4105777_SMW_REPORT.pdf
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- Attached to
- TH-1H Helicopter Axial Pumps
- Solicitation number
- FD2060-25-00202
- Issued by
-
Defense Logistics Agency Aviation
About this file
This document is a Surplus Materiel Worksheet (AFMC Form 813) dated 25 February 2025 for evaluating surplus materiel for a specific hydraulic system component. The worksheet concerns National Stock Number (NSN) 4320008728798GA, Part Number 204-076-006-1, for use in hydraulic systems, with a CAGE code of 97499. The evaluation indicates that surplus materiel may be considered, specifically for new/unused government surplus items manufactured by Eaton Aerospace (CAGE: 62983).
Key evaluation criteria include part number verification, 100% end item inspection for condition, and traceability to an approved design listed on the 204-076-006 Qualified Products Listing (QPL). The document notes that only products listed on the QPL have demonstrated satisfactory compliance with procurement specification requirements. The worksheet is completed by Andrew L. Danielson from AFLCMC/WIUED, who recommends acceptance of surplus units manufactured by Eaton Aerospace subject to the specified inspection and verification criteria.
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Text version
SURPLUS MATERIEL WORKSHEET
DATE
25 FEB 2025
I. REQUEST FOR EVALUATION
NSN
4320008728798GA
PART NUMBER
204-076-006-1
CAGE
97499
APPLICATION
Hydraulic Systems
IMS
Danielson, Andrew L
OFFICE SYMBOL
AFLCMC / WIUED
PHONE
478-787-9756
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 X
N
N
N
Y 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 97499(AFMCFARS 5352.211-9011) MFG 204-076-006-1P/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
VERIFIABLE DIMENSION (AFMCFARS 5352.211-9012) DESIGN ACTIVITY
DRAWING NUMBER
LOCATION OF INSPECTION TESTING (AFMCFARS 5352.211-9015)
INITIAL ACCEPTABILITY ITEMS (AFMCFARS 5352.211-9014) A QUANTITY OF ITEMS WILL BE TESTED FOR INITIAL ACCEPTANCE
TEST WILL BE CONDUCTED USING THE FOLLOWING CRITERIA (and location of testing)
OVERHAUL AND CERTIFICATION (AFMCFARS 5352.211-9010)
OTHER SPECIAL REQUIREMENTS (Explain)
Danielson, Andrew LNAME: 25 FEB 2025DATE:
Items must provide traceability to an approved design. Approved designs are listed on the 204-076-006 Qualified Products Listing (QPL), by part number and manufacturer.
Surplus units manufactured by Eaton Aerospace (CAGE: 62983) will be accepted.
100% end item inspection for condition
REMARKS
JUSTIFICATION FOR UNACCEPTABLE SURPLUS MATERIEL
Only products listed on the QPL have demonstrated satisfactory compliance with all requirements of the procurement specification.
EVALUATOR
Danielson, Andrew L
OFFICE SYMBOL
AFLCMC / WIUED
PHONE
478-787-9756 / 468-5668
COMPLETE DATE
25 FEB 2025
SIGNATURE
//SIGNED// Danielson, Andrew L
USER TYPE
Engineer
SIGNATURE DATE
25 FEB 2025
Page 1 of 1AFMC FORM 813, 20000323 (IMT-V1) Version 8Generated by PRPS using Jasper Reports on 14 Mar 2025
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