A01- Ex E CDRL ML26.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 100 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 this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302, and to the Office of Management and Budget, Paperwork Reduction Project (0704-0188), Washington, D.C. 20503. Please DO NOT RETURN your form to either of these addresses. 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

TDP TM OTHER

D. SYSTEM/ITEM E. CONTRACT/PR NO. NO. F. CONTRACTOR

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE 17. Price Group

7. DD 250 REQ7. DD 250 REQ 9. DIST

STATEMENT

REQUIRED

10. FREQUENCY10. FREQUENCY 12. DATE OF FIRST SUBMISSION12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

18. Estimated Total Price

a. ADDRESSEE

b. COPIES

FINAL

8. APP CODE 11. AS OF DATE 13. DATE OF SUBSEQUENT SUBMISSION

Draft Reg Repro

16. REMARKS

15. Total

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

DD Form 1423-1, JUN 90 Previous editions are obsolete

1007/183 S/N 0102-LF-010-5500

15.

TBD X

DI-MISC-80043B

LT

N/A

D AS REQ

When Revised

16NOV18

0 1 0 0 1 0 0 2 0

0 1 0

0 5 0

Thru QAR NSWC Crane (JXRT) Lot/Partial Shipment NSWC Corona (Fallbrook)

TBD

TBDSee Block 16M69A1 LDC and M1147 Training Fuze

A001 Ammunition Data Card

NSWC Crane Munitions Acquisition Branch (JXRT)Section E

AS REQ

YUKAWA.RICHARD.KYLE.146166

Digitally signed by YUKAWA.RICHARD.KYLE.1461669790 DN: c=US, o=U.S. Government, ou=DoD, ou=PKI, ou=USN, cn=YUKAWA.RICHARD.KYLE.1461669790 Date: 2018.11.16 15:52:41 -05'00'

Pages

Ammunition and Explosive Technical Data

Block E: Solicitation W52P1J8169M801; PRON TI9A09E141

Blk 4: Data Cards shall be prepared in accordance with MIL-STD-1168C as changed by ADL exceptions and the Contract Data List by accessing the Worldwide Ammunition-Data Repository Program (WARP) which is located on the Munitions History Program (WHP) website at:

https://mhp.redstone.army.mil/. An access Request Form must be completed before WARP can be accessed and data cards input. The MHP Help Desk may be reached at (256) 313-2143 and questions specific to WARP should be addressed to Joint Munitions Command (AMSJM-QAP) at:

(309) 782-2697, 7447, 7107, or 7360.

The Contractor shall, in WARP enter the following points of contact, in the order specified:

1) Email address of Government Acquisition Engineer/Technician or DCMA QAR (as

GARA)

2) debra.kaiser.ctr@navy.mil (info copy only)

Blk 10, 12, 13: Data Cards provided to NSWC Crane and those sent with shipments shall be hard copy printouts generated with the WARP Program and shall be signed and dated by the Government inspector. NSWC Crane submissions shall also include a hard copy printout of same data cards (see MIL-STD-1168B, Para 4.12.5).

When ballistic tests are required, two hard copies shall be sent to the Proving Ground with shipment and two to the Proving Ground by mail.

Data Cards provided to NSWC Crane, Munitions Acquisition Branch (JXRT) shall be submitted upon completion of each lot.

Form Approved OMB No. 0704-0188

Public reporting burden for this collection of information is estimated to average 100 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 this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302, and to the Office of Management and Budget, Paperwork Reduction Project (0704-0188), Washington, D.C. 20503. Please DO NOT RETURN your form to either of these addresses. 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

TDP TM OTHER

D. SYSTEM/ITEM E. CONTRACT/PR NO. NO. F. CONTRACTOR

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE 17. Price Group

7. DD 250 REQ7. DD 250 REQ 9. DIST

STATEMENT

REQUIRED

10. FREQUENCY10. FREQUENCY 12. DATE OF FIRST SUBMISSION12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

18. Estimated Total Price

a. ADDRESSEE

b. COPIES

FINAL

8. APP CODE 11. AS OF DATE 13. DATE OF SUBSEQUENT SUBMISSION

Draft Reg Repro

16. REMARKS

15. Total

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

DD Form 1423-1, JUN 90 Previous editions are obsolete

1007/183 S/N 0102-LF-010-5500

TBD X

DI-MGMT-81987

XX

A

D

AS REQ

When Revised

16NOV18

0 1 0 0 1 0 0 1 0 0 1 0

0 4 0

Thru QAR* NSWC Crane (JXRT) NSWC Corona (MS22) NSWC Corona (Fallbrook)

TBD

TBDSee Block 16M69A1 LDC and M1147 Training Fuze

A002 Statistical Process Control Plan (SPC)

NSWC Crane Munitions Acquisition Branch (JXRT)Section E

AS REQ

YUKAWA.RICHARD.KYLE.146166

Digitally signed by YUKAWA.RICHARD.KYLE.1461669790 DN: c=US, o=U.S. Government, ou=DoD, ou=PKI, ou=USN, cn=YUKAWA.RICHARD.KYLE.1461669790 Date: 2018.11.16 15:54:52 -05'00'

PagesPage 02 of 17

Block E: Solicitation W52P1J8169M801; PRON T19A09E141

Blk 8: The Government requires 45 days to review the plan after receipt. Comments will be provided to AMSJM-CDC by NSWC Crane, Munitions Acquisition Branch (JXRT). Disposition of the General and Detailed sections as well as milestones will be provided by AMSJM-CDC through the PCO. If disapproved, the contractor has 14 days to revise and resubmit.

Blk 12: General and Detailed sections to be submitted at least 60 days prior to initiation of production or 60 days prior to First Article (FA) test (if FA is required). If general section was previously accepted, submit updated/revised milestones in time-frames as stated above.

N/A

Form Approved OMB No. 0704-0188

Public reporting burden for this collection of information is estimated to average 100 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 this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302, and to the Office of Management and Budget, Paperwork Reduction Project (0704-0188), Washington, D.C. 20503. Please DO NOT RETURN your form to either of these addresses. 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

TDP TM OTHER

D. SYSTEM/ITEM E. CONTRACT/PR NO. NO. F. CONTRACTOR

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE 17. Price Group

7. DD 250 REQ7. DD 250 REQ 9. DIST

STATEMENT

REQUIRED

10. FREQUENCY10. FREQUENCY 12. DATE OF FIRST SUBMISSION12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

18. Estimated Total Price

a. ADDRESSEE

b. COPIES

FINAL

8. APP CODE 11. AS OF DATE 13. DATE OF SUBSEQUENT SUBMISSION

Draft Reg Repro

16. REMARKS

15. Total

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

DD Form 1423-1, JUN 90 Previous editions are obsolete

1007/183 S/N 0102-LF-010-5500

TBD X

DI-QCIC-81722

XX

When Revised

16NOV18

0 1 0 0 1 0 0 1 0 0 1 0

0 4 0

Thru QAR NSWC Crane (JXRT)

AMSJM-QAP

NSWC Corona (Fallbrook)

TBD

TBDSee Block 16M69A1 LDC and M1147 Training Fuze

A003 Quality Program Plan

NSWC Crane Munitions Acquisition Branch (JXRT)Section E

AS REQ

YUKAWA.RICHARD.KYLE.146166

Digitally signed by YUKAWA.RICHARD.KYLE.1461669790 DN: c=US, o=U.S. Government, ou=DoD, ou=PKI, ou=USN, cn=YUKAWA.RICHARD.KYLE.1461669790 Date: 2018.11.16 15:55:59 -05'00'

Pages

N/A

Block E: Solicitation W52P1J8169M801; PRON T19A09E141

Blk 8: Government will review within 30 days of receipt. If disapproved, the contractor has 14 days to revise and resubmit.

Blk 12: Plan shall be submitted thru QAR to all addresses prior to initiation of production.

Form Approved OMB No. 0704-0188

Public reporting burden for this collection of information is estimated to average 100 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 this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302, and to the Office of Management and Budget, Paperwork Reduction Project (0704-0188), Washington, D.C. 20503. Please DO NOT RETURN your form to either of these addresses. 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

TDP TM OTHER

D. SYSTEM/ITEM E. CONTRACT/PR NO. NO. F. CONTRACTOR

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE 17. Price Group

7. DD 250 REQ7. DD 250 REQ 9. DIST

STATEMENT

REQUIRED

10. FREQUENCY10. FREQUENCY 12. DATE OF FIRST SUBMISSION12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

18. Estimated Total Price

a. ADDRESSEE

b. COPIES

FINAL

8. APP CODE 11. AS OF DATE 13. DATE OF SUBSEQUENT SUBMISSION

Draft Reg Repro

16. REMARKS

15. Total

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

DD Form 1423-1, JUN 90 Previous editions are obsolete

1007/183 S/N 0102-LF-010-5500

TBD X

DI-NDTI-80603A

LT

When Revised

16NOV18

0 1 0 0 1 0 0 1 0

0 1 0

0 3 0

Thru QAR* NSWC Crane (JXRT)

AMSJM-CDC

See Remarks* NSWC Corona (Fallbrook)

TBD

TBDSee Block 16M69A1 LDC and M1147 Training Fuze

A004 Test Procedure

NSWC Crane Munitions Acquisition Branch (JXRT)Section E

AS REQ

YUKAWA.RICHARD.KYLE.146166

Digitally signed by YUKAWA.RICHARD.KYLE.1461669790 DN: c=US, o=U.S. Government, ou=DoD, ou=PKI, ou=USN, cn=YUKAWA.RICHARD.KYLE.1461669790 Date: 2018.11.16 15:57:31 -05'00'

PagesPage 04 of 17

Block E: Solicitation W52P1J8169M801; PRON T19A09E141

Blk 8: Government will review within 30 days of receipt. If disapproved, the contractor has 14 days to revise and resubmit.

Blk 12, 13: Procedures shall be submitted thru QAR to all addresses prior to submission of First Article (FA).

*If all the specified requirements of this data item have been completely incorporated in the Management Plan or Inspection System Plan, separate submittal to comply with DD 1423 is not required.

First Article Inspection Procedures

Form Approved OMB No. 0704-0188

Public reporting burden for this collection of information is estimated to average 100 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 this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302, and to the Office of Management and Budget, Paperwork Reduction Project (0704-0188), Washington, D.C. 20503. Please DO NOT RETURN your form to either of these addresses. 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

TDP TM OTHER

D. SYSTEM/ITEM E. CONTRACT/PR NO. NO. F. CONTRACTOR

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE 17. Price Group

7. DD 250 REQ7. DD 250 REQ 9. DIST

STATEMENT

REQUIRED

10. FREQUENCY10. FREQUENCY 12. DATE OF FIRST SUBMISSION12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

18. Estimated Total Price

a. ADDRESSEE

b. COPIES

FINAL

8. APP CODE 11. AS OF DATE 13. DATE OF SUBSEQUENT SUBMISSION

Draft Reg Repro

16. REMARKS

15. Total

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

DD Form 1423-1, JUN 90 Previous editions are obsolete

1007/183 S/N 0102-LF-010-5500

TBD X

DI-MGMT-81978

LT

A

D AS REQ

When Revised

16NOV18

0 1 0 0 1 0 0 1 0 0 1 0

0 4 0

Thru QAR NSWC Crane (JXRT) w/FA Shipment NSWC Corona (Fallbrook)

TBD

TBDSee Block 16M69A1 LDC and M1147 Training Fuze

A005 Acceptance Description Sheets

NSWC Crane Munitions Acquisition Branch (JXRT)Section E

AS REQ

YUKAWA.RICHARD.KYLE.146166

Digitally signed by YUKAWA.RICHARD.KYLE.1461669790 DN: c=US, o=U.S. Government, ou=DoD, ou=PKI, ou=USN, cn=YUKAWA.RICHARD.KYLE.1461669790 Date: 2018.11.16 15:58:46 -05'00'

Pages

First Article Inspection and Test Reports

Block E: Solicitation W52P1J8169M801; PRON T19A09E141

Blk 8: Government will review/approve within 30 days of receipt. If disapproved, the contractor has 14 days to revise and resubmit.

Blk 12: Reports shall be submitted thru QAR to all addresses.

Form Approved OMB No. 0704-0188

Public reporting burden for this collection of information is estimated to average 100 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 this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302, and to the Office of Management and Budget, Paperwork Reduction Project (0704-0188), Washington, D.C. 20503. Please DO NOT RETURN your form to either of these addresses. 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

TDP TM OTHER

D. SYSTEM/ITEM E. CONTRACT/PR NO. NO. F. CONTRACTOR

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE 17. Price Group

7. DD 250 REQ7. DD 250 REQ 9. DIST

STATEMENT

REQUIRED

10. FREQUENCY10. FREQUENCY 12. DATE OF FIRST SUBMISSION12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

18. Estimated Total Price

a. ADDRESSEE

b. COPIES

FINAL

8. APP CODE 11. AS OF DATE 13. DATE OF SUBSEQUENT SUBMISSION

Draft Reg Repro

16. REMARKS

15. Total

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

DD Form 1423-1, JUN 90 Previous editions are obsolete

1007/183 S/N 0102-LF-010-5500

TBD X

DI-MGMT-81978

LT

N/A

D AS REQ

When Revised

16NOV18

0 1 0 0 1 0 0 1 0

0 3 0

Thru QAR NSWC Crane (JXRT) NSWC Corona (Fallbrook)

TBD

TBDSee Block 16M69A1 LDC and M1147 Training Fuze

A007 Acceptance Description Sheets

NSWC Crane Munitions Acquisition Branch (JXRT)Section E

AS REQ

YUKAWA.RICHARD.KYLE.146166

Digitally signed by YUKAWA.RICHARD.KYLE.1461669790 DN: c=US, o=U.S. Government, ou=DoD, ou=PKI, ou=USN, cn=YUKAWA.RICHARD.KYLE.1461669790 Date: 2018.11.16 16:01:12 -05'00'

Pages

Production Acceptance Inspection and Test Reports

Block E: Solicitation W52P1J8169M801; PRON T19A09E141

Blk 10, 12: *Reports shall be submitted through QAR to all addresses.

Reports shall be submitted upon completion of each lot.

Form Approved OMB No. 0704-0188

Public reporting burden for this collection of information is estimated to average 100 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 this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302, and to the Office of Management and Budget, Paperwork Reduction Project (0704-0188), Washington, D.C. 20503. Please DO NOT RETURN your form to either of these addresses. 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

TDP TM OTHER

D. SYSTEM/ITEM E. CONTRACT/PR NO. NO. F. CONTRACTOR

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE 17. Price Group

7. DD 250 REQ7. DD 250 REQ 9. DIST

STATEMENT

REQUIRED

10. FREQUENCY10. FREQUENCY 12. DATE OF FIRST SUBMISSION12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

18. Estimated Total Price

a. ADDRESSEE

b. COPIES

FINAL

8. APP CODE 11. AS OF DATE 13. DATE OF SUBSEQUENT SUBMISSION

Draft Reg Repro

16. REMARKS

15. Total

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

DD Form 1423-1, JUN 90 Previous editions are obsolete

1007/183 S/N 0102-LF-010-5500

TBD X

DI-NDTI-80603A

When Revised

16NOV18

0 1 0 0 1 0 0 1 0

0 1 0

0 4 0

Thru QAR* NSWC Crane (JXRT)

AMSJM-CDC

See Remarks* NSWC Corona (Fallbrook)

TBD

TBDSee Block 16M69A1 LDC and M1147 Training Fuze

A006 Test Procedure

NSWC Crane Munitions Acquisition Branch (JXRT)Section E

AS REQ

YUKAWA.RICHARD.KYLE.146166

Digitally signed by YUKAWA.RICHARD.KYLE.1461669790 DN: c=US, o=U.S. Government, ou=DoD, ou=PKI, ou=USN, cn=YUKAWA.RICHARD.KYLE.1461669790 Date: 2018.11.16 16:00:05 -05'00'

PagesPage 06 of 17

Block E: Solicitation W52P1J8169M801; PRON T19A09E141

Blk 8: The Government will review within 30 days of receipt. If disapproved, the contractor has 14 days to revise and resubmit.

Blk 10, 12: Procedures shall be submitted thru QAR to all addresses prior to initiation of production.

*If all the specified requirements of this data item have been completely incorporated in the Quality Program Plan or Inspection System Plan, separate submittal to comply with this DD 1423 is not required.

Production Acceptance Inspection and Test Procedures

Form Approved OMB No. 0704-0188

Public reporting burden for this collection of information is estimated to average 100 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 this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302, and to the Office of Management and Budget, Paperwork Reduction Project (0704-0188), Washington, D.C. 20503. Please DO NOT RETURN your form to either of these addresses. 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

TDP TM OTHER

D. SYSTEM/ITEM E. CONTRACT/PR NO. NO. F. CONTRACTOR

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE 17. Price Group

7. DD 250 REQ7. DD 250 REQ 9. DIST

STATEMENT

REQUIRED

10. FREQUENCY10. FREQUENCY 12. DATE OF FIRST SUBMISSION12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

18. Estimated Total Price

a. ADDRESSEE

b. COPIES

FINAL

8. APP CODE 11. AS OF DATE 13. DATE OF SUBSEQUENT SUBMISSION

Draft Reg Repro

16. REMARKS

15. Total

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

DD Form 1423-1, JUN 90 Previous editions are obsolete

1007/183 S/N 0102-LF-010-5500

TBD X

DI-SESS-81004E

30 days after Gov’t approval

16NOV18

0 1 0 0 1 0 0 1 0 0 1 0

0 4 0

Thru QAR* NSWC Crane (JXRT) NSWC Corona (MS22) NSWC Corona (Fallbrook)

TBD

TBDSee Block 16M69A1 LDC and M1147 Training Fuze

A008 Special Inspection Equipment (SIE) Drawings/Models and Associated Lists

NSWC Crane Munitions Acquisition Branch (JXRT)Section E

AS REQ

YUKAWA.RICHARD.KYLE.146166

Digitally signed by YUKAWA.RICHARD.KYLE.1461669790 DN: c=US, o=U.S. Government, ou=DoD, ou=PKI, ou=USN, cn=YUKAWA.RICHARD.KYLE.1461669790 Date: 2018.11.16 16:02:30 -05'00'

PagesPage 08 of 17

Block E: Solicitation W52P1J8169M801; PRON T19A09E141

Blk 4, 8, 10, 12: *Drawings shall be provided in Contractor format. All Contractor Acceptance Inspection Equipment designs for those inspection characteristics classified as “minor” shall be submitted through the QAR for review and approval. Submit revisions 30 days after Government review and approval. Government will review within 30 days.

Design Documentation (Minor Characteristics)

Form Approved OMB No. 0704-0188

Public reporting burden for this collection of information is estimated to average 100 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 this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302, and to the Office of Management and Budget, Paperwork Reduction Project (0704-0188), Washington, D.C. 20503. Please DO NOT RETURN your form to either of these addresses. 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

TDP TM OTHER

D. SYSTEM/ITEM E. CONTRACT/PR NO. NO. F. CONTRACTOR

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE 17. Price Group

7. DD 250 REQ7. DD 250 REQ 9. DIST

STATEMENT

REQUIRED

10. FREQUENCY10. FREQUENCY 12. DATE OF FIRST SUBMISSION12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

18. Estimated Total Price

a. ADDRESSEE

b. COPIES

FINAL

8. APP CODE 11. AS OF DATE 13. DATE OF SUBSEQUENT SUBMISSION

Draft Reg Repro

16. REMARKS

15. Total

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

DD Form 1423-1, JUN 90 Previous editions are obsolete

1007/183 S/N 0102-LF-010-5500

TBD X

DI-SESS-81004E

30 days after Gov’t approval

16NOV18

0 1 0 0 1 0 0 1 0 0 1 0

0 4 0

Thru QAR* NSWC Crane (JXRT) NSWC Corona (MS22) NSWC Corona (Fallbrook)

TBD

TBDSee Block 16M69A1 LDC and M1147 Training Fuze

A009 Special Inspection Equipment (SIE) Drawings/Models and Associated Lists

NSWC Crane Munitions Acquisition Branch (JXRT)Section E

AS REQ

YUKAWA.RICHARD.KYLE.146166

Digitally signed by YUKAWA.RICHARD.KYLE.1461669790 DN: c=US, o=U.S. Government, ou=DoD, ou=PKI, ou=USN, cn=YUKAWA.RICHARD.KYLE.1461669790 Date: 2018.11.16 16:03:55 -05'00'

PagesPage 09 of 17

Block E: Solicitation W52P1J8169M801; PRON T19A09E141

Blk 8, 10, 12: *Drawings shall be provided in Contractor format. All Contractor Special Acceptance Inspection Equipment Operating Instructions for those Acceptance Inspection Equipment designs for inspection characteristics classified as “Critical” or “Major” shall be submitted through the QAR to NSWC Crane, Munitions Acquisition Branch (JXRT) and NSWC Corona (MS22) for review and approval. NSWC Crane, Munitions Acquisition Branch (JXRT) will provide approval/disapproval of operating instructions. Submit revisions 30 days after Government review and approval.

Design Documentation (Major/Critical Characteristics)

Form Approved OMB No. 0704-0188

Public reporting burden for this collection of information is estimated to average 100 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 this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302, and to the Office of Management and Budget, Paperwork Reduction Project (0704-0188), Washington, D.C. 20503. Please DO NOT RETURN your form to either of these addresses. 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

TDP TM OTHER

D. SYSTEM/ITEM E. CONTRACT/PR NO. NO. F. CONTRACTOR

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE 17. Price Group

7. DD 250 REQ7. DD 250 REQ 9. DIST

STATEMENT

REQUIRED

10. FREQUENCY10. FREQUENCY 12. DATE OF FIRST SUBMISSION12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

18. Estimated Total Price

a. ADDRESSEE

b. COPIES

FINAL

8. APP CODE 11. AS OF DATE 13. DATE OF SUBSEQUENT SUBMISSION

Draft Reg Repro

16. REMARKS

15. Total

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

DD Form 1423-1, JUN 90 Previous editions are obsolete

1007/183 S/N 0102-LF-010-5500

TBD X

DI-QCIC-81960

When Revised

16NOV18

0 1 0 0 1 0 0 1 0 0 1 0

0 4 0

*Thru QAR NSWC Crane (JXRT) NSWC Corona (MS22) NSWC Corona (Fallbrook)

TBD

TBDSee Block 16M69A1 LDC and M1147 Training Fuze

A010 Measurement System Evaluation (MSE)

NSWC Crane Munitions Acquisition Branch (JXRT)Section E

AS REQ

YUKAWA.RICHARD.KYLE.146166

Digitally signed by YUKAWA.RICHARD.KYLE.1461669790 DN: c=US, o=U.S. Government, ou=DoD, ou=PKI, ou=USN, cn=YUKAWA.RICHARD.KYLE.1461669790 Date: 2018.11.16 16:05:16 -05'00'

PagesPage 10 of 17

Block E: Solicitation W52P1J8169M801; PRON T19A09E141

Blk 8,10,12:

*All Contractors’ Special Inspection Equipment Operating Instructions for those Acceptance Inspection Equipment designs for inspection characteristics classified as “Minor” shall be submitted to the QAR for review and approval. The Government will review within 30 days of receipt. If disapproved, Contractor has 14 days to revise and resubmit.

*All Contractor’s Special Inspection Equipment Operating Instructions or those Acceptance Inspection Equipment designs for inspection characteristics classified as “Critical” or “Major” shall be submitted through the QAR to NSWC Crane, Munitions Acquisition Branch (JXRT) and NSWC Corona (MS22) for review and approval. NSWC Crane, Munitions Acquisition Branch (JXRT) will provide approval/disapproval of operating instructions. The Government will review within 30 days of receipt. If disapproved, Contractor has 14 days to revise and resubmit.

If all the specified requirements of this data item have been completely incorporated in the Special Inspection Equipment Drawings, separate submittal to comply with this DD 1423 is not required.

Special Inspection Equipment (SIE) Operating Instructions

Form Approved OMB No. 0704-0188

Public reporting burden for this collection of information is estimated to average 100 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 this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302, and to the Office of Management and Budget, Paperwork Reduction Project (0704-0188), Washington, D.C. 20503. Please DO NOT RETURN your form to either of these addresses. 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

TDP TM OTHER

D. SYSTEM/ITEM E. CONTRACT/PR NO. NO. F. CONTRACTOR

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE 17. Price Group

7. DD 250 REQ7. DD 250 REQ 9. DIST

STATEMENT

REQUIRED

10. FREQUENCY10. FREQUENCY 12. DATE OF FIRST SUBMISSION12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

18. Estimated Total Price

a. ADDRESSEE

b. COPIES

FINAL

8. APP CODE 11. AS OF DATE 13. DATE OF SUBSEQUENT SUBMISSION

Draft Reg Repro

16. REMARKS

15. Total

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

DD Form 1423-1, JUN 90 Previous editions are obsolete

1007/183 S/N 0102-LF-010-5500

TBD X

DI-SESS-80639D

N/A

When Revised

16NOV18

0 1 0 0 1 0 0 1 0

0 3 0

Thru QAR* NSWC Crane (JXRT) NSWC Corona (Fallbrook)

TBD

TBDSee Block 16M69A1 LDC and M1147 Training Fuze

A011 Engineering Change Proposal (ECP)

NSWC Crane Munitions Acquisition Branch (JXRT)Section E

AS REQ

YUKAWA.RICHARD.KYLE.146166

Digitally signed by YUKAWA.RICHARD.KYLE.1461669790 DN: c=US, o=U.S. Government, ou=DoD, ou=PKI, ou=USN, cn=YUKAWA.RICHARD.KYLE.1461669790 Date: 2018.11.16 16:06:20 -05'00'

Pages

N/A

Block E: Solicitation W52P1J8169M801; PRON T19A09E141

Blk 4: Use of format of DD Form 1692 (Page 1 only – Short Form) is recommended. Form may be downloaded at https://www.pica.army.mil/prod_techdata/cmdocs-links.htm.

*ECPs shall be submitted thru QAR to all addresses. Material Review Board Authority shall be withheld.

ECPs shall be numbered serially with the number constructed as follows:

a. Last 4 digits of the contract number

b. E

c. Sequential serial number starting with “0001”

Example: 0756E0001 (First ECP under the contract).

Form Approved OMB No. 0704-0188

Public reporting burden for this collection of information is estimated to average 100 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 this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302, and to the Office of Management and Budget, Paperwork Reduction Project (0704-0188), Washington, D.C. 20503. Please DO NOT RETURN your form to either of these addresses. 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

TDP TM OTHER

D. SYSTEM/ITEM E. CONTRACT/PR NO. NO. F. CONTRACTOR

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE 17. Price Group

7. DD 250 REQ7. DD 250 REQ 9. DIST

STATEMENT

REQUIRED

10. FREQUENCY10. FREQUENCY 12. DATE OF FIRST SUBMISSION12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

18. Estimated Total Price

a. ADDRESSEE

b. COPIES

FINAL

8. APP CODE 11. AS OF DATE 13. DATE OF SUBSEQUENT SUBMISSION

Draft Reg Repro

16. REMARKS

15. Total

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

DD Form 1423-1, JUN 90 Previous editions are obsolete

1007/183 S/N 0102-LF-010-5500

TBD X

DI-MISC-80246

LT

A

D AS REQ

When Revised

16NOV18

0 1 0 0 1 0 0 1 0 0 1 0

0 4 0

Thru QAR* NSWC Crane (JXRT)

AMSJM-QAP

NSWC Corona (Fallbrook)

TBD

TBDSee Block 16M69A1 LDC and M1147 Training Fuze

A013 Ballistic Acceptance Test Report

NSWC Crane Munitions Acquisition Branch (JXRT)Section E

AS REQ

YUKAWA.RICHARD.KYLE.146166

Digitally signed by YUKAWA.RICHARD.KYLE.1461669790 DN: c=US, o=U.S. Government, ou=DoD, ou=PKI, ou=USN, cn=YUKAWA.RICHARD.KYLE.1461669790 Date: 2018.11.16 16:08:52 -05'00'

Pages

N/A

Block E: Solicitation W52P1J8169M801; PRON T19A09E141

Blk 10, 12, 13: *Reports shall be submitted through QAR to all addresses. Government will review within 30 days of receipt. If disapproved, the contractor has 14 days to revise and resubmit.

Form Approved OMB No. 0704-0188

Public reporting burden for this collection of information is estimated to average 100 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 this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302, and to the Office of Management and Budget, Paperwork Reduction Project (0704-0188), Washington, D.C. 20503. Please DO NOT RETURN your form to either of these addresses. 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

TDP TM OTHER

D. SYSTEM/ITEM E. CONTRACT/PR NO. NO. F. CONTRACTOR

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE 17. Price Group

7. DD 250 REQ7. DD 250 REQ 9. DIST

STATEMENT

REQUIRED

10. FREQUENCY10. FREQUENCY 12. DATE OF FIRST SUBMISSION12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

18. Estimated Total Price

a. ADDRESSEE

b. COPIES

FINAL

8. APP CODE 11. AS OF DATE 13. DATE OF SUBSEQUENT SUBMISSION

Draft Reg Repro

16. REMARKS

15. Total

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

DD Form 1423-1, JUN 90 Previous editions are obsolete

1007/183 S/N 0102-LF-010-5500

TBD X

DI-SESS-80640D

LT

D

AS REQ

When Revised

16NOV18

0 1 0 0 1 0 0 1 0

0 3 0

QAR*

NSWC Crane (JXRT) NSWC Corona (Fallbrook)

TBD

TBDSee Block 16M69A1 LDC and M1147 Training Fuze

A012 Request for Variance (RFV)

NSWC Crane Munitions Acquisition Branch (JXRT)Section E

AS REQ

YUKAWA.RICHARD.KYLE.146166

Digitally signed by YUKAWA.RICHARD.KYLE.1461669790 DN: c=US, o=U.S. Government, ou=DoD, ou=PKI, ou=USN, cn=YUKAWA.RICHARD.KYLE.1461669790 Date: 2018.11.16 16:07:35 -05'00'

Pages

N/A

Block E: Solicitation W52P1J8169M801; PRON T19A09E141

Blk 4: Use of format of DD Form 1694 is recommended. Form can be provided by contacting the JXRT RTA or PQM.

- Blk 10 of DD Form 1694: Enter the Revision of the Drawing and/or Specification

- Blk 12c of DD From 1694: For Navy Drawings, enter “DOD-STD-2101”.

*RFVs shall be submitted through QAR to all addresses. Material Review Board Authority withheld.

RFVs shall be numbered serially with the number constructed as follows:

a. Last 4 digits of the contract

b. V

c. Sequential serial number starting with “0001”

Example: 0756V0001 (First Variance under the contract).

Form Approved OMB No. 0704-0188

Public reporting burden for this collection of information is estimated to average 100 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 this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302, and to the Office of Management and Budget, Paperwork Reduction Project (0704-0188), Washington, D.C. 20503. Please DO NOT RETURN your form to either of these addresses. 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

TDP TM OTHER

D. SYSTEM/ITEM E. CONTRACT/PR NO. NO. F. CONTRACTOR

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE 17. Price Group

7. DD 250 REQ7. DD 250 REQ 9. DIST

STATEMENT

REQUIRED

10. FREQUENCY10. FREQUENCY 12. DATE OF FIRST SUBMISSION12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

18. Estimated Total Price

a. ADDRESSEE

b. COPIES

FINAL

8. APP CODE 11. AS OF DATE 13. DATE OF SUBSEQUENT SUBMISSION

Draft Reg Repro

16. REMARKS

15. Total

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

DD Form 1423-1, JUN 90 Previous editions are obsolete

1007/183 S/N 0102-LF-010-5500

TBD X

DI-MGMT-80004A (Tailored)

See Blk 16

See Blk 16

16NOV18

0 1 0 0 1 0 0 1 0 0 1 0 0 1 0

0 5 0

PCO

NSWC Crane (JXRT)

QAR

AMSJM-QAP

NSWC Corona (Fallbrook)

TBD

TBDSee Block 16M69A1 LDC and M1147 Training Fuze

A014 Management Plan

NSWC Crane Munitions Acquisition Branch (JXRT) Section E

See Blk 16

YUKAWA.RICHARD.KYLE.146166

Digitally signed by YUKAWA.RICHARD.KYLE.1461669790 DN: c=US, o=U.S. Government, ou=DoD, ou=PKI, ou=USN, cn=YUKAWA.RICHARD.KYLE.1461669790 Date: 2018.11.16 16:10:12 -05'00'

Pages

Critical Characteristics Control (CCC) Plan

Block E: Solicitation W52P1J8169M801; PRON T19A09E141

Delete paragraphs 10.3.6 and 10.3.7. Contractor’s electronic format using Microsoft Word or comparable software is acceptable.

Additional guidance on content of the CCC Plan is available at:

http://www.ardec.army.mil/organizations/QESA

Blk 10: Contractor shall submit plan covering all Critical characteristics as required in contract clause reference.

Blk 12: Contractor shall submit 60 days prior to First Article (FA) or production if FA is not applicable. Government will respond within 45 days of receipt of original and any required revisions. Unless otherwise specified, Contractor shall submit revisions within 10 days of receipt of Government response.

Blk 13: Unless otherwise specified, if CCC Plan changes after initial Government approval, Contractor shall resubmit revised plan for Government approval.

Form Approved OMB No. 0704-0188

Public reporting burden for this collection of information is estimated to average 100 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 this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302, and to the Office of Management and Budget, Paperwork Reduction Project (0704-0188), Washington, D.C. 20503. Please DO NOT RETURN your form to either of these addresses. 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

TDP TM OTHER

D. SYSTEM/ITEM E. CONTRACT/PR NO. NO. F. CONTRACTOR

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE 17. Price Group

7. DD 250 REQ7. DD 250 REQ 9. DIST

STATEMENT

REQUIRED

10. FREQUENCY10. FREQUENCY 12. DATE OF FIRST SUBMISSION12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

18. Estimated Total Price

a. ADDRESSEE

b. COPIES

FINAL

8. APP CODE 11. AS OF DATE 13. DATE OF SUBSEQUENT SUBMISSION

Draft Reg Repro

16. REMARKS

15. Total

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

DD Form 1423-1, JUN 90 Previous editions are obsolete

1007/183 S/N 0102-LF-010-5500

TBD X

DI-MGMT-80004A (Tailored)

See Blk 16

See Blk 16

16NOV18

0 1 0 0 1 0 0 1 0 0 1 0 0 1 0

0 5 0

PCO

NSWC Crane (JXRT)

QAR

AMSJM-QAP

NSWC Corona (Fallbrook)

TBD

TBDSee Block 16M69A1 LDC and M1147 Training Fuze

A015 Management Plan

NSWC Crane Munitions Acquisition Branch (JXRT)Section E

See Blk 16

YUKAWA.RICHARD.KYLE.146166

Digitally signed by YUKAWA.RICHARD.KYLE.1461669790 DN: c=US, o=U.S. Government, ou=DoD, ou=PKI, ou=USN, cn=YUKAWA.RICHARD.KYLE.1461669790 Date: 2018.11.16 16:11:22 -05'00'

Pages

Critical Plans of Action (CPOA)

Block E: Solicitation W52P1J8169M801; PRON T19A09E141

Delete paragraphs 10.3.6 and 10.3.7. Contractor’s electronic format using Microsoft Word or comparable software is acceptable.

Additional guidance on content of the CCC Plan is available at:

http://www.ardec.army.mil/organizations/QESA

Blk 10: Contractor may voluntarily submit a CPOA for all critical characteristics as specified in the contract clause reference.

Blk 12: Contractor shall submit the CPOA for approval prior to use. Government will respond within 45 days of receipt of original and any required revision. Unless otherwise specified, Contractor shall submit revisions within 10 days of receipt of Government response. Unless otherwise approved by the PCO, the CPOA is not authorized for use prior to Government approval.

Blk 13: Unless otherwise specified, if the CPOA changes after initial Government approval, Contractor shall resubmit revised plan for Government approval.

Form Approved OMB No. 0704-0188

Public reporting burden for this collection of information is estimated to average 100 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 this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302, and to the Office of Management and Budget, Paperwork Reduction Project (0704-0188), Washington, D.C. 20503. Please DO NOT RETURN your form to either of these addresses. 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

TDP TM OTHER

D. SYSTEM/ITEM E. CONTRACT/PR NO. NO. F. CONTRACTOR

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE 17. Price Group

7. DD 250 REQ7. DD 250 REQ 9. DIST

STATEMENT

REQUIRED

10. FREQUENCY10. FREQUENCY 12. DATE OF FIRST SUBMISSION12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

18. Estimated Total Price

a. ADDRESSEE

b. COPIES

FINAL

8. APP CODE 11. AS OF DATE 13. DATE OF SUBSEQUENT SUBMISSION

Draft Reg Repro

16. REMARKS

15. Total

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

DD Form 1423-1, JUN 90 Previous editions are obsolete

1007/183 S/N 0102-LF-010-5500

TBD X

DI-SAFT-80970A

See Blk 16

16NOV18

0 1 0 0 1 0 0 1 0 0 1 0 0 1 0

0 5 0

PCO

NSWC Crane (JXRT)

QAR

AMSJM-QAP

NSWC Corona (Fallbrook)

TBD

TBDSee Block 16M69A1 LDC and M1147 Training Fuze

A016 Critical Safety Item, Characteristic and Defect Report

NSWC Crane Munitions Acquisition Branch (JXRT)Section E

See Blk 16

YUKAWA.RICHARD.KYLE.146166

Digitally signed by YUKAWA.RICHARD.KYLE.1461669790 DN: c=US, o=U.S. Government, ou=DoD, ou=PKI, ou=USN, cn=YUKAWA.RICHARD.KYLE.1461669790 Date: 2018.11.16 16:12:23 -05'00'

Pages

CICCL, Notification, Investigation, Segregated Material Use and Restart Request

Block E: Solicitation W52P1J8169M801; PRON T19A09E141

Critical Item Characteristics List (CICCL) (DID paragraph 3.3):

Blks 12 and 13: If applicable, Contractor shall submit 60 days prior to First Article (FA) or production if FA is not applicable. Government will respond within 45 days of receipt of original and any required revisions. Unless otherwise stated, Contractor shall submit revisions within 10 days of receipt of Government response.

Notification of a Critical Defect (DID paragraph 4.1):

Blks 12 and 13: Unless otherwise approved by the PCO, notification of the occurrence of any critical defects shall be made to Government (see distribution list) within 24 hours of the event, by the most expeditious means available.

Root Cause Investigation and Corrective Action (DID paragraph 4.2):

Blks 12 and 13: Contractor shall submit to Government, see list, for approval. Government will respond with 45 days of receipt of original and any required revisions. Unless otherwise stated, Contractor shall submit revisions within 10 days of receipt of Government response.

Segregated Suspect Material Use (DID paragraph 4.3):

Blks 12 and 13: Contractor shall submit to the Government, see list, for approval. Government will respond within 45 days of receipt of original and any required revisions. Unless otherwise stated, Contractor shall submit revisions within 10 days of receipt of Government response.

Request to Restart Operations (DID paragraph 4.3):

Blks 12 and 13: Contractor shall submit to Government, see list, for approval. Government will respond within 10 days of receipt.

Form Approved OMB No. 0704-0188

Public reporting burden for this collection of information is estimated to average 100 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 this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302, and to the Office of Management and Budget, Paperwork Reduction Project (0704-0188), Washington, D.C. 20503. Please DO NOT RETURN your form to either of these addresses. 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 X TM OTHER

E. CONTRACT/PR NO. NO. F. CONTRACTORD. SYSTEM/ITEM

See Block 16 TBD

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE

A017 Failure Summary and Analysis Report N/A

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE 17. Price Group

DI-SESS-80255A Section ESection E NSWC Crane Munitions

Acquisition Branch (JXRT)

7. DD 250 REQ7. DD 250 REQ 9. DIST

STATEMENT

REQUIRED

10. FREQUENCY10. FREQUENCY 12. DATE OF FIRST SUBMISSION12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

18. Estimated Total Price

LTLT See Blk 16 AS REQQ AS REQQ

a. ADDRESSEE

b. COPIES

FINAL

8. APP CODE 11. AS OF DATE 13. DATE OF SUBSEQUENT SUBMISSION

AA AS REQ AS REQ Draft Reg Repro

16. REMARKS Thru QAR* 0 1 0 Block E:

Blk 5: SQAP-JXRT-01 paragraph 6. F. (5)

Blk 8, 12: The Government will review/approve within 30 days of receipt. Reports shall be submitted thru QAR to all addresses.

Blk 9: Distribution D – Distribution Authorized to the DOD and U.S. DOD Contractors only (Critical Technology) (Jan 2009). Other requests for this document shall be referred to Commanding Officer, Code JXRT, NSWC Crane, IN 47522-5001.

WARNING: This document contains technical data whose export is restricted by the Arms Export Control Act, (Title 22, U.S.C., Sec. 2751 (ET SEQ.) or the Export Administration Act of 1979, as amended, Title 50, U.S.C. App 2401, ET SEQ. Violations of these export laws are subject to severe criminal penalties. Disseminate IAW provisions of DOD Directive 5230.25.

Destruction Notice: For classified documents, follow the procedures in DoD 5220.22-M, Industrial Security Manual, Sections 11-19 or DoD 5200.1-R, Information Security Program Regulation, Chapter IX. For unclassified, limited documents, destroy by any method that will prevent disclosure of contents or reconstruction of the document.

GOVERNMENT DOCUMENTATION SHALL BE DESTROYED UPON COMPLETION

OF THE CONTRACT OR PURCHASE ORDER. USE OF GOVERNMENT

DOCUMENTATION FOR COMMERICAL PURPOSES IS FORBIDDEN.

Blk 14: COMMANDING OFFICER

CODE JXRT BLDG 3395

NAVSURFWARCENDIV

300 HIGHWAY 361

CRANE IN 47522-5001

NSWC Crane (JXRT) 0 1 0 NSWC Corona (Fallbrook) 0 1 0

15. Total 0 3 0

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

DD Form 1423-1, JUN 90 Previous editions are obsolete 1007/183 S/N 0102-LF-010-5500 Page 17 of 17 Pages

YUKAWA.RICHARD.KYL

E.1461669790

Digitally signed by YUKAWA.RICHARD.KYLE.1461669790 DN: c=US, o=U.S. Government, ou=DoD, ou=PKI, ou=USN, cn=YUKAWA.RICHARD.KYLE.1461669790 Date: 2018.12.11 10:32:10 -05'00'

M69A1 LINEAR DEMOLITION CHARGE

AND

M1147 TRAINING FUZE

FY 19

The following CDRLs apply:

CDRL TITLE OF DATA ITEM

A001 AMMUNITION DATA CARD - AMMUNITION AND EXPLOSIVE

TECHNICAL DATA

A002 STATISTICAL PROCESS CONTROL PLAN (SPC)

A003 QUALITY PROGRAM PLAN

A004 TEST PROCEDURE – FIRST ARTICLE INSPECTION

PROCEDURES

A005 ACCEPTANCE DESCRIPTION SHEETS - FIRST ARTICLE

INSPECTION AND TEST REPORTS

A006 TEST PROCEDURE – PRODUCTION ACCEPTANCE INSPECTION

AND TEST PROCEDURES

A007 ACCEPTANCE DESCRIPTION SHEETS - PRODUCTION

ACCEPTANCE INSPECTION AND TEST REPORTS

A008 SPECIAL INSPECTION EQUIPMENT (SIE) DRAWINGS/

MODELS AND ASSOCIATED LISTS - DESIGN

DOCUMENTATION (Minor Characteristics)

A009 SPECIAL INSPECTION EQUIPMENT (SIE) DRAWINGS/

MODELS AND ASSOCIATED LISTS - DESIGN

DOCUMENTATION (Major/Critical Characteristics)

A010 MEASUREMENT SYSTEM EVALUATION (MSE) - SPECIAL

INSPECTION EQUIPMENT (SIE) OPERATING INSTRUCTIONS

A011 ENGINEERING CHANGE PROPOSAL (ECP)

A012 REQUEST FOR VARIANCE (RFV)

Attachment (4)

A013 BALLISTIC ACCEPTANCE TEST REPORT

A014 MANAGEMENT PLAN – CRITICAL CHARACTERISTICS

CONTROL (CCC) PLAN

A015 MANAGEMENT PLAN – CRITICAL PLANS OF ACTION (CPOA)

A016 CRITICAL SAFETY ITEM, CHARACTERISTIC AND DEFECT

REPORT - CICCL, NOTIFICATION, INVESTIGATION,

SEGREGATED MATERIAL USE AND RESTART REQUEST

A017 FAILURE SUMMARY AND ANALYSIS REPORT