3158138_SMW_REPORT.pdf

SURPLUS MATERIEL WORKSHEET

DATE

18 DEC 2020

I. REQUEST FOR EVALUATION

NSN

3110014544610NZ

PART NUMBER

4083144

CAGE

77445

APPLICATION

F100 #4 Brng Rear Seal Seat

IMS

Reaves, Jason W

OFFICE SYMBOL

421 SCMS / GUMAD

PHONE

405-734-8708

SURPLUS MATERIEL MAY BE AVAILABLE TO FULFILL THE GOVERNMENT'S NEEDS FOR THIS ITEM. AS A RESULT, AN EVALUATION MUST BE PERFORMED

IAW AFMC FAR SUPPLEMENT PART 5352.

THE EVALUATION ON THIS ITEM INDICATES SURPLUS MATERIEL WILL BE CONSIDERED IN THE FOLLOWING TYPES / CATEGORIES

II. EVALUATION CRITERIA (For types/categories deemed acceptable)

ACCEPT-

ABLE (Y/N)

P/N AND

MFG

VERIFI-

CATION

PRIOR

GOV'T

OWNER-

SHIP

100% END

ITEM

INSPECT

TEST AND

VERIFI-

CATION

VERIFI-

ABLE

DIMEN-

SIONS

LOCATION

INSPEC-

TION

TESTING

INITIAL

ACCEPT-

ABILITY

ITEMS

OVERHAUL

AND

CERTIFI-

CATION

OTHER

(Explain in Remarks)

Y X X

N

N

N

Y X X X

N

N

N

G O V T

S U R P L U S

NEW/UNUSED

NEW/RECONDITIONED

NEW/MODIFIED

USED/OVERHAULED

C O M M L

S U R P L U S

NEW/UNUSED

NEW/RECONDITIONED

NEW/MODIFIED

USED/OVERHAULED

SURPLUS EVALUATION CRITERIA (If Section 11a. indicates surplus materiel may be considered). (Fill in blanks as appropriate)

PART NUMBER VERIFICATION 77445(AFMCFARS 5352.211-9011) MFG 4083144P/N

PRIOR GOVERNMENT OWNERSHIP (AFMCFARS 5352.211-9015)

100% END ITEM INSPECTION (AFMCFARS 5352.211-9017)

TEST AND VERIFICATION (AFMCFARS 5352.211-9013) TECH ORDER NUMBER 2J-F100-24 and 13-7

VERIFIABLE DIMENSION (AFMCFARS 5352.211-9012) DESIGN ACTIVITY 4083144

DRAWING NUMBER 4083144

LOCATION OF INSPECTION TESTING (AFMCFARS 5352.211-9015)

INITIAL ACCEPTABILITY ITEMS 8(AFMCFARS 5352.211-9014) A QUANTITY OF ITEMS WILL BE TESTED FOR INITIAL ACCEPTANCE

Measurements on the blueprint.

TEST WILL BE CONDUCTED USING THE FOLLOWING CRITERIA (and location of testing)

OVERHAUL AND CERTIFICATION (AFMCFARS 5352.211-9010)

Parts must be new, unused and in ORIGINAL packaging to ensure provenance. If original box is deteriorated, it MUST be packed inside a new box with the part.

OTHER SPECIAL REQUIREMENTS (Explain)

Kopp, Stephen MNAME: 21 DEC 2020DATE:

See above and below.

REMARKS

JUSTIFICATION FOR UNACCEPTABLE SURPLUS MATERIEL

If the parts are not NEW, UNUSED and/or are missing the ORIGINAL packaging, the items will be rejected.

EVALUATOR

Olsson, James D

OFFICE SYMBOL

AFLCMC / LPEA2

PHONE

405-622-7829 / 892-7829

COMPLETE DATE

01 FEB 2021

SIGNATURE

//SIGNED// Olsson, James D

USER TYPE

Engineer

SIGNATURE DATE

01 FEB 2021

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