807.pdf

RECOMMENDED QUALITY ASSURANCE PROVISIONS

AND SPECIAL INSPECTION REQUIREMENTS

1. PR / MIPR NUMBER

2. NATIONAL STOCK NUMBER

1135010979848NB

3. POINT OF INSPECTION

SOURCE DESTINATION

X

SEE DFARS 246.402

4. POINT OF ACCEPTANCE

SOURCE DESTINATION

X

5. ITEM MANAGER / PHONE

Cooksey, Nicole L / 801-775-4588

6. EQUIPMENT SPEC / PHONE

Tams, Shelby / 801-586-1853

7. CONTRACT QUALITY REQUIREMENTS/SPECIAL INSPECTION REQUIREMENTS

CERTIFICATE OF CONFORMANCE

FAR 52.246-15

CONTRACT RESPONSIBILITY

FOR INSPECTION

FAR 52.246-1

STANDARD INSPECTION

FAR 52.246-2,-3,-4,-5 OR -6

AS APPLICABLE TO CONTRACT

X HIGHER LEVEL CONTRACT QUALITY REQUIREMENTS

ISO 9001:2000

COMMERCIAL ITEM INSPECTION

FAR 52.212-4

OTHER (Describe in Block 8)

8. REMARKS

Hyde, Alden SNAME: 04 APR 2022DATE:

Office: GUEA

Standard Inspection per FAR 52.246-2,-3,-4,-5 OR -6 as applicable to contract with emphasis on:

- Configuration: Overall to Dwg, No Damage, Clean Finishes, Threads Are Clean And Uniform.

- Complete Certs Package; Materials, Components, Vendor Inspection.

- Marking; Correct, Readable

- Packaging; Individually Packaged, Sufficient Padding, Inner/Outer Package Markings Correct, Addressed Correctly

- Any FA or Production discrepancies Noted and Corrected

INFO

PN: 77D47919G2 Noun: Seal Assy CLC Function: Used on the Forward Section Arming and Fuzing Subassembly CAGE: 98747 NHA: 77E48271 Approximate Size: 3.815 in. X 1.435 in.

ESD Sensitive: No T.O. Number: 11N-RV12A-4 ES Code: 4A

8a. OZONE DEPLETING SUBSTANCES (ODS)

X STATEMENT

"I HAVE REVIEWED THE REQUIREMENT, INCLUDING AVAILABLE TECHNICAL DOCUMENTATION, AND BELIEVE THAT IT DOES NOT REQUIRE THE CONTRACTOR USE CLASS I OZONE DEPLETING SUBSTANCES (ODS) IDENTIFIED IN AIR FORCE POLICY, NOR IS IT WRITTEN SO THAT IT CAN

ONLY BE MET BY THE USE OF A CLASS I ODS."

WAIVER (SEE AF FARS 5323)

NOTE: Quality provisions as annotated hereon will not be downgraded without Technical Authority coordination. The Technical Authority must be notified if award selection is made to a new source using Acquisition Method Code (AMC) 3, 4, or 5.

9. QUALITY PRE-AWARD SURVEY

YES NEW SOURCE

PREVIOUS SOURCEX NO

AFMC PARTICIPATION

RECOMMENDED

10. CODES

A. I&A

B. CQR

G

11. SIGNATURE OF TECHNICAL AUTHORITY

Hyde, Alden S

ORGANIZATION / SYMBOL

414 SCMS / GUEAA

PHONE

801-586-6899 / 586-6899

DATE

12 APR 2022

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