photographs, or other documentation too voluminous to include in the main body of the report. This includes referenced documentation not previously provided by the Government, and test/inspection reports from any associated test/inspection activity that may have performed some of the testing/inspecting requirements.

3 End of DI-NDTI-80809B