Appendix D Template.pdf

24 November 2015 Appendix D - AE2100 QEC Propeller Controls Inspection

Appendix D Page 1 of 14

UNCLASSIFIED/FOR OFFICIAL USE ONLY

Performed at: TMMC Date: ______________ QEC S/N: LMG7169- Removed from Engine S/N: KC-130J Event BUNO:

Instrument Type Instrument S/N Probe Type Probe S/N Cs -137

Efficiency (%)

Nominal Minimum Detectible

Activity (MDA)

Calibration Date

LAM12 1309LAM12008 N/A N/A N/A

*All items within this document were surveyed for radioactive contamination using the LAM 12 bulk counter or inspection probe in accessible locations. Some items were also swiped/swabbed depending on geometry or presence of loose debris (ex. dirt) to obtain a removable (loose) contamination value. The highest reading was placed in data column.

_____No loose contamination above 1,000 dpm/100 cm2, fixed contamination above 5,000 dpm/100 cm2, or 15,000 dpm total activity per component was found on any component.

X X X Radiation Safety Officer Surveyor Reviewer Signature/Printed Name/Date Signature/Printed Name/Date Signature/Printed Name/Date

X X X Signature/Printed Name/Date Signature/Printed Name/Date Signature/Printed Name/Date

X X X Signature/Printed Name/Date Signature/Printed Name/Date Signature/Printed Name/Date

Appendix D Page 2 of 14

UNCLASSIFIED/FOR OFFICIAL USE ONLY

QEC Propeller Controls Inspection Requirements:

List all of the equipment used for the inspection on Page 1.

Circumferential items/features shall be inspected at a minimum of three locations with up to a 360 degree inspection as available. Reading from circumferential location with highest reading shall be recorded.

Inspection surface points that exceed 0.5 inch from the survey instrument probe shall be wiped, and the wipe shall be analyzed for radioactivity.

This inspection has instances where multiple items share the same figure and description; survey all items and record the highest value.

For parts with a large surface area describe the dimensions and location of the area(s) that exhibits contamination in excess of 5,000 dpm/100 cm2.

Part numbers are representative numbers listed for reference only. Refer to applicable C-130 publications for alternate part numbers.

Parts will be measured with o-ring packings attached unless otherwise noted. Support clamps shall remain on the removed component and be inspected along with the removed component.

For item surveys which have an Item # “All Assy”, items shall be hand frisked as an assembly and record the highest hand frisk survey reading in the initial survey block.

For items requiring LAM 12 survey, if hand frisk survey readings are below limits, items shall also be surveyed in the LAM 12 bulk counter as an assembly and record the reading in the Initial LAM 12 survey block.

If bulk counter and hand frisk survey readings are within the limits on page 1 of this appendix, then further disassembly is not required and the “All Assy” reading shall be applied to all parts in the table.

If hand frisk survey or LAM 12 survey readings are above the limits, then followed approved DECON procedures identified in the plan, record individual item survey data, and circle any parts on the diagram that are quarantined.

Appendix D Page 3 of 14

UNCLASSIFIED/FOR OFFICIAL USE ONLY

QEC Propeller Controls Inspection Requirements: (continued)

“N/R” used throughout this document signifies “not required”. “N/A” used throughout this document signifies “not applicable”.

For item surveys which have an Item # “All Assy” and require LAM 12 survey, if all of the items identified will not fit in the LAM 12 simultaneously, annotate on the survey page accordingly, and use the LAM 12 results ID column to differentiate between “lots” of parts surveyed.

If contamination is found on items not specifically identified in the tables, then manually annotate survey location and values on the bottom of the survey sheet.

Apply any transmission factors to the LAM 12 results as deemed appropriate for the component being surveyed and ensure the transmission factor is recorded on the LAM 12 survey form. As a guide, use the following transmission factors:

Thickness of Metal Transmission Factor

0.5 inch 0.75

1.0 inch 0.50

2.0 inch 0.25

For items surveyed utilizing the LAM 12 bulk counter, insert the LAM 12 results ID number in the applicable results ID column of the survey sheet and attach applicable LAM 12 printouts to the inspection package. Annotate appendix page, figure number, item number, and applied transmission factors on each LAM 12 printout.

Appendix D Page 4 of 14

UNCLASSIFIED/FOR OFFICIAL USE ONLY

SUPPLEMENTAL QUARANTINE PARTS LIST SHEET INSTRUCTIONS

One sheet is provided. Attach additional sheets, as necessary.

Enter engine S/N from Page 1, module (QEC, PGB, GMAD, torquemeter, or power section), and last survey date.

In the Appen. - Page # column, enter the appendix letter, followed by a “–“, then the appendix page number.

Enter the figure #, item #, and description from the applicable survey sheet, in the applicable columns.

Enter the P/N and S/N identified on the part, in the applicable columns. If the part is not serialized, enter “N/A” in the S/N column.

Enter final survey measurement, final loose measurement, final LAM 12 results ID, and final LAM 12 measurement from the applicable DECON sheet, in the applicable columns.

In the space provided in page footer, enter the page number of the applicable quarantine page.

Engine S/N Module Module S/N Date

FRISK Surveyor's Signature/Printed Name/Date FRISK Reviewer's Signature/Printed Name/Date

LAM 12 Surveyor's Signature/Printed Name/Date LAM 12 Reviewer's Signature/Printed Name/Date

Appendix D - Page __________ of 14

UNCLASSIFIED/FOR OFFICIAL USE ONLY

QUARANTINED PARTS LIST

Appen.

Page # Figure # Item # Description P/N S/N Final Survey

(dpm/100 cm2)

Final Loose/ Swipe (dpm/

100 cm2)

Final LAM 12 Results

ID

Final LAM 12 Survey (dpm total activity)

Appendix D Page 6 of 14

UNCLASSIFIED/FOR OFFICIAL USE ONLY

SUPPLEMENTAL DECON SHEET INSTRUCTIONS

Attach sheet(s) as required following the frisk/LAM 12 initial survey page and before applicable LAM 12 survey sheets.

Enter the survey date, meter, probe, engine S/N, LAM 12 survey date, LAM 12 S/N, background, and Beta efficiency.

In the DECON Method column, annotate method of decontamination used (such as wipe, wash tank, etc.); provide additional comments as required.

Enter the figure number and item number that corresponds to the applicable survey page.

At the bottom of the page annotate survey plan page followed by “–“ then number of Supplemental DECON sheets.

Add detailed findings in the “Additional Comments” section, to include, but not limited to, areas on each component with the highest survey readings.

Survey Date Meter P/N 2224 Meter S/N

Probe P/N 43-93 Probe S/N

QEC S/N

LMG7169-

LAM 12 Survey Date LAM 12 S/N

1309LAM12008

Background (cpm) (field intentionally left blank)

FRISK Surveyor's Signature/Printed Name/Date FRISK Reviewer's Signature/Printed Name/Date

LAM 12 Surveyor's Signature/Printed Name/Date LAM 12 Reviewer's Signature/Printed Name/Date

Appendix D – Page __________ of 14

UNCLASSIFIED/FOR OFFICIAL USE ONLY

SUPPLEMENTAL DECON SHEET

FIGURE NUMBER:

Item # Initial Survey

(dpm/100 cm2)

Final Survey (dpm/100 cm2)

Initial Loose/ Swipe

(dpm/100 cm2)

Final Loose/ Swipe

(dpm/100 cm2)

Initial LAM 12 Results ID

Initial LAM 12 Survey (dpm total activity)

Final LAM 12 Results ID

Final LAM 12 Survey (dpm total activity)

DECON

Method

Quarantined?

(Y or N)

ADDITIONAL COMMENTS:

Appendix D Page 8 of 14

UNCLASSIFIED/FOR OFFICIAL USE ONLY

61-20-00 FIGURE 1 PROPELLER CONTROLS

Survey Date Meter P/N 2224 Meter S/N

Probe P/N 43-93 Probe S/N

QEC S/N

LMG7169-

LAM 12 Survey Date LAM 12 S/N

1309LAM12008

Background (cpm) (field intentionally left blank)

FRISK Surveyor's Signature/Printed Name/Date FRISK Reviewer's Signature/Printed Name/Date

LAM 12 Surveyor's Signature/Printed Name/Date LAM 12 Reviewer's Signature/Printed Name/Date

Appendix D Page 9 of 14

UNCLASSIFIED/FOR OFFICIAL USE ONLY

61-20-00 FIGURE 1 PROPELLER CONTROLS

Item No Description P/N Initial Survey

(dpm/100 cm2)

Initial Loose/ Swipe

(dpm/100 cm2)

Initial LAM 12 Results ID

Initial LAM 12 Survey (dpm total activity)

DECON

Performed?

(Y or N)

Quarantined?

(Y or N)

ALL

ASSY

61-20-00 FIGURE 1 PROPELLER

CONTROLS N/A

10 OVERSPEED GOVERNOR,

PROPELLER 697052004

35 SEAL PLATE, SOLENOID 661002704

40 PITCH CONTROL UNIT, PROPELLER 697053003

697053004

45 CLAMP 666000254

PRESSURE SWITCH, PITCH

CONTROL UNIT (DO NOT REMOVE

PRESSURE SWITCH FROM PCU

(ITEM 40) UNLESS CONTAMINATION

IS FOUND)

666000587 666000620

70 AUXILIARY FEATHER PUMP 697065001

130 JUMPER MS25083-

2BC7

155 MOUNTING, AUXILIARY FEATHER

PUMP 3350029-3

Note: Parts belonging to an assembly may be placed in the LAM 12 with the assembly.

Note: Auxiliary Feather Pump Hose Assemblies are listed in the QEC Sub Systems Inspection 79-20-00 Figure 8 items 390 and 655.

Appendix D Page 10 of 14

UNCLASSIFIED/FOR OFFICIAL USE ONLY

61-20-00 FIGURE 2 BRUSH BLOCK PULSE PROBES 30-60-00 FIGURE 1 PROPELLER ANTI-ICE AND DEICE

(1 OF 2)

Survey Date Meter P/N 2224 Meter S/N

Probe P/N 43-93 Probe S/N

QEC S/N

LMG7169-

LAM 12 Survey Date LAM 12 S/N

1309LAM12008

Background (cpm) (field intentionally left blank)

FRISK Surveyor's Signature/Printed Name/Date FRISK Reviewer's Signature/Printed Name/Date

LAM 12 Surveyor's Signature/Printed Name/Date LAM 12 Reviewer's Signature/Printed Name/Date

Appendix D Page 11 of 14

UNCLASSIFIED/FOR OFFICIAL USE ONLY

61-20-00 FIGURE 2 BRUSH BLOCK PULSE PROBES

AND 30-60-00 FIGURE 1 PROPELLER ANTI-ICE AND DEICE (1 OF 2)

Item No Description P/N Initial Survey

(dpm/100 cm2)

Initial Loose/ Swipe

(dpm/100 cm2)

Initial LAM 12 Results ID

Initial LAM 12 Survey (dpm total activity)

DECON

Performed?

(Y or N)

Quarantined?

(Y or N)

ALL

ASSY

61-20-00 FIGURE 2 BRUSH BLOCK

PULSE PROBES AND 30-60-00

FIGURE 1 PROPELLER ANTI-ICE

AND DEICE

N/A

N/A 61-20-00 FIGURE 2 BRUSH BLOCK

PULSE PROBES N/A

5 BRACKET UNIT, BRUSH BLOCK 697057004

30 PULSE PROBE ASSY 666000424

35 PULSE PROBE ASSY 666000453

N/A 30-60-00 FIGURE 1 PROPELLER

ANTI-ICE AND DEICE N/A

20 BRUSH BLOCK ASSY WITH

HARNESS 697057233

175 BRACKET ASSY, BRUSH BLOCK 697057231

Note: Parts belonging to an assembly may be placed in the LAM 12 with the assembly.

Note: if "ALL ASSY" bulk counter measurement is less than 15,000 dpm total activity per component, then removal of pulse probes, items 30 and 35, and disassembly per 30-60-00 is not required, unless otherwise directed.

Appendix D Page 12 of 14

30-60-00 FIGURE 1 PROPELLER ANTI-ICE AND DEICE (2 OF 2)

Survey Date Meter P/N 2224 Meter S/N

Probe P/N 43-93 Probe S/N

QEC S/N

LMG7169-

LAM 12 Survey Date LAM 12 S/N

1309LAM12008

Background (cpm) (field intentionally left blank)

FRISK Surveyor's Signature/Printed Name/Date FRISK Reviewer's Signature/Printed Name/Date

LAM 12 Surveyor's Signature/Printed Name/Date LAM 12 Reviewer's Signature/Printed Name/Date

Appendix D Page 13 of 14

UNCLASSIFIED/FOR OFFICIAL USE ONLY

30-60-00 FIGURE 1 PROPELLER ANTI-ICE AND DEICE (2 OF 2)

Item No Description P/N Initial Survey

(dpm/100 cm2)

Initial Loose/ Swipe

(dpm/100 cm2)

Initial LAM 12 Results ID

Initial LAM 12 Survey (dpm total activity)

DECON

Performed?

(Y or N)

Quarantined?

(Y or N)

ALL

ASSY

61-20-00 FIGURE 2 BRUSH BLOCK

PULSE PROBES AND 30-60-00

FIGURE 1 PROPELLER ANTI-ICE

AND DEICE

N/A

N/A 30-60-00 FIGURE 1 PROPELLER

ANTI-ICE AND DEICE N/A

45 HARNESS, BRUSH POWER 697057228

50 HARNESS, BRUSH WEAR 697057213

70 COVER, REAR 697057310

100 STRAP, LINK P901028

105 BRUSH ASSEMBLY 666000561

110 BRUSH ASSEMBLY 666000562

135 RESISTOR ASSEMBLY 697057222

140 PLATE, LH RETENTION 697057311

145 PLATE, RH RETENTION 697057312

Note: if "ALL ASSY" bulk counter measurement is less than 15,000 dpm total activity per component, then disassembly per 30-60-00 is not required, unless otherwise directed.

Appendix D Page 14 of 14

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