A04.0 COC_21897023_HEPA Filter Assy.pdf

CERTIFICATE OF COMPLIANCE ENCLOSURE, PAGE 1 OF 6

REQUIRED CERTIFICATIONS INSTRUCTIONS

Certifications for all tests, inspections and examinations checked on this form shall be supplied with each shipment of material. Certifications shall be as outlined below.

1. The certification shall specifically list each test, inspection and examination checked on this attachment and separately certify the results of each test, inspection and examination. Each certification shall contain either original or exact copies of quantitative or qualitative test reports, as applicable, issued by the testing organization; data transcribed to another organization’s forms are not acceptable. If the vendor performs the laboratory testing, the certification will note the “Original Laboratory Reports are on file at our facility.” Certifications must be complete and objective.

2. The certification shall be made identifiable by containing the contract number, and the heat, batch or vendor traceability number marked on the material. The vendor’s trademark shall be applied to the material. Traceability is defined as the positive method of identifying material to its objective quality evidence. Objective quality evidence is the quantitative data of all mechanical and chemical tests performed to prove that the material supplied complies with its procuring specification. When a vendor traceability number consists of more than one heat or batch, the vendor shall furnish certifications for all heats or batches identified by traceability number.

3. For Chemical Analysis:

a. The chemical analysis certification shall include a tabulation of the complete chemical test analysis.

b. If the specification requires more than one chemical analysis be performed, the certification shall include the results of all the analyses.

4. Chemical Analysis for detrimental material: A previous chemical analysis performed on identical material (size and volume may vary), may be supplied, provided it was conducted within 4 years from the date of receipt of this contracted material.

5. For Mechanical Properties.

6. Photostatic copy of certification originated by the test facility performing the mechanical properties test on the material after performance of all processes which change the mechanical properties of the material, such as heat treating, forging, cold working, etc. (Photostat of original Mill Certification is acceptable only if no processes were performed to change the material properties).

7. The mechanical properties certification shall include the actual test data for tensile, yield, elongation, reduction in area, and hardness when required by specification.

a. If the specification requires more than one mechanical properties test be performed, the certification shall include the results of all the tests.

JOB ORDER

88MSM00001

KEY OP

KO ITEM

REV

IDN

2189-7023

IDN REV

2305.3 Form Rev 09/2017

CERTIFICATE OF COMPLIANCE ENCLOSURE, PAGE 2 OF 6

REQUIRED CERTIFICATIONS INSTRUCTIONS (cont’d)

8. For components (i.e., assemblies), the certifications shall be supplied for all material utilized to fabricate the pressure boundary parts of the assembly, including the fasteners used to hold the pressure boundary parts together and stems which penetrate the pressure boundary.

9. The material seamless certification shall consist of a specific statement that the material is seamless (e.g., material is certified seamless, material shown on this report is seamless, etc.).

10. Certificate of Compliance

a. When detailed Certification Reports are required, a certification statement shall appear with the reports attesting that:

The inspection and test reports (as applicable) provided represent the actual attributes of the items furnished on this contract and indicate full compliance with all contract requirements.

The contractor may use the form, sheet 4 of this enclosure.

b. When detailed Certification Reports are not required, the vendor is liable for conducting all tests, analyses, inspections, examinations, etc. as specified by the contract and specifications whether certifications are required or not. In these instances the certification shall attest that:

All items furnished on this contract are in full compliance with all contract requirements.

The contractor may use the form, sheet 5 of this enclosure.

c. The certification of compliance shall contain the signature and title of the vendor official designated responsible for Quality Assurance.

**PRINTED, TYPED, OR COMPUTER GENERATED SIGNATURES ARE NOT ACCEPTABLE**

KEY OP

KO ITEM

REV

IDN

2189-7023

IDN REV

CERTIFICATE OF COMPLIANCE ENCLOSURE, PAGE 3 OF 6

REQUIRED CERTIFICATION REPORTS

CONTRACT No. DOCUMENT No. 2189-7023

TEST INSPECTIONS, ANALYSIS &

EXAMINATIONS

CERTS

REQ’D

TEST INSPECTIONS, ANALYSIS &

EXAMINATIONS

CERTS

REQ’D

CHEMICAL ANALYSIS RADIOGRAPHIC INSPECTION

CHEMICAL ANALYSIS FOR

DETRIMENTAL MATERIAL

MAGNETIC PARTICLE TEST

GENERIC IDENTITY ULTRASONIC (SOUNDNESS)

MECHANICAL PROPERTIES ULTRASONIC (THICKNESS)

(1) TENSILE LIQUID PENETRANT

(2) YIELD HYDROSTATIC TEST

(3) ELONGATION AIR TEST

(4) REDUCTION IN AREA BURST TEST

(5) OTHER SEAT LEAKAGE (MAIN SEAT)

HARDNESS SEAT LEAKAGE (BACK SEAT)

DUCTILITY CLEANLINESS

FLATTENING TEST SEAMLESS

ELASTIC PROOF LOAD TEST VISUAL THREAD/DIMENSIONAL THREAD

JOB ORDER

88MSM00001

KEY OP

KO ITEM

REV

IDN

2189-7023

IDN REV

CERTIFICATE OF COMPLIANCE ENCLOSURE, PAGE 4 OF 6

REQUIRED CERTIFICATION REPORTS (cont’d)

CONTRACT No. DOCUMENT No. 2189-7023

TEST INSPECTIONS, ANALYSIS &

EXAMINATIONS

CERTS

REQ’D

TEST INSPECTIONS, ANALYSIS &

EXAMINATIONS

CERTS

REQ’D

WEDGE TEST VISUAL

STRIPPING TEST DIMENSIONAL

SHEAR TEST WORKMANSHIP

TORQUE TEST MARKING INSPECTION

BREAKING TEST PLATING EXAM

BENDING TEST EXPANDING TEST

CUPROUS OXIDE DELTA FERRITE

DECARBURIZATION FERRITE NUMBER

INTERGRANULAR CORROSION

CERTIFICATES OF COMPLIANCE (COC)

SHALL BE PROVIDED STATING THAT

THE FILTERS CONFORM TO ALL THE

REQUIREMENTS OF ASME AG-1,

SECTION FK, AND THAT

MANUFACTURE DATE IS NOT MORE

THAN 1-YEAR (365-DAYS) PRIOR TO

START OF RECEIPT INSPECTION.

X

MACROSCOPIC EXAMINATION

MICROSCOPIC EXAMINATION

EMBRITTLEMENT TEST

GRAIN SIZE EXAM

DENSITY

KEY OP

KO ITEM

REV

IDN

2189-7023

IDN REV

CERTIFICATE OF COMPLIANCE ENCLOSURE, PAGE 5 OF 6

CERTIFICATE OF COMPLIANCE

COMPANY NAME

MATERIAL IDENTIFICATION (COMPLETE APPLICABLE ITEMS)

CONTRACT NO. __________________________ ORDER NO __________

ITEM NO. _______________________

NATIONAL/LOCAL STOCK NUMBER NSN/LSN________________________

MANUFACTURER’S PART NO. ____________________________

MANUFACTURER’S SERIAL NO. __________________________

DRAWING AND PIECE NO. ______________________________

MANUFACTURER’S LOT/HEAT NOS. AS MARKED ON THE MATERIAL:

ALL INSPECTION AND TEST REPORTS REQUIRED BY ATTACHMENT I TO EXHIBIT A (DD FORM 1423) FOR

TRACEABILITY TO EACH CONTRACT ITEM MUST ACCOMPANY THIS SIGNED STATEMENT:

THE INSPECTION AND TEST REPORTS (AS APPLICABLE) PROVIDED REPRESENT THE ACTUAL ATTRIBUTES

OF THE ITEMS FURNISHED ON THIS CONTRACT AND INDICATE FULL COMPLIANCE WITH ALL CONTRACT

REQUIREMENTS.

SIGNATURE ________________________________ DATE _________

QUALITY ASSURANCE OFFICIAL

TITLE ________________________________

[Attachment (1) to Exhibit A (DD1423)

Use when detailed Certificate Reports are required]

KEY OP

KO ITEM

REV

IDN

2189-7023

IDN REV

CERTIFICATE OF COMPLIANCE ENCLOSURE, PAGE 6 OF 6

CERTIFICATE OF COMPLIANCE

COMPANY NAME

MATERIAL IDENTIFICATION (COMPLETE APPLICABLE ITEMS)

CONTRACT NO. __________________________ ORDER NO ___________

ITEM NO. _______________________

NATIONAL/LOCAL STOCK NUMBER NSN/LSN ________________________

MANUFACTURER’S PART NO. ____________________________

MANUFACTURER’S SERIAL NO. __________________________

DRAWING AND PIECE NO. ______________________________

MANUFACTURER’S LOT/HEAT NOS. AS MARKED ON THE MATERIAL:

I ATTEST ALL ITEMS FURNISHED ON THIS CONTRACT ARE IN FULL COMPLIANCE WITH ALL CONTRACT

REQUIREMENTS.

SIGNATURE ________________________________ DATE _______

QUALITY ASSURANCE OFFICIAL

TITLE _________________________________

[Attachment (1) to Exhibit A (DD1423)]

KEY OP

KO ITEM

REV

IDN

2189-7023

IDN REV